How can mental health-informed youth work help young people?
How the ‘blended approach’ of Right Here, underpinned by young people’s involvement and strong relationships, generates positive outcomes for young people.
Youth work is about helping young people to have the best lives they can. But what happens when you focus youth work explicitly on young people’s mental health and wellbeing, as the five-year Right Here project did, developed by Paul Hamlyn Foundation and the Mental Health Foundation?
The foundations funded and worked with four local partnerships led by youth work organisations in Brighton and Hove, Fermanagh, the London Borough of Newham, and Sheffield – exploring how mental health-informed youth work might deliver distinctive outcomes for young people that may not be delivered by traditional NHS services.
What did Right Here find out?
Many young people feel that the default for Mental Health Services (CAMHS or AMHS) is that the service sees problems rather than seeing people. During Right Here’s lifetime, over 3,000 young people were involved in activities funded by the programme. The evaluation of Right Here, undertaken by the Institute for Voluntary Action Research (IVAR), pointed to a range of benefits for the young people who took part. IVAR noted that these benefits often came from a blend of activities and that the benefits were often cumulative: “an activity, new relationship or awareness led to more sustained involvement in other activities”.
The activities generated by the Right Here partnerships fell into four categories:
- Raising awareness of mental health and wellbeing with young people
- Building confidence and resilience for some young people
- Influencing policy, practice and practitioners locally
- Young people developing and delivering products and services.
Many Right Here activities brought together young people who had experience of mental health difficulties with those who did not, enabling interactions and personal relationships that may not have otherwise occurred.
By generating opportunities and services that were informed by mental health and wellbeing principles, opportunities for support and progression for young people were cemented in localities where traditionally structured mental health services may fail to reach young people or where those services are limited in the range of services they can offer.
IVAR found that there were six areas of benefit for young people from being involved in the mental health-informed youth work approach offered by Right Here:
- Mental health awareness
- Confidence in opinions
- Changing behaviour: handling anger and distress
- Relationships with family
- Responding to challenges and opportunities
- Pursuing opportunities beyond Right Here
Each local partnership was voluntary sector-led and was encouraged to find ways to involve young people in all levels of activity. This meant that young people could have a variety of depths of involvement, from one-off encounters to deep involvement in the partnership, and with work affecting both local and national matters.
For some young people, simply taking part in activities when emotions and feelings are not declared off-limits, and where staff and other young people understand if problems arise, can be revelatory. Right Here found that as young people tried out and enjoyed new activities and developed good relationships – often for the first time – they began to find a confidence in their own voice that they may not have possessed before.
Young people also found that being involved in influencing and policy work made their confidence grow further and this, in turn, made it easier for them to speak up for themselves and others, both within Right Here and more widely.
By using youth work skills and mental health knowledge, Right Here could deliver activities that helped young people to move from feeling that what they said did not matter to having evidence that it did. One Right Here worker, speaking about a young person taking part in a ‘Cage the Rage’ anger-management course, explained to IVAR how a young man turned up with his hoodie up, refusing to engage, mobile phone in hand and shut off to what was happening: “By the end of the six weeks you could see he was more relaxed – his hoodie was down, he was smiling, and in the evaluation he said, ‘I’ve really enjoyed this. My confidence has been built up that much.’”
Being able to join in with activities and contribute to organisations in a way that mattered and where it was possible to see the effect of their efforts made a big difference to some young people. As one young person told IVAR: “Being part of Right Here has made me trust my instincts, it does matter what I think and what I say. People actually listen. At the end of meetings, people say, ‘Oh my god, I’m glad you came with all those questions.’ It’s a massive confidence boost.”
IVAR observed that: “As the young people’s self-awareness and confidence developed (or returned), they became more able to take on the challenges they encountered both within Right Here and in their personal lives. In turn, this contributed to them becoming more interested in and motivated to take up new opportunities (both within Right Here and beyond).”
For some young people, their involvement with Right Here helped them to broaden their horizons and to develop a wider peer group – outcomes that traditionally structured young people’s mental health services might find difficult to achieve.
More aware of mental health
IVAR found that young people who participated in Right Here local projects often emerged more aware of their mental health and wellbeing, had more confidence in their ability to recognise others’ emotions, and had a better understanding of how their own behaviour affects others. This was true of young people who experienced mental health difficulties as well as those who did not.
The fact that Right Here’s activities mixed young people who experienced mental health difficulties with young people who did not helped young people to view mental health difficulty as a potentially ordinary part of life. As one young person told the evaluators: “For me, the most important thing was understanding that everybody has mental health [and] that I’m not unusual in sometimes having problems.”
Young people learnt about ‘good’ as well as ‘bad’ mental health, and that people do ‘come through’ periods of poor mental health. Using youth work approaches underpinned with a mental health orientation made it possible to guide young people’s natural wish to share experiences towards a better knowledge of their own and other people’s mental health.
Alchemising bad experiences into good
Young people who have had poor experiences of care and services are often keen to help others have better experiences. This was certainly the case with some Right Here young people who said that their involvement had enabled them to put their experiences, including negative experiences of mental health services, to good use. One young person said: "A lot of people in the STAMP group [Right Here Sheffield young people’s panel] have been let down by mental health services in Sheffield, so to feel for the first time that a mental health service is taking young people’s voices and ideas on board is great."
This process was referred to by IVAR as “alchemising bad experiences into good”: a process by which young people could redeem or make use of experiences that would have otherwise remained mainly negative for them. By being able to contribute the knowledge and awareness that comes with such experience, to have it validated and then put to a positive end, young people were empowered to move beyond the situation in which they found themselves.
