Clubs step in to support young people with mental health problems

According to research by the Nuffield Foundation published last month, the proportion of 15- and 16-year-olds suffering from anxiety or depression has doubled in the past 30 years.

With this in mind, in February the government pledged £22m to increase the availability of talking therapies to children and young people with mental health problems through its improving access to psychological therapies (IAPT) programme.

Part of the money will finance training for professionals including teachers and youth workers, so that they can intervene early to support young people before mental health problems escalate.

Meanwhile, the charity Clubs for Young People has just concluded a three-year initiative exploring how youth clubs can support young people with emotional problems. The project found that youth provision could play a vital role in stopping young people with "low-level" mental health problems from developing a more serious illness, particularly in the most disadvantaged communities.

Helen Marshall, chief executive of Clubs for Young People, argues that young people are dealing with more complex issues than ever before. "I think mental health problems are becoming more prevalent because of the challenges young people are facing, such as increasing youth unemployment, the cut to education maintenance allowance and university fees," she says.

"Add to that the increase in social media and the fact that the way people communicate has totally changed, it's a really tough time to be a young person."

She argues that youth clubs are best placed to work with young people who are less likely to turn to their GP or local health services for support, such as those living in deprived areas.

"Around 40 per cent of youth clubs are in areas of social deprivation and young people from disadvantaged communities have higher levels of mental health issues," she explains.

Coping with problems

"Up to 15 per cent of disadvantaged young people have diagnosed mental health issues, so the chances are that there are far higher numbers with undiagnosed problems or who are struggling to cope with issues such as bullying, self-esteem, relationship issues or things that are happening at home."

She adds: "Young people are more likely to access a range of services if they are available to them in their community and in an accessible environment in which they feel comfortable. It's just common sense."

As part of the three-year project, Clubs for Young People commissioned the charity Young Devon to conduct research into how youth clubs support young people with mental health problems.

The research included the design of a toolkit to help youth professionals recognise a range of mental health problems, as well as a training programme for youth workers, which is being developed with mental health charity Young Minds.

Tim Tod, chief executive of Young Devon, was keen to work with Clubs for Young People, having been involved in developing a range of community-based counselling and psychotherapy services for young people in Devon.

"We were becoming increasingly aware of the need to try and equip more of our frontline workers to be confident in supporting and engaging with young people with mental health difficulties," he says. "We wanted to address the issues that many youth workers have in dealing with young people who have mental health anxieties. There can be a degree of panic when professionals feel it is outside of their area of expertise and don't quite know what to do next."

The toolkit offers youth workers practical advice on how to approach common emotional and mental health problems, and explains when to refer young people onto more specialist services.

"A lot of young people have anxieties to do with relationships at home, relationships with friends, bullying and self-image," Tod explains. "Young people can feel very overwhelmed with these things, so youth workers need to be able to play a useful role in reassuring young people. For some young people, talking to a trusted youth worker about a problem can be sufficient to help get them back to a space where they feel able to cope, so that can stop things deteriorating to the point where they need a higher level intervention."

Recognising the signs

But for young people with more profound issues, such as depression or an eating disorder, youth workers need to be able to recognise the problem quickly, so that they can encourage the young person to access support.

"Stigma can often make a young person reticent to seek help, which means that their problem gets bigger," Tod says. "For us, a key part of this work is making sure that young people get to talk to someone they trust at the earliest opportunity. If it becomes clear that there is a level of need that might require additional support, our job is to reassure young people that the agencies we might link them into are only interested in helping them get better.

"We can also reassure young people on issues around confidentiality and notification of parents, so that isn't a barrier to them getting help."

Andrew McCulloch, chief executive of the Mental Health Foundation, believes that delivering talking therapies through youth clubs and other "non-traditional" settings, such as schools, will be essential to improving early intervention for young people affected by mental health problems.

"More than one million children and young people in the UK have a mental illness at any one time," he says. "If we are to tackle this growing burden, we need to make sure that these young people are able to access a treatment that is right for them, as early as possible."

McCulloch adds that professionals such as youth workers and teachers need training in mental health awareness and child development to both nurture emotional wellbeing and identify mental health problems early to avoid the current approach whereby young people are left to reach crisis point with their problems, before receiving support.

On the £22m government investment into the IAPT programme, he admits that "the jury is still out" on whether the cash will be sufficient to expand state-of-the-art psychological therapies across the country,
as well as train non-clinical professionals and existing NHS professionals who come into contact with children and young people.

"We must nonetheless celebrate the fact that the government has recognised children and young people need psychological therapies delivered in a range of settings and styles," he says.

The next step, McCulloch believes, is to increase collaborative working with young people, so that their views can fundamentally shape provision.

"The voices of children and young people must be at the heart of new service development and commissioning," he says. "When young people work in partnership with health professionals, effective and innovative early interventions are put in place."

CASE STUDY: BRANDON CARRSIDE YOUTH CLUB

Julie O'Connor, project manager

Brandon Carrside Youth Club in Durham took part in Clubs for Young People's research exploring how youth clubs are working to support young people with mental health issues. Julie O'Connor, project manager at the club, believes young people are facing "immense pressures" on their mental health.

"Many young people do not have a secure, stable life at home, so having a youth club where they can go and feel safe and appreciated and talk in confidence is really important," she says. "The issues they come to us with are so wide-ranging - from bullying to family and relationship problems. Others are at risk of becoming offenders or are facing problems such as their parents being in prison."

O'Connor says the whole ethos of the club is focused on building young people's confidence and providing positive role models. "We discuss their needs and aspirations and organise activities they would like to try," she explains. "It could be anything, such as a day out to the cinema and for a meal. If young people have positive experiences taking part in activities, then it all contributes to raising their self-esteem."

While social activities build young people's confidence and being part of the club offers a network of support, youth workers at Brandon Carrside also carry out intensive work with young people who have specific issues.

"Sometimes you may be the only adult that can positively influence their future," O'Connor says. "For some young people, I act as their one-to-one counsellor or mentor. For others, we support them to
access partner agencies, for example if they have drug and alcohol problems or need bereavement counselling."

She argues that more mental health services should be delivered in "young people-friendly" settings. "Child and adolescent mental health services can sometimes feel quite impersonal," she says. "The way forward is to try and engage young people in environments where they feel comfortable."