Models of peer advocacy developed by selected projects

funded by Diana, Princess of Wales Memorial Fund

Evaluation report by the National Childrens Bureau

Robert Harnett

Models of peer advocacy

CONTENTS

Page

1. Introduction ................................................................................................................1

1.1. Scope of the report .......................................................................................................1

1.2. What is peer advocacy?................................................................................................1

1.3. Ten projects supported by the Diana Fund...................................................................3

2. Evaluation overview ...................................................................................................6

2.1. Aims and objectives of the evaluation .........................................................................6

2.2. Methods. .......................................................................................................................6

3. Four practice models.....................................................................................................8

3.1. Young Refugees Rights Project ..................................................................................8

3.2. Young Peoples Mental Health Project ........................................................................15

3.3. Young Peoples Training Project. ................................................................................19

3.4. Youth Crisis Project .....................................................................................................23

4. Discussion: messages from the research......................................................................29

4.1. Recruitment and group membership ............................................................................29

4.2. Creating a supportive environment ..............................................................................31

4.3. Running peer advocacy groups ....................................................................................33

4.4. Getting young peoples voices heard ...........................................................................35

5. Conclusions ....................................................................................................................37

5.1. Models of peer advocacy..............................................................................................37

5.2. Project successes ..........................................................................................................37

References ..........................................................................................................................40

Acknowledgements The National Childrens Bureau would like to thank the young people and staff at all of the projects who kindly gave up their time to speak about their experiences. This study was funded by Diana, Princess of Wales Memorial Fund. Robert Harnett National Childrens Bureau March 2004

1. Introduction 1.1. Scope of the report Between 2001-3 the Diana, Princess of Wales Memorial Fund (the Diana Fund) supported a number of projects across Britain through its Transition to Adulthood and Independence grant-making programme. This programme was aimed at young people aged 12-25 and was targeted to support disadvantaged groups, including refugees and asylum seekers, prisoners families, young people with mental health problems and young people with learning disabilities. Many of the projects funded through this programme contained elements of advocacy, campaigning and awareness-raising in their bids. The Diana Fund was eager to learn as much as possible from the programme of work and to disseminate examples of good practice from funded projects to other organisations seeking to implement similar work. As part of this strategy, the National Childrens Bureau (NCB) was commissioned to explore and model the ways in which peer advocacy had been used in a selection of funded projects and to evaluate the relative success of these models at achieving desired outcomes. The purpose of this piece of work was not, therefore, to carry out individual project evaluations; rather, it was to look at common themes across the projects. This report begins with a review of the literature relating to peer advocacy and then briefly describes ten projects that were identified as potential peer advocacy projects. The remainder of the report focuses on four projects that were selected for more detailed exploration and evaluation. These are presented as stand-alone case studies. The key messages from discussions with various stakeholders in the projects are discussed in Chapter 4. The concluding chapter addresses the fundamental questions posed at the start of the evaluation. 1.2. What is peer advocacy? Advocacy is about enabling peoples views and wishes to be heard (Atkinson, 1999). In the literature, two fundamental advocacy models have been identified: citizen advocacy and self-advocacy. Citizen advocacy is where relatively powerful individuals seek to understand the views and wishes of less powerful people and represent them to a third party, such as a policy-maker, as if they were their own (OBrien, 1987). Self-advocacy seeks to involve individuals who share common experiences of oppression in self-advocacy support groups in order to empower them to engage with, and change, the structures that oppress them (Hodgson, 1995). In principle, peer advocacy can be based on either the citizen or self-advocacy model but has a distinct character in that the advocate(s) have insider knowledge and experience of the individual or group on whose behalf they are advocating (Atkinson, 1999). In other words, peer advocacy involves people who share similar circumstances, such as age or type of disability. In this respect it is similar to types of peer support such as peer mentoring (Hartley-Brewer, 2003). Peer advocacy, as opposed to more dominant types of peer support, is concerned with representing young peoples views with the intention of influencing change.

