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

How empowerment comes through the relationships that develop ‘through doing’.

Young people are often impatient for change; this is as true in relation to services that support young people with mental health needs as it is in other areas. Many organisations talk about their vital work in empowering young people, but just how can this be translated into practical actions?

Right Here was a five-year national programme launched in 2009 by Paul Hamlyn Foundation and the Mental Health Foundation to explore new ways of working with young people to develop mental health and wellbeing activities. The programme funded four local partnerships – in Brighton and Hove, Fermanagh, the London Borough of Newham, and Sheffield – for five years to co-produce new mental health and wellbeing services and projects with young people. One of the objectives of the programme was to make it possible for young people to influence the shape, form and activities of each regional partnership and the landscape of young people’s service provision as a whole

What did Right Here find out?

Each of the four Right Here partnerships took a blended approach to the involvement of young people in the structure and development of their projects and in terms of influence. This initially began with a traditional youth-involvement structure based upon youth panels contributing to governance and decision-making within the partnerships. This ‘seat at the top table’ model has been common in youth work for many years.

However, the evaluation of Right Here by the Institute for Voluntary Action Research (IVAR)  found that empowerment was as much about young people ‘finding themselves’ and being provided a safe and supportive environment where they could develop and grow as people as it was about plugging them into larger democratic or organisational frameworks. Indeed, the initial youth panel approach was revised from 2011 onwards, with participation broadening to a more blended ‘growing through doing’ approach. Being involved with activities where it was possible to observe the effect of your involvement over time on the overall shape and direction of those activities was vital for young people in discovering their own power to influence events.

The evaluation of Right Here made clear that for young people within the projects, empowerment is not the same as simply being offered an opportunity to speak on your own or others’ behalves; empowerment is not simply a matter of being encouraged to ‘have your say’. Young people, especially those who have had difficult or challenging life events or conditions, require a mixture of support, encouragement, feedback and validation to become comfortable in their own capacity to take control of situations.

In the blended programme of Right Here’s projects and opportunities, --Link to Project Summaries-- it was possible for young people, some for the first time, to find relationships and friendships where they felt that their opinion was listened to and respected. This, in turn, influenced them to further explore and try out this ‘voice’. For some young people, this growing confidence came from exploring mental health-related issues and wellbeing activities; for others, it came from being involved in supportive and inclusive youth work-informed spaces, which helped them to form stable relationships with project workers and other young people.

Through involvement in new activities and new relationships, young people learnt that they could do things they hadn’t before thought possible, like spreading the word about Right Here and speaking to commissioners and service providers.

Right Here projects were successful in this where they provided training and support for young people to develop a tactical or strategic approach to this influencing work. True partnerships in supporting young people to ‘make a difference’ involved working with young people to identify what additional skills, training and resources they needed to make the best impact on their activities. For example, Right Here Brighton and Hove trained young people in research skills so that they could carry out a study into young people’s experiences of GP usage and GPs’ attitudes to mental health. --Link to Brighton and Hove Case Study and Findings of Right Here Brighton and Hove’s youth-led research-- In Sheffield, young people wanted a group that both supported their mental health needs and also allowed them to share their experience with others. As IVAR describes: “Participants were recruited as a cohort because ‘we wanted them to go through training and really come together as a group’ and the experience began with a weekend residential. Following the residential the group met regularly throughout the year to ‘relax and recharge’ and to identify ways for speaking with others and ‘spreading the word’. Some young people went into colleges, others spoke at open days. Benefits of participating ranged from reducing their own internal stigma about mental health to gaining skills in public speaking and confidence to contribute their opinions, for example, to advise on Child and Adolescent Mental Health Services (CAMHS).”

Right Here’s partnerships became more successful at local influencing over time, building upon existing relationships and getting young people ‘in front’ of local decision-makers and funders. This approach involved young people acting as advocates for changes to the way existing services are provided and advocating, by example, for the kinds of activities represented by Right Here.

