Youth Fed’s mental health programme intends to provide an alternative to crisis or secondary mental health support. The programme aims to ensure that young people can find help easily at an early point of need. The approach also works with families with the aim of improving their capacity to support young people within the household.
The ambition
The Youth Federation (Youth Fed) is a third sector organisation which supports young people aged 8-25. It operates across the North West of England, including in Chester and Cheshire West, where it provides a mental health support programme. The mental health programme draws funding from Cheshire Clinical Commissioning Group and local charitable funders. The programme is well integrated into local authority service pathways and has been supported by elected members and strategic boards.
Youth Fed also offers Targeted Youth Support Services, which are coproduced with young people and offer opportunities to be creative, learn new skills, and connect socially in a safe space – all protective factors for mental health. These services are funded by the Cheshire West and Chester Council, and can be offered where appropriate to young people engaged in the mental health programme.
Youth Fed’s mental health programme intends to provide an alternative to crisis or secondary mental health support. Access to these services can be subject to waiting lists and high thresholds of need. By taking a holistic, prevention-focused approach to increasing resilience, the programme aims to ensure that young people can find help easily at an early point of need. The approach also works with families with the aim of improving their capacity to support young people within the household.
The approach
The programme provides support for young people and their families as well as opportunities for other organisations to develop the skills of their staff in identifying and responding to mental health concerns amongst young people.
Young people can refer themselves to the programme or be referred by a trusted adult. Youth Fed also takes referrals from a range of sources: uniformed groups, schools, colleges, third sector partners, GPs and Job Centres. The programme has good links with local authority services which work with families and young people and refer to the programme when appropriate, including early help and prevention, family support, youth services and social services.
Young people and their families normally receive support for 6-12 weeks, or for as long as required. This support focuses on building resilience and improving psychological education. The approach aims to build both individual and collective responses to a young person’s difficulties, encouraging family members in particular to be closely involved with the young person’s journey at every stage of referral, signposting, or treatment.
Support is offered in a variety of settings:
- Focused, evidence based interventions, including individual and groups therapy delivered face to face, online, and by telephone
- Guided online sessions on topics including anxiety, depression, coping with stress, sleep, money worries, self-harm, resilience, mindfulness and coping with long term physical conditions
- Young people and their parents/carers are brought together in group sessions in the community, including schools, youth clubs, and at uniformed groups.
The one-to-one treatment is based on Acceptance and Commitment Therapy (ACT). In ACT, a therapist works with a young person in explore their feelings, work through their life challenges, and identify how different responses or coping behaviours can create, exacerbate, or manage challenges. Depending on their individual circumstances, a young person might see a therapist for only a few sessions or attend individual therapy sessions for a year or longer. The service operates five days a week from 8am-8pm to allow much more flexible access for young people and their families.
How this approach works with families
Youth Fed’s mental health programme recognises that raising awareness and improving resilience is relevant to all the families it supports. The service aims to understand family members’ needs and experiences. This helps shape the contribution that families can make to a young person’s mental health and wellbeing.
“We can now take the knowledge you've given on board and be more supportive as parents.” Parent of a young person
The service acknowledges that, for various reasons, families can find it difficult to access or engage with mainstream services. These reasons might be practical. The service adopts a family centred and mutually negotiated appointment framework. This approach helps families to navigate barriers to making appointments such as competing priorities for the child and family around schooling, employment, health and care, and childcare. Appointments are built around family schedules and are available as part of an 8am-8pm service offer.
Other issues might centre on trust. Youth Fed takes a non-judgemental approach and works towards family life being a positive factor for young people. Youth Fed consults with young people to better understand these barriers and concerns, which has helped identify stigma as a reason for hesitation in seeking help from mental health services, demonstrating the need to prioritise awareness raising and education on mental health.
Impact
The mental health programme reports to the CCG and provides data to the NHS Mental Health Services Data Set. Changes in young people are monitored using the shortened Warwick-Edinburgh Mental Well-being Scale (SWEMWEBS), as well as through weekly progress reporting and qualitative feedback from young people, their parents, carers, and siblings. Youth Fed takes a strengths-based approach to understanding these changes, which focuses on the person or family’s abilities and assets (resilience, aspirations, confidence) rather than symptoms and difficulties.
“The support had been very beneficial, it has provided more structure to my routine, it has helped me meet new people and look into future possibilities [and] opportunities that I hadn't considered before. It has helped me and my family understand what I'm going I'm through and develop ways of managing it.” Young person, aged 18.
The service is relatively new, having been first launched in September 2019. By the end of 2020, the service had supported 226 children and young people and 200 parents/carers. This includes online advice and more than 4000 one-to-one conversations. The majority of young people supported are over the age of 15. Internal outcome monitoring has found significant improvements in mental wellbeing among young people directly after the intervention which were sustained at the three-month follow-up review.
Lessons learned
A supportive local system: Youth Fed fits within a local system where lived experience and community perspectives feed into service design and strategy through the West Cheshire Mental Health Forum, which is funded by Cheshire Clinical Commissioning Group and a subgroup of the West Cheshire Mental Health Partnership Board. The Board brings together senior leaders from the council, NHS, with several voluntary sector representatives, lived experience representatives, and the elected member mental health champion, Cllr Gareth Gould. This has been seen as instrumental in promoting mental health and wellbeing locally and in developing good relationships between service providers, strengthening practitioner knowledge of wider service offers, like Youth Fed, and improving young people and families’ experiences of referrals and pathways.
Youth Fed has consistently supported the Forum’s activities…The Forum has taken the view that an all-age approach is important in providing effective services in mental health and YouthFed does just that in its many activities. This will be a key element in the local authority mental health strategy currently being developed in Cheshire West and Chester.” David Bull, Chair, West Cheshire Mental Health Forum.
Listening and responding to young people: Youth Fed actively involves young people in decision making around their support and has consulted young people through focus groups to help shape the support offer. This process has produced learning on young people’s preferences and concerns, highlighted the effect of labelling and stigma on help seeking behaviours, and explored family distress and its impact from the perspective of young people.
Working with families: Families are recognised as a critical part of the solution. Families can provide consistent, everyday support for young people to help them achieve and maintain their goals for staying mentally well. Family members benefit from impartial, accurate advice, access to tools and resources, and practical support for their own needs. Youth Fed’s flexible and non-judgemental approach to working with families has been seen as an important enabler of family involvement.
