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24 November 2020
Young people's mental health needs are growing. Open-access services are the solution.
As the mental health impact of the pandemic grows, more and more young people need access to mental health and wellbeing services. Our Policy and Campaigns Officer, Ruby Waterworth, makes the case for open-access, early support in the mould of Youth Access YIACS.
Young people’s mental health is one of the most pressing issues facing us today. Even before the pandemic, young people’s emotional and mental health needs were on the rise, with support failing to keep up with need. Now, eight months of coronavirus restrictions have seen mounting of pressures on the young, just as NHS services are forced to grapple with entirely new challenges to their ability to provide care. Now more than ever, young people need mental health services designed just for them, that they can access easily and quickly in their local area.
Fortunately, the many decades of experience and expertise among Youth Access’ membership means that open-access, early support for young people is not a new approach. As a network, we have long known that support for young people can’t be broken up into individual issues, with young people passed from service to service and little communication in between. We know that long waiting times, arbitrary thresholds for support and an over-reliance on high-level, emergency care serve no-one – not young people, not the services designed to support them, nor wider society.
The Youth Information, Advice and Counselling Services – also known as YIACS – in Youth Access’ network do just that, providing quality early support for young people, for a wide range of issues – whether that be housing, employment, mental health or welfare, on the high streets and in the town centres where young people can easily access them. Importantly, YIACS provide support typically up to the age of 25, ensuring that young people don’t fall through the gaps as they approach 18.
Youth Access is the national membership organisation for over 170 youth information, advice and counselling services (YIACS).
YIACS are organisations rooted in local communities all over the country that provide free, easily accessible and age-appropriate support to young people aged 11-25 with a wide range of issues.
Our members routinely help young people from marginalised groups who might not otherwise be receiving support, including looked-after children, young people with experience of the criminal justice system, LGBTQ+ young people, refugees and young people from BAME backgrounds.
YIACS see young people as more than just a mental health diagnosis, and support them with a wide range of issues, providing advice and information services that can help young people access their rights and entitlements, and address broader issues that go hand in hand with mental health - such as housing, money and relationships – sometimes referred to as the “social determinants” of mental health.
Youth Access YIACS are present in local communities across the UK. They have generally grown out of a ‘bottom-up’ development process without central direction from government, and thus vary greatly in the type and scope of services that they offer. Their independence and ability to adapt to the local context are absolutely vital, but there are some key characteristics and functions that they all share.
We have identified the following core functions of YIACS. These are the functions that are the priority for the YIACS model, and may be delivered through a range of delivery structures:
Initial contact point for young people
Young person-centred assessments
Information, advice and/or advocacy on rights-related matters
Advice, support and/or advocacy on health and wellbeing
Young people’s feedback, involvement and participation
Safeguarding young people’s welfare
Local and national partnership working
Signposting and referral
Monitoring and evaluation
Evidence-informed one to one psychological therapies
Access to young person-friendly information
A multi-disciplinary, competent workforce
We have also identified additional functions of YIACS. These bring added value to young people, though they are not essential to the model (though they may be for young people):
Opportunities for young people to share and learn together
Integrating specialist provision
Telephone and online help and support
Intensive/specialist housing support
Outreach services and activities
While not all Youth Access members can offer this full range of services due to commissioning barriers, local circumstances and individual areas of focus, this is the gold standard to which YIACS should strive.
YIACS’ main purpose is to offer an integrated approach to young people’s health and wellbeing concerns through a unique combination of prevention, early intervention and crisis work. The services are underpinned by a common set of values and principles.
YIACS’ relationships with young people are led by young people and offered on the basis of:
Trust and respect
Honesty and consistency
Hope and optimism
The principles that all YIACS adhere to are:
YIACS are open access and respond to all young people regardless of the nature, complexity or severity of their initial concerns or needs
YIACS are young person-centred and available on a self-referral basis
YIACS offer a safe and confidential environment in which young people can seek help and support
YIACS are provided flexibly to reflect young people’s changing needs as they make the transition to adulthood
YIACS are responsive to the different communities of young people they serve
YIACS uphold and advocate for young people’s rights and support young people to have a voice in the decisions and issues that impact on them
YIACS are committed to delivering best practice by offering high quality, evidence-informed services through appropriately trained and competent staff
YIACS recognise their duty to be accountable to all their stakeholders, particularly the local communities in which they operate
At Youth Access we believe in the power of young people to shape their own futures, and support them to campaign for transformational change to deliver the services and systems that meet their needs and fulfil their rights. We practice what we preach by supporting young people to raise their voice and influence how services are designed and run.
Our Altogether Better charter was created in partnership with over 200 young people from across the country, and outlines how services can deliver a young person-friendly mental health and wellbeing service. Since the charter was created in 2018, we have worked with our members to promote the charter, and pilot a scheme for young people to give feedback to services based on their adherence to the charter’s principles.
In times of crisis, as statutory services struggle to adapt to changing needs, it is often the voluntary sector left picking up the pieces. The Covid-19 crisis has been no different. YIACS have led the sector in innovating to quickly pivot to offer remote and digital services to ensure that young people continued to receive the support they needed.
As we emerge from coronavirus lockdown, the mental health system faces the challenge of unprecedented levels of demand for support at a time when accessing traditional services is more difficult than ever. Empowering YIACS to extend their young person-centred services to even more young people, and build on the innovations of lockdown to offer a blended model of service delivery that offers face-to-face support alongside remote interventions, will be key if we want our coronavirus recovery to respect young people’s human rights.
Supporting these organisations will require, at a minimum, flexible, ringfenced funding, training in adapted models of working for practitioners and a commitment to giving them a seat at the table in mental health planning at a local and national level.
“After struggling to get counselling through CAMHS, my therapist basically disappeared after a couple of really difficult sessions. By the time they found someone else I was too old for CAMHS and adult services wouldn’t take me till I was 18.
“Luckily I was also in touch with a local youth advice and counselling service at Berwick Youth Project - who have been amazing. I’m 23 now and for 10 years they’ve been my lifeline. From helping me deal with the death of my Dad to making sure I had a laptop to start Uni, they consistently go above and beyond for me. After my own experiences, I couldn’t imagine building that sort of trust anywhere else.”
Natalie, a young person who received counselling at her local Youth Information Advice and Counselling Service (YIACS)
The evidence behind YIACS-type services is compelling: research shows that the youth counselling provided through Youth Access services show similar clinical outcomes to those reported in CAMHS or school-based support, all while achieving much higher levels of satisfaction among young people. The same report also shows that voluntary sector organisations are supporting much higher proportions of ‘older’ young people, young people from LGBTQ+ and BME communities, as well as those who have experience of the youth justice system. This demonstrates the key role that Youth Access members and wider voluntary and community organisations play in providing support for young people who face multiple barriers and whose needs ‘traditional’ mental health support has historically failed to meet.
Such successes aren’t limited to mental health support, however. The links between poor mental health and wider issues affecting young people are clear, and mean that support can’t be limited to counselling or CBT. It’s no surprise, therefore, that advice services provided by Youth Access members – on housing, debt and employment issues, for example – are also shown to improve young people’s stress levels and/or general wellbeing. This is what young activists on Youth Access’ Our Minds Our Future campaign call a ‘Whole Life Approach’ to mental health, which has young people’s participation and holistic needs at its heart. It’s also been showcased throughout the coronavirus pandemic, with Youth Access members adapting their support to meet new restrictions and challenges with impressive innovation and speed.
Such an approach is cost effective, too: for young people who’ve reported improvements in their stress or health thanks to advice support, GP savings have been estimated to reach £108 per young person. And that’s just in General Practice: investment in early support for young people spanning mental health, information and advice has the potential to significantly reduce pressure and costs across government departments and statutory provision.
It’s no surprise, then, that YIACS-type services have long been hailed as a key pillar of young people’s mental health support in the community. Yet these open-access services have often not received the recognition and government backing warranted by this success. With a lack of dedicated, sustainable local funding, many Youth Access members are forced to “patchwork” funding together to keep vital services running, while a lack of representation of young people and voluntary sector organisations in local decision-making prevents the kind of transformational local change that could see this model become the norm for mental health provision across the country.
That’s why Youth Access has joined with the The Children’s Society and YoungMinds to organise an online cross-party panel discussion on how to improve the availability of early, community-based services for children and young people with emerging mental health needs. We will be using this platform to raise awareness about the successes of community-based support for young people to an audience of parliamentarians from across the political spectrum, officials, and senior colleagues from charities.
Our request to policymakers is clear: don’t start from scratch. Instead, look to the organisations already doing this great work, listen to what they and young people need, and invest to ensure the sustainability and expansion of support that takes the whole young person into account.
We hope that bringing together government, cross party members of parliament, officials, charities, service providers and young people today, will kick start a more joined-up, collaborative approach to mental health and take us one step closer to achieving a system that truly meets young people’s needs and rights, both now and in the long term.
What can I do?
Get in touch. If you want to discuss how we can work together to ensure young people get the early support they need, email us at ruby@youthaccess.org.uk
Join us! Youth Access is a powerful network of services providing information, advice and counselling to young people. Find out more and become a member here
Read our joint briefing with YoungMinds and the Children's Society on open-access mental health support for young people. Download it here [pdf].