1

Peer advocacy groups

Most peer advocacy has taken place within a group context based upon the self-advocacy model, where children and young people who share similar experiences are brought together to learn how to advocate for themselves and/or on behalf of their peer group. The advantages of using groups of young people over the idea of young people operating as individual advocates, are that children and young people have the support of their peers to express themselves, develop their own ideas and find solutions to problems (Russell, 2001). Peer advocacy groups have been successful at enabling the voices of looked after children and young people to be heard in decisions over the development of local authority childrens rights services (Gomes, 1995; VCC, 1998), and have led to changes in social services practice (Willow, 2002). They have also been used in the development of advocacy services for young disabled people (GLAD, 2000), and to inform training programmes for social care professionals to learn about advocacy and childrens rights (Boylan & Lebacq, 2000). Many well-established national and local advocacy service providers have set up peer advocacy groups to influence their own policy and practice (South Glamorgan Advocacy Scheme, 1994; Dalrymple & Payne, 1994; Russell, 2001). One-to-one peer advocacy

Few examples of peer advocacy based on the citizen advocacy model exist in the literature. The majority of known schemes have been in support of young disabled people such as a network of peer advocates who worked with young arthritis sufferers to promote their awareness of and involvement in services (Barlow & Harrison, 1996). Other examples include independent-living advocates representing the views of young disabled people living in centres for independent living (Kestenbaum, 1996), deaf people representing the views of young deaf people (Reid, 1994) and disabled young people advocating on behalf of other young disabled people in residential institutions (Greene, 1998). Messages from research

Research has identified a number of barriers preventing projects, services and groups from using peer advocacy as a means to promote young peoples voices. Evaluations have highlighted the problems of recruiting suitable advocates (JRF, 1994; Harding, 1995; Sim & Mackay, 1997), which poses a particular problem for schemes aiming to recruit young people as one-to-one peer advocates because young people have been found to lack the confidence to take on such a role (GLAD, 2000) and reluctant to be associated with other young people in a similar position to themselves (Greene, 1998). Where it has been possible to recruit young people as peer advocates, it has been found that it is necessary to provide training and ongoing support in order to enable young people to fully understand the role and to develop their confidence and self-assertiveness skills (Russell, 2001). Most established advocacy providers and services provide close supervision for their advocates from experienced advocates in addition to providing them with initial and ongoing training. The final major barrier to providing effective peer advocacy is the problem of engaging with service providers and other people in authority (Harding, 1995). Atkinson (1999) for example suggests that one of the main factors preventing advocacy from working is resistance from adult-led services and organisations, which, without support from other adults, makes it very difficult for young people to engage in forums that would enable their voices to be heard.

2

1.3. Ten projects supported by the Diana Fund Ten projects were initially included in this study and a brief summary of each is provided below. Allsorts Youth Project: LGB Youth Team

Allsorts Youth Project was set up by a group of volunteers in October 1999 to address the needs of lesbian, gay and bisexual (LGB) young people in and around Brighton. Initially, a number of services were set up on a voluntary basis, including an under-26 drop-in, website, newsletter, lending library, confidential phone-line and email, workshops for LGB young people and training sessions for people working in agencies providing services to LGB young people. Due to the demand for services, Allsorts sought funding to set up the LGB Youth Team. The LBG Youth Team was to have two strands: a) to promote the well-being of LGB young people through the development of self-help groups, and b) to support and advocate for LGB young people who were in crisis, such as sex workers, homeless people and drug users. Both strands of work were to have a peer support element built into them. The self-help workshops were to be peer-led and delivered in schools, colleges and youth groups in the area; the crisis support was to be provided on a one-to-one basis and peer-delivered. Childrens Rights Officers & Advocates: Young Peoples Training Project

The mission of the Childrens Rights Officers & Advocates (CROA) is to develop local childrens rights and advocacy services for looked after young people and those in need. In June 1999, funded by the Nuffield Foundation and NSPCC, CROA launched their National Development Project to assist local authorities to meet government targets for setting up appropriate (child-focused) childrens rights and advocacy services. CROA sought additional funds from the Diana Fund to recruit a training officer to train 15 young people to participate in this process. Once trained, it was proposed that the young people recruited to the project would then be employed by CROA to mobilise other young people in local authorities to become involved in the development of childrens rights services in their local areas. Save the Children Fund: Young Refugees Rights Project

In 2000, Save the Children Fund (SCF) secured funding from the Diana Fund to develop a number of projects to support young separated refugees1 in England. Following a needs assessment based on interviews with 125 young refugees conducted during the first year of the project (Save the Children, 2002a), eight pilot initiatives were set up across the country. Four of the projects proposed to use a peer support and advocacy framework to achieve the aim of changing policy and practice relating to separated refugee children. These included the use of a peer adviser based at Heathrow, a peer mentoring project in Oxford, a young womens group in Hammersmith and Fulham and a peer supported young refugees rights project, based in West London.

