Groups are increasingly used to deliver behavior change interventions, but such interventions are seldom based on theory and research on social group processes. A consequence of this is that existing group interventions are often heterogenous and difficult to evaluate. The social identity approach addresses important questions relevant to the design and delivery of group interventions for supporting behavior change. Drawing on this approach, the social identity model of behavior change explains how group processes can be harnessed in behavior change interventions. The model prioritizes the establishment of shared social identity among intervention group members and outlines how, through six core group resources, social identification can shape delivery of intervention content to achieve behavior change. Evidence for the key resources specified in the model is presented, and a step-by-step guide provided, to support the operationalization of the model’s principles in practice.

This poem, by the Irish poet and Nobel Laureate, Seamus Heaney, is as applicable to sustaining healthy communities as it is to sustaining marital harmony, which is the purpose for which it was originally written. As the scaffolding provided the foundational structure from which Heaney and his wife built the walls of their marriage, so too we can develop communities through our own collective efforts, drawing on support from health and social care practitioners of various persuasions where and when required. Once it is established, we can gain confidence from the fact that we can use what we have built together to help our communities to endure and thrive when they, too, are threatened by adversity.

Public health is defined by the UK’s Faculty of Public Health as ‘The science and art of promoting and protecting health and well being, preventing ill health and prolonging life through the organised efforts of society’.

This definition locates the causes of ill health and the remedies in the realms of personal and societal agency, and not only in the remit of health practitioners. Although the latter have a role as members of society to make prevention a reality for themselves, families and communities, they play a special part in preventing further ill health for people who suffer mental illness and are seeking help for it.

Other chapters in this book attend to the relational and social fabric that enables people to flourish; it is made of good and trusting relationships, and material conditions that permit thought about purpose and meaning beyond survival.

This chapter pulls together key matters in this book. Its title is a quote from a line given to one of the characters in Hamlet by Shakespeare. That sentence perfectly outlines the intention of Section 5 of this book and the function of this final chapter in which I endeavour to align theory, research and the practical impacts of the topics covered by this book with the circumstances in which we find health services as we near the close of the second decade of the twenty-first century. But, first, I return to Chapter 1, to recapture some of those circumstances. Then, I look at the matters on which I think we should focus in order to sustain healthcare services and incorporate the social agenda identified in this book.

Social relationships affect health. Of that we are certain. People who are more strongly connected live longer (e.g. Holt-Lunstad et al., 2010), are in better health (e.g. Boden-Albala et al., 2005) and experience better wellbeing (e.g. Helliwell & Putnam, 2004). None of us is immune to these effects although, clearly, poverty, inequality and age, among other factors, contribute to, and exacerbate the consequences of, social disconnection.

What is more remarkable, in the context of the evidence-base showing the profound impact of these effects, is the relatively limited investment in efforts to build and preserve the social capital of vulnerable communities, on health grounds. Recognising the potential benefits that social resources bring and the mechanisms through which they can emerge is important, but not enough. What is needed is a coherent approach to embed these resources in communities to ensure that the products of social connectedness can be sustained in the longer term.

This book’s roots are in an impactful seminar series hosted by the Royal College of Psychiatrists in which practitioners and scientists from a wide array of disciplines came together in 2014 to explore the social influences on our health and recovery from ill health. This volume echoes the evocative conversations in that College and is intended to rehearse research of potentially great impact. It presents practitioners, researchers, policymakers and students of a wide array of disciplines and roles with the material to support them in better harnessing what we now know about the impact of social factors on health. Thereby, the editors hope to influence how practitioners and the responsible authorities work together with members of the public and communities to design and deliver services. Our aspiration is to contribute to creating better-targeted approaches to promoting health and mental health and more effective and integrated interventions for people who have health problems or disorders.

In the process of researching this chapter, the first author spent a crisp December day touring London’s major bookshops in an attempt to discover what recent books on health might have to say about leadership and what those on leadership might have to say about health. It was a pleasant way to spend a day, but, as a research exercise, it was something of a failure. Of the books on health, not a single one had an index entry for leadership and most restricted their coverage of the topic to general discussions of team and patient management as aspects of effective healthcare. Conversely, very few of the books on leadership had much to say about health, although the biographies of influential leaders (e.g. Obama, Gillard, Thatcher) typically included significant sections devoted to the biographee’s policy on health (e.g. democratisation, rationalisation, privatisation).

One of the central ideas that is explored throughout this book is that people’s social lives and the social worlds they inhabit have a critical bearing on their health. At one level this message is uncontroversial. There is, after all, plenty of evidence both that social contact, social connections and a rich social life are good for one’s wellbeing (House et al., 1988) and, that those people who are disadvantaged in this respect as a result, for example, of poverty, prejudice or other forms of social exclusion suffer from relatively poor health outcomes (Wilkinson & Marmot, 2003). In this chapter, though, we present a rather more nuanced analysis, which suggests that particular forms of social interaction have an especially important role to play in these dynamics. They are those forms that are grounded in shared social identity, an internalised sense of shared group membership, and an associated sense that one is part of a bigger ‘us’.

This chapter rounds off Section 2. In it, one of the authors, Jonathan Montgomery, begins by highlighting his view of the recurrent themes that arise from all eight chapters in this section.

Then, one of the editors, Alex Haslam, responds by substantially agreeing with Jonathan Montgomery. However, Haslam takes the opportunity to clarify one of the points that Montgomery makes with the intention of drawing attention to a key issue that runs like an artery through the body of this book. This concerns the nature of personalised healthcare and how this should best be understood and delivered. Haslam cautions that, in the process of developing personalised care, we should avoid the temptation to reduce peoples’ maladies to their individual conditions.

This chapter does two things. First, it shows how social identity principles can explain the basic psychological and behavioural effects of crowd membership. Second, it describes some recent research and applied work that shows how these basic effects operate to contribute to harmonious outcomes in potentially dangerous crowd events.

We begin by explaining some of the fundamental psychology of crowd membership in the next section.

The purpose of this chapter is to serve as a bridge between the chapters in the previous three sections and those in this fourth section. Thus far, we have sought to analyse the social bases of mental and physical wellbeing. Now, we turn to the question of how the fruits of these analyses can be applied in practice. That is, we have been reporting and interpreting the way the world impacts individual people for long enough; it is time to consider how we might change the world in order to improve our wellbeing.