Mental health informed youth work: what Right Here learned and what could come next

Right Here was a five-year young people’s mental health and wellbeing programme developed and managed by Paul Hamlyn Foundation and the Mental Health Foundation.

It funded four local partnerships – in Brighton and Hove, Fermanagh, the London Borough of Newham, and Sheffield – to work with young people aged 16–25 to co-produce and deliver mental health and wellbeing activities, projects, research and opportunities. The programme ran from 2009–2014.

Former Manager of Right Here, Susan Blishen, takes stock of what Right Here learned and achieved, and what could come next...

Summing up over half a decade of activity in four sites across the UK is difficult. Working out what this activity actually means for those who might follow in its footsteps doubly so. We’ve concluded that where Right Here worked well it was a kind of mental health informed youth work; taking everything that’s brilliant about youth work and youth workers and simply focusing it more closely on the mental health and wellbeing of young people.

When we set up Right Here, way back in 2009, we imagined we were going to change the world, or at least the policy and practice world around young people’s mental health and wellbeing. We talked about creating a new service model around young people’s mental health that would reduce the numbers of young people developing treatable mental health problems.

Five years on and we are a lot wiser. Our original ambitions were tempered by austerity and the radical changes to the health and social care structure that came with the Health and Social Care Act 2012.

The reality of the youth mental health field is that it remains complex, messy and disjointed. Who’s in charge of young people’s mental health, locally and nationally? Why does the policy rhetoric about the value of prevention, early intervention, joined up working, the life-course approach, never match the reality? Why do Child and Adolescent Mental Health Services (CAMHS) and adult mental health services (AMHS) find it so difficult to work together, making young people’s transitions from one to the other so torturous? Why are mental health professionals within specialist mental health services often so loathe to work and share their knowledge with those who work on the front line with young people and who need their help to better support these young people?

What did we find out?

While I cannot claim that Right Here solved the problems above, it did create a bank of knowledge gained by learning through doing, which we hope others will draw on in years to come. You’ll find some of this learning in the articles Mark Brown and I wrote – co-production at its best - which are published today under the broad theme of mental health informed youth work.

The barriers to the changes we’d hoped for are as great now as they were when we started, and our £6m investment over five years was never going to change that. As for our ambition to create a new model of service provision, well we wised up on that one too, with the help of our evaluators, the Institute of Voluntary Action Research (IVAR). Here’s how they judged that ambition in their penultimate report to the two foundations. Tactfully put, I think.

“We are aware that there has been some interest in teasing out a Right Here ‘model’ but that, to date, this has proved elusive. We suggest that one possible explanation for this is that producing a ‘model’ ignores the influence of context on what works and what does not in a given place and at a given time. We also suggest that a Right Here ‘model’ will be predicated on the availability of a considerable level of financial investment which is unlikely to be available again, potentially rendering the ‘model’ less relevant and useful to others.”

So, what did we achieve? Well, quite a lot actually, though on a more modest scale. This is IVAR’s final verdict from their last evaluation report:

“We reported on a wide variety of achievements locally and nationally, including evidence that Right Here brought real benefit not only to local young people but also to the local policies and practices that affect them. The initiative leaves behind a significant legacy: the integration of mental health and youth work practice; new approaches locally to involving young people in policy development and the co-design of services; and improved awareness among local health practitioners and commissioners. Finally, the initiative leaves a cohort of young people whose confidence, mental health awareness and overall wellbeing have been changed by Right Here.”

Where next?

Taking IVAR’s evaluations as raw material and add our reflections and analysis, we’ve written a series of articles to give those who are interested in new ways of working in, or thinking about, youth mental health some ideas to explore, and roads to take, or not take.

I hope some of you will get the opportunity to test these hypotheses in practice, to learn as you go, and to make that learning available to others, just as we’ve done. From my six years’ experience in the field, I’d say this is just what the sector needs. To whet your appetite, here are some of the themes we’ve explored in our articles and some of our tentative conclusions.

How does mental health informed youth work help young people?

At heart youth work is already doing much of value to young people's mental health and wellbeing. We're suggesting, given the right conditions and people that it might do even more.

How can youth work reduce the stigma and isolation felt by young people with mental health difficulties?

Right Here was unusual in bringing together young people with and without diagnosed mental health problems. The conversations and relationships that arose helped to normalise mental health and to make young people aware that the world isn’t neatly divided into the camps of the well and unwell.

How does mental health informed youth work empower young people to make change happen?

Right Here created a wide range of opportunities for young people: to get out of the house; to enjoy themselves; to be creative and purposeful; to be with others; to gain new skills and confidence; and, finally, to influence. These opportunities were really important in themselves – just as, or potentially, more important, than the chance to develop a “service”. The more opportunities like this came the young people’s way, and the more they could see the fruits of their labours, the more empowered they felt and the better advocates for their projects they became. The young people who benefitted the most from RH were those who ‘learned through doing'.

How can co-production be made a reality in youth work-led mental health?

Co-production is a process which requires a lot of flexibility on the part of participants, organisers, and funders. At its best, this process will bring out the best in the young people and those they’re working with, with each playing to their strengths, i.e., young people talking about and doing things they’re interested in and good at (not sitting on panels, or commenting on policy necessarily) and the adult professionals, doing the same.

Find the articles and read more about the Right Here project here

Hear Susan Blishen present on Right Here at the International Association of Youth Mental Health Annual Conference

About the author 

Susan Blishen is a consultant to Right Here, responsible for disseminating the learning from the initiative and the final evaluation results. She was one of the principal architects of Right Here, which she managed from its inception in 2009. She is also an expert advisor to BIG’s Headstart programme.