1 The term refugee is used in this report to describe people seeking asylum and those with leave to remain

3

Youth Clubs UK: Body, Mind & Society

Youth Clubs UK was concerned about a lack of support for young women with eating disorders. YCUK secured funding from the Diana Fund to develop educational resources to be delivered to young women in community settings. This programme was to be called Body, Mind & Society, and it was hoped that when completed it would be disseminated to youth workers across Britain through a series of education and training events. It was proposed that a sample of young women with eating disorders would be brought together in four locations to work through set activities and exercises with the aid of a project worker in order to focus the resources to appeal to the target group. A second sample of young women was to be recruited to pilot the resulting resource, and a smaller group would deliver the evaluated programme to a number of groups of youth workers around the country. Project for Advocacy, Counselling and Education: Youth Development Project

The Project for Advocacy, Counselling and Education (PACE) has developed a number of services for lesbian and gay young people, such as workshops, counselling and youth services. Despite running these initiatives for some time, the organisation recognised that few of its users were young people (aged 16-25) and through a project grant from the Diana Fund intended to address this shortfall. The project grant was for a full-time youth development manager and a part-time project worker to set up an outreach-type project to try and engage LG young people with existing PACE services. One of the strategies it proposed to implement was a peer support service. Enable: Open Your Mind Not Your Mouth

In a survey conducted by Enable, it was found that the incidence of bullying towards young people with learning disabilities was unacceptably high but that there were very few places for the victims of bullying to go to for help. Enable set up a project in partnership with organisations in two other European countries to train a small group of young people with learning disabilities to work with children in schools to combat the problems of bullying. The funding for this project only allowed for a small number of children to be trained and only a fraction of schools visited. The Diana Fund awarded a grant to Enable to expand the project to train more young people to reach more schools. Mental Health Foundation: Crisis Advocacy

The Mental Health Foundation (MHF) is committed to developing young person-focused mental health services, and has conducted a number of research projects to find out the best way to involve young people in the planning and delivery of such services. MHF secured funding from a number of sources to run consultation projects in four mental health settings in order to develop models of good practice. The Diana Fund was part of this consortium, which paid for the recruitment of four part-time consultation workers to work with young people in each setting.

4

Children in Scotland: Citizenship in Practice

From their survey of organisations promoting the involvement of children and young people, Children in Scotland (CIS) identified a need to promote the participation of young people with disabilities (especially those from ethnic minority backgrounds) in decision-making. CIS secured funding from the Diana Fund to further develop an already established support network for groups and organisations representing the interests of disabled and minority ethnic children. The ideas generated from this network were to be fed into an existing childrens policy network. Hear Our Voice: Young Peoples Mental Health Project

Hear Our Voice (HOV) seeks to involve young people at risk of developing mental health problems in the planning and delivery of local mental health services. They do this through a process of consultation and feedback to local organisations and service providers such as child and adult mental health services. The project supported by the Diana Fund was to continue this work through a network of local support groups for young people in need. It was hoped that five groups would be set up to meet on a weekly basis: for young men, young women, young people leaving care, young people with eating disorders and young people with specific mental health problems. A monthly group would be set up for LGB people in partnership with another local organisation, and a group for young people in rural areas which would meet on a bi-monthly basis was to be set up in partnership with Young Farmers Clubs and community regeneration groups. Council for Disabled Children: Developing a Disability Rights Agenda

The Council for Disabled Children (CDC) project was geared towards developing a disability rights agenda, the idea being to put policy into practice by facilitating change in a range of statutory, voluntary and private services to make them more accessible and inclusive to young people with learning disabilities. To develop the disability rights agenda, CDC proposed to work with young people, their carers and service providers to develop and test a resource pack. The resource pack was to include protocols for information sharing and advice to services on how to implement provisions in the Disability Discrimination Act and to maximise the impