After investing in data collection, we noticed a pattern of young people (up to 45% of help seekers) who weren’t responding to our standard offer of 6 structured appointments of counselling, were generally engaging less consistently with any support, and were showing poorer outcomes.
We identified this group as:
- having higher health inequalities / more complex and inter-related needs
- less able to manage being on a waiting list without support
- often without social or structural capital to attend structured sessions
- being disadvantaged by rigid (traditional) support offers.
Research shows that young people with high levels of structural challenges including homelessness, financial deprivation, and Adverse Childhood Experiences (ACEs), generally have poorer access to mental health services and poor outcomes[1].
We knew they were not well served locally, and we wanted to do something about it.
The new approach-purposely flexible
With funding from the Department of Health and Social Care and support from the Centre for Mental Health[2] we embarked on a project to tackle this health inequality and piloted a more flexible and engagement-focussed service offer which:
- understands that some young people’s mental health will deteriorate on a long waiting list, and straight away implements check-in calls and signposts to resources.
- offers multiple methods of contact (often young people choose shorter contacts – phone/email/WhatsApp).
- allows young people to dip in and out depending on their life situations without penalty.
- takes time to build a ’trusted relationship’ with a youth engagement worker allowing young people to open up and communicate their situation.
- moves away from a culture of blame or hopelessness around a young person’s struggle to engage and towards a responsive solution.
“So I would just rock up on a Thursday afternoon at the walk-in centre [without appointment]… and then mosey in. I liked not having the fear and anxiety of cancelling an appointment or the fear of losing any help... if I’d had a particularly taxing day and the thought of having to bring everything back up again, which was kind of my issue at the time, it just wouldn’t have worked. At the time I didn’t have the capacity to explain that”
Our alternative model requires longer-term, tenacious, flexible, and patient support, acknowledging the barriers young people experiencing health, social and economic inequalities can face in accessing support.
What is the impact of our work?
A Centre for Mental Health report found that due to the Centre 33 model of flexibility:
- There was increased engagement
- The trend of non-engagement was being reversed
- The non-traditional support was just as effective as the traditional model
- Young people with more complex needs accessed more meetings and more support minutes, and they achieved better mental health outcomes and were as likely to achieve their goals.
Young people interviewed experienced general mental health improvement, better understanding of their own mental health and improved ability to communicate about it.
Young people know we are on their side and have fed back the positive impact of the warmth of the staff, their tenacity and willingness to be flexible, and the offer of a service regardless of any potential complications or barriers.
“Without them I wouldn’t be where I am. They seem informal, but it’s been the best out of everywhere I’ve been.”