Changing and growing
The Right Here projects were structured in such a way as to allow young people to find a level of involvement that suited them. For some, this involved taking on more responsibility, or taking on different roles when new opportunities emerged as the projects developed. Other young people simply attended a particular activity. Some moved from more peripheral involvement to a more central role, including at a national level, as their engagement with Right Here developed. The breadth and depth of opportunity provided young people with positive choices and the chance to find roles that ‘fit’ and that challenged them. In some cases, the skills gained through these experiences enabled the young people to secure paid work within the Right Here delivery organisations.
As the IVAR evaluation remarks:
“Many young people across the local projects took on leadership roles. Some represented their projects at the national Right Here panel, attending the showcase events, meeting other young people from across the country. Young people from Fermanagh and Newham visited and learnt from each other. They became volunteers, supporting others on the programme, setting up and running events, becoming mental health ambassadors and wellbeing champions, and going into schools and other youth projects to talk about mental health. In Newham, two young people from the project applied for and were appointed to paid community development worker roles, and another carried out an evaluation of a Wellbeing Champions training programme as part of her university studies. Young people in Brighton and Hove devised and delivered workshops for GPs locally and nationally to explore ways to improve practice. As a result of making radical changes to their behaviour (as noted earlier, for example, spotting and containing anger), some young people reported feeling more in control of their lives and able to look to the future, take up education or training and work towards a career.”
While this type of progression is not uncommon in youth work settings, we would be hard-pressed to find similar opportunities within statutory mental health services.
Handling emotions and building relationships
Right Here met many young people with a variety of difficult or challenging life situations.
By foregrounding knowledge of mental health in the practice of youth work, Right Here helped to prepare youth work professionals for strong emotions and difficult experiences in the lives of the young people with whom they worked. The youth workers became better equipped and more confident in providing young people with the skills and self-knowledge to help them understand and modify their own behaviours and relationships.
IVAR stated: "Young people said that taking part in Right Here activities had, over time, helped them to spot their own anger or distress and get better at handling these emotions. For young people, this was a positive result in itself, but we found it also acted as a stepping stone to changing other aspects of their lives, such as family relationships and pursuing opportunities. In a minority of cases, young people believed that, through Right Here, they were less likely to become violent or to self-harm when they became angry or upset." The young people learnt to recognise and understand their anger and, critically, to help themselves and one another.
By bringing young people together in a way that removed some of the isolation and stigma of their previous experiences, Right Here also helped young people to build relationships of mutual support and respect.
As IVAR put it: "We learnt that many of the young people who became Right Here 'regulars', participating in a blend of activities and volunteering over time, had been isolated, lonely, without a friendship group and experiencing difficulties in their relationships with parents and relatives. Young people said that the warmth and companionship of Right Here had enabled them to grow and develop relationships with their peers (sometimes blossoming into friendships), to 'find their voice' so that they were able to speak to new people, and to make some changes in family relationships. One project worker explained: 'They have created friendships and groups for the first time. Many have been quite isolated. They have been able to discuss their issues, they have formed a network. They have formed friendship groups, and for some for the first time.'"
For some of the young people that Right Here worked with, fear of violence was a big part of their lives. These young people, primarily those living in the London Borough of Newham, had experienced, witnessed or knew someone who had been the victim of violence. Right Here Newham had enabled their young people to empathise with others, to think about what might be driving such behaviour, and to develop the skills to confidently stop themselves from inflaming a situation.
When IVAR spoke to siblings, carers and parents of young people involved in Right Here, they found that these new skills and relationships had often changed these young people’s interactions with others for the better.
So, what can we conclude?
IVAR found that Right Here’s young people-led, mental health-informed youth work could generate positive outcomes for the young people who were deeply involved in the projects (as co-producers and deliverers), as well as for participants who gave less time. The blended approach of Right Here, underpinned by young people’s input, created opportunities very different to those that might be provided by traditional mental health services. Young people, some for the first time, were able to enjoy relationships that recognised their emotional and mental health needs outside of a therapeutic context and enabled them to broaden their horizons.
IVAR suggested that these changes in the young people – their newfound confidence and willingness to take on challenges and opportunities – are likely to be permanent in some cases: “Our findings suggest that part of Right Here’s legacy is likely to be that young people have remained involved as volunteers, either directly in mental health and wellbeing initiatives or more broadly in supporting their peers. Individually, we also found examples of young people continuing to pursue activities that they had first encountered through Right Here.”
“We learnt that Right Here participants had taken up new volunteering opportunities not only within Right Here projects or their ‘host’ organisation, but also in other local, especially mental health, projects. They were actively pursuing work experience, career pathways, job opportunities and the chance to take up or resume their education or training. The young people we spoke to perceived a direct relationship between the self-awareness and confidence gained from being a part of Right Here and their ability to look at and work to their ambitions for the future.”
“For some, this was about getting back on a track that they had been on before; for others, it was finding a whole new pathway.”
In a time of increasing fears around young people’s mental health and wellbeing, mental health and wellbeing-informed youth work may be a vital companion to medical treatment and support services.
The Right Here programme has laid the groundwork for other areas to explore using youth work and youth work-led organisations to create opportunities for young people to learn about and develop skills, knowledge and resilience to improve their mental health and wellbeing.
The benefits could be substantial. As one young person told IVAR: “The difference between how I was when I started and now – it’s black and white. Before that I never would have thought about doing education again – now I’m doing my A levels. Before it, I wouldn’t have talked to anybody – now I just talk to people when I want. It’s been transformational.”