At a local level, IVAR identified a number of factors important to young people and adults influencing local decision-makers and making changes:

  • Having the space and time to experiment: the scale of the funding and the fact that it enabled, in some instances, matched funding was very important. The luxury of being able to take time to develop and test a multiplicity of approaches, particularly in the current climate, was a major factor enabling change.
  • Managing to find the right people/gain critical introductions: this was about not only finding out about people in roles, but finding out about who really acted as the gatekeepers to local influencing, something which particularly took time for those projects where influencing work was relatively new.
  • Having engaged staff who can respond to lessons and setbacks (key characteristics: passionate, adaptable, resilient, determined).
  • Active engagement of Steering Group: having interested and engaged Steering Group members, and developing through them links with key individuals to influence, was vital in achieving some change.
  • Prioritising and investing in activities that help young people think through services and policies and ‘prepare themselves’ for getting their message across to those who need influencing. Some participants spoke about the amount of time that needed to be invested in this, and the fact that this had surprised them. However, they also spoke of how very worthwhile it was, given how the results and outcomes in each project had been greatly influenced by moments when young people were enabled to speak to those in positions of influence.
  • Identifying and using familiar and easier tools than just ‘straight’ presentation (in particular drama) to help young people express their views. It was important to take time to think about what suits as a communication medium and not just the message itself.
  • ‘Penny-dropping moment’: all of the projects had moments they could describe vividly, when young people had come face-to-face with commissioners, which triggered a ‘light bulb moment’ for them. It is interesting that much of the language used around this was visual, as the key common factor was the literal physical bringing together of the young people with those who needed to listen, enabling moments of communication that leapfrogged the rational and enabled an emotional understanding.
  • Jolting out of a rut: getting young people’s voices aired in traditionally functioning, relatively static, and unchallenged groupings was effective.
  • ‘Tipping point’: what seemed to change here was that a point of no return was reached, after which, in several cases, the key commissioners or policymakers found it impossible to return to a position of knowing-and-not-acting. This idea of building critical momentum, and the tipping over to acceptance, was one experienced in several projects. This moment was described as people ‘having bits of their humanity activated’ and causing that to surface.
  • Swift and flexible action: the fact that staff were able to respond quickly to opportunities and change tack to suit new circumstances was vital.
  • Realisation of the extent of mental health benefits in youth work: the increased ability to understand and, importantly, describe (and, in some cases, measure) the mental health benefits of the youth work was key and eye-opening for some participants who had been engaged in youth work for many years.
  • Small steps will get you there: participants identified that there were often only small, incremental steps needed rather than anything major. Attending meetings, having the right conversations, and ‘just keeping on’ were vital to achieve change.

What can we conclude?

By choosing to fund youth work-led partnerships and to focus on young people as ‘co-producers’ of programmes of activities focusing on young people’s mental health and wellbeing, Right Here was intending to ‘be the change it wanted to see’. As befits the youth work-led context of Right Here, empowerment came first and foremost in the relationships that developed through doing; this allowed young people to grow and change as activities grew and changed, leaving them feeling valued, understood and supported.

What proved to be most influential on local policy and practice was the combination of young people finding the space, support and resources to make things happen and developing the confidence to show these things to local decision-makers and professionals. Relating the experience of Brighton and Hove Clinical Commissioning Group (CCG) in working with their local Right Here project, one board member said: “We had a presentation from the young people to the clinical leads at the Clinical Commissioning Group to hear about the work that they’d been doing. We were very impressed and as a consequence of that they were invited to come and talk to us at the six weekly city-wide ‘teach-in’. They presented to one of the workshops. There were doctors, nurses and admin staff present. We were all really impressed in the room when they came. I thought they were really good, really articulate, and quite non-judgemental. It didn’t feel adversarial. I think the feedback from the learning scheme where all the practices came was high. The staff said they’d learned a lot and it had opened their eyes. I didn’t hear anything negative at all.”

Voluntary sector youth work organisations can provide the flexibility for young people to grow and change in the context of being involved with making things happen. Influencing local and national policy and practice is a long game, which requires the organisations involved to have a degree of stability and a clear sense of what they are trying to achieve. Young people are best involved in this process when they are helped to develop skills, confidence and ideas through the continued support of the organisation. The voluntary sector can influence the statutory sector both by example and by supporting people and communities to best represent themselves and their wishes.

Read more about Right Here and making youth work led mental health for young people a reality.