A think piece on young people’s mental health from Cassandra Harrison, Chief Executive Youth Access.
Youth Access is the national membership organisation for Youth Information, Advice and Counselling Services (YIACS), also known as “open-access hubs” or “one-stop-shops". These community-based, easily accessible services support young people aged 13 to 25 with a wide range of issues.
Given the events of the last year, this 'Mental Health Awareness Week' feels particularly relevant. Now more than ever, young people need mental health services designed for them, that they can access easily and quickly in their local area. The pandemic has also highlighted how mental health does not exist in a vacuum. Employment, housing, debt, relationships: all affect, and can be affected by, our mental health, and since young people are navigating these challenges for the first time, councils and Youth Access members both have crucial roles to play in helping them along the often rocky road into adulthood.
A Partnership full of potential
As councils across the country lead the recovery from the pandemic, and with their responsibilities for children, family and public health, there are clear opportunities for working collaboratively and strategically with local YIACS. Councils and Youth Access members have much common cause. They are organisations rooted in their local communities, with a deep commitment to the people they serve. They have a key role in helping people with the multi-faceted aspects of their lives, from housing and employment to wellbeing. Both provide essential support to young people from marginalised groups or facing complex challenges, including young carers, care experienced young people, and refugees.
YIACS are accessible, youth-centred spaces and evidence shows they have a wider reach than statutory services. If given a seat at the table, they can provide valuable insight into the needs of local young people and how to meet them. Some of our members already work closely with local authority colleagues, commissioned by them and Clinical Commissioning Groups (CCGs) to deliver their unique combination of prevention, early intervention and crisis support.
By working in genuine partnership, councils and YIACS have the potential to be a powerful force in providing the holistic, community-based support that young people and the evidence tell us is needed.
Mancroft Advice Project (MAP) is working with Norfolk County Council to transform mental health services in the local area. They are recognised as a key strategic partner and sit on the Managing Group that leads planning and delivery to make services more accessible, young person-centred and community focused. As a result, MAP has brought their expertise and helped involve young people in the decision-making. They are also commissioned by the council and NHS to provide advice and counselling services. This partnership work feeds into an overarching, jointly formulated strategy setting out the aspirations for young people in Norfolk, overseen by an Alliance Board, chaired by the council and with involvement from local VCS organisations including MAP. This collaborative approach has led to a shared vision and commitment from all organisations.
Not just a mental health diagnosis
While young people have faced the sharp edge of the ‘mental health crisis’ for some time, with the widest ‘treatment gap’ and steadily inclining needs, the COVID-19 pandemic has created a treacherous and uncertain terrain for those making the journey into adulthood. To address these challenges, and stay mentally well, young people need support across all areas of their life, not just their mental health diagnosis.
“Mental health services were not effective in the sense that they did not tackle any problems I was facing and instead asked questions that were not along the lines of what was needed. It is often the case that counselling services do not consider the individuality factor that comes with mental health.” – Young person from Youth Access member No 5, Reading
Adolescence throws up specific challenges and so services require a specific approach, different to that for children or older adults. Equally, young people are not a homogenous group - individuals and communities have different needs, so mental health support must be flexible, responsive and based around the needs of that person, not the limits of the system.
The Youth Access YIACS model ensures counselling and mental health support is accompanied by a range of social and practical support to help address the social determinants of mental health, such as financial and job insecurity, discrimination and poor living conditions.This is even more important when seeking to address socio-economic inequalities, many of which have been exacerbated by the COVID-19 pandemic. Since our members are rooted in the community, with a depth of understanding of the changing needs of local young people, they can build services around that need.
“Over the pandemic unemployment and financial hardship meant that we quickly developed a food parcel delivery service (including toiletries, condoms and sanitary wear) that has exploded with demand... We have had to quickly learn how to do things online - like meetings, support groups etc.” – Youth Access Member, The Warren of Hull
Providing a bridge, not a cliff edge
For young people around age 18 who face major upheaval such as leaving education, leaving home or the care system, joining the workforce and gaining financial independence, this also comes hand-in-hand with losing access to vital support from various children’s agencies.
“I have struggled quite severely with anxiety and depression for as long as I can remember. I remember going to the doctors and not being taken very seriously. I then went up when I was about 17 and was told I could not be given help due to my age. I was then told when I was 18 that I would be put on a waiting list for CBT which could be up to a year.”
For every local area to have a truly inclusive offer for all young people up to age 25, plans must go beyond schools and Child and Adolescent Mental Health Service (CAMHS), so that young people are given a bridge, rather than a cliff edge, as they approach adulthood.
A recovery from COVID-19 that centres young people’s rights
As we prepare for a period of recovery and seek to understand the true cost of the pandemic to young people’s mental health, we must get to grips with its effect on their lives as a whole. 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.
We know that, instead, the way forward is to make sure that support is accessible to all young people, listens to them and takes into account all of their needs under one roof. We know that lots of young people who have emerging needs, and who don’t necessarily require specialist mental health care, would benefit from support of some kind – support that is lacking significantly under the current system. This is what young people have for years been calling for and what our members have proved works time and time again. It’s also what human rights say young people are entitled to.