When seeking support for a mental health condition, young people are often required to navigate a complex system of statutory and voluntary sector services, with considerable waiting times. Barriers to finding out about and accessing relevant mental health services persist, often for those who need them the most. In this blog, Dina Papamichael outlines the potential to learn from existing advocacy models to improve young people’s awareness and take up of various health services.

While this turbulent year has prompted new concern around mental health, the mental health of young people in the UK was deteriorating before the pandemic – probable mental health conditions increased from 10.8% in 2017 to 16% in July 2020 across all age, sex, and ethnic groups [1]. Looking ahead, research from Young Minds has shown that 67% of young people believe that the pandemic will have a long-term negative effect on their mental health [2] . Against this backdrop, it is crucial that young people understand their rights and choices; and face open doors when seeking out support.

A bumpy road to help

The journey from identifying a need for mental health support to accessing appropriate care is often fraught with obstacles. Rocket Science’s recent research for Young Westminster Foundation has highlighted that a significant proportion of young people (43%) find it difficult to find out about mental health services, and an even higher proportion (47%) find it difficult to access services [3]. Even when young people are aware that support is out there, concerns around confidentiality, cost, stigma and waiting times can reduce willingness to engage.

 A wide range of providers and services exist to support young people’s mental health in the UK, including:

  • Local NHS Child and Adolescent Mental Health Services (CAMHS)

  • Voluntary sector services such as Relate or Off the Record

  • Private/independent sector counselling

  • Support provided within schools e.g. by Schools Mental Health Practitioners

  • Primary care – It is estimated that one third of GP appointments involve a mental health component [4]

While many young people can rely on a family member, teacher, or youth worker to help them understand and navigate options for support, this is far from universal. This means that young people can be left in crisis without feeling listened to or empowered to get help.

A need for advocacy

Advocates help young people to navigate complex service landscapes by listening to their needs, helping them to understand their options, accompanying them to appointments or acting on their behalf e.g. writing letters or making phone calls.

The National Standards for the Provision of Children’s Advocacy Services define advocacy as follows: ‘Advocacy is about speaking up for children and young people. Advocacy is about empowering children and young people to make sure that their rights are respected and their views and wishes are heard at all times. Advocacy is about representing the views, wishes and needs of children and young people to decision-makers, and helping them to navigate the system.’ [5]

Examples of existing youth advocacy models within youth justice; mental health recovery settings and homelessness include:

  • Just for Kids Law – Youth Advocates work with young people to help them access legal support and other specialist services they need to resolve issues relating to e.g. housing; immigration and residency status; finance and social services

  • National Youth Advocacy Service – Advocates work within a variety of locked, rehabilitative, and residential mental health recovery settings within the Priory for children and adolescents to help them be actively involved in decisions that affect their care and treatment

  • Coram Voice – Homelessness Outreach Advocates help young people to move into safe housing and access the financial, housing and educational benefits which they are entitled to.

Alongside advocacy services, link workers with a strong knowledge of voluntary sector services are increasingly being used to signpost individuals in the community, reducing a reliance on GPs to keep up with a continuously evolving service landscape.

Learning from existing youth advocacy and link worker models can be used to inform local initiatives which put those most at risk of mental health issues, and least empowered to navigate the system at their core.

Making advocacy work for young people

Established principles for good advocacy services include building up young people’s personal power; working at the individual’s pace and following their instructions; earning trust and being there for a young person; learning from young people’s views to constantly improve [6]. Within a mental health context, it is important that advocacy services are:

Communicative – this includes reaching young people in spaces where they are comfortable and providing clarity on what the advocacy service can offer

  • Simple, equitable and easy to contact – addressing barriers to access and providing options for young people to reach out e.g. email, social media, call or webchat

  • Trauma informed – having an awareness of the prevalence of trauma amongst young people and minimising risks of re-traumatisation

  • Culturally informed – ensuring that young people feel understood and that the advocacy offer is tailored to their needs and experiences

  • Support the transition to adult services – Including young people between 18 – 25 to ensure no one falls through the crack during the transition to adult services

  • Picking up on specific service issues – such as missed appointments or where the level of support they receive isn’t right

Dina Papamichael is a Principal Consultant in our London Office. If you would like more information on our work or how we can help you please get in touch with dina.papamichael@rocketsciencelab.co.uk