Integrating a youth participation model in a youth mental health service: Challenges and lessons learned

• By Dominiek Coates and Deborah Howe
• Child & Youth Services, Vol 0, No 0, (2016)
  
  

It is now widely understood that young people have a right to participate in decisions affecting them. This should mean more than consultation and include integration in the decision-making process; to achieve this, organisations need to invest fully in the implementation of youth participation schemes (Burns and Birrell, 2014).

This article discusses the evaluation of a tiered participation model developed by Headspace, the national youth mental health foundation in Australia. In 2013, Headspace re-established their model for youth participation, the Youth Alliance (YA), drawing on the previous model and a literature review. Two key issues informing the model are:

• Appropriate remuneration - meaning more than simply costs
  
  
• Flexibility - adapting to the strengths and abilities of individual young people.

The result is a three-tiered approach in which participants chose their level of engagement, which can range from ad hoc consultation (tier three), volunteering (tier two), to flexible employment (tier one). This evaluation drew on young people's perspectives to inform continued development. Three focus groups for young people were held, and one for management, with findings supplemented by a review of YA records.

Recruitment

A major challenge is engaging a diverse group, not just the most easily engaged young people. Here a tiered approach has some limitations, with one manager recognising those who are more difficult to engage may simply be ‘pushed' to a lower participation level for ease. However, recruitment did result in a diverse group of 12 tier-two consultants. The two main reasons they joined were to:

• Overcome barriers for young people
  
  
• Build confidence and friendships.

Integration of young people into the workplace

Existing staff were supportive of youth participation, viewing it as beneficial to the service and participants. However, a major worry was the risk of young people breaching client confidentiality, which was managed via training and careful supervision. Clinicians were also concerned about participation increasing the distress experienced by young people and exposing them to secondary trauma - though the limited research evidence on this issue suggests that participation may contribute to protection from further mental health issues. A "wellness plan" was put in place for all consultants prior to their involvement. Another concern was whether youth consultants should be current clients or if not, how much time should have passed since involvement before becoming a consultant. In this instance, only one person was a current client and it appears participation aided the transition from current to former.

The model's tiered approach

The tiered approach to participation presented significant challenges, including difficulties in recruiting due to issues of potential age discrimination when recruiting for tier one. Some attrition from such programmes is inevitable but in this case there was speculation that the model's lack of clarity contributed. In the focus groups all YA consultants expressed the wish to be employees, believing this would support full integration, and enable them to be "taken more seriously". Many consultants also wanted to be employees because they found voucher remuneration tokenistic. Importantly, this was seen as reducing their ability to truly volunteer, with one consultant commenting: "It's better to either be an employee or truly volunteer your time. Either is fine."

These challenges resulted in tier-two discontinuing, and eight young people being employed at tier one, forming phase two of the YA.

Consultants recommended three additional areas for development of the YA. These were:

• Balancing independent and group work
  
  
• Greater role clarity, feedback and direction, particularly to manage expectations about what the project could achieve
  
  
• The importance of coaching and training opportunities.
  
  

Implications for practice

Youth participation can benefit young people, organisations and the community but barriers to implementation persist including integration of a youth participation model into existing structures and staff's attitudes towards and perceptions of youth participation. To overcome these barriers the authors recommend:

• Addressing staff concerns, ensuring they understand the potential benefits of youth participation and that they are consulted and kept informed throughout
  
  
• Engaging a core group of five or six young people as employees, or a larger group as volunteers
  
  
• Accepting that youth participation models will evolve over time
  
  

Building the evidence for implementing youth participation models.
The research section for this special report is based on a selection of academic studies which have been explored and summarised by Research in Practice part of the Dartington Hall Trust.


Further reading

Related resources:

• SCIE resources on co-production in social care: What is it and how to do it
• Children's participation in decision-making: a children's views report by the Office of the Children's Commissioner
• Participation work by the Office of the Children's Commissioner with young children and their families aimed at reducing the impact of low income
• Children and young people giving feedback on services for children in need: ideas from a participation programme by the Office for the Children's Commissioner
• Achieving emotional wellbeing for looked after children: a whole system approach by the NSPCC
• Learning from the Relationships Matter project, challenging and promoting continued relationships between practitioners and care leavers
• The Department for Education has recently published the user journey mapping research report and website.
• An evaluation of the impact of children's participation on The Children's Society and its stakeholders
• Emerging learning from the Council for Disabled Children Learning and innovation programme including promising practice around co-production
  
  

Related resources by Research in Practice:

• Voice of the child: Evidence review
• Attachment: Frontline briefing
• Adolescent mental health: Frontline briefing
• That Difficult Age: Developing a more effective response to risks in adolescence: Evidence scope
• Communicating effectively with children under 5: Frontline briefing
• Communicating effectively with Children Under 5: Webinar recording
• Communicating effectively with children: In-house workshop
• June 2016 Communicating with children and young people with developmental delay, communication difficulties and disabilities: Frontline briefing
• June 2016 Young person-centred approaches in Child Sexual Exploitation (CSE): Building self-efficacy and promoting participation: Frontline briefing
• July 2016 Young person-centred approaches in Child Sexual Exploitation (CSE): Building self-efficacy and promoting participation: Webinar
• System redesign with young people's voices centre stage: Blog by Louise Bazalgette from NSPCC and Jake Garber from DfE's Innovation Unit
• Evaluation tools and guides including:
• Embedding the Voice of Children and Young People in Service Evaluation: Evaluation Tool
• Ethics for research with children, young people and vulnerable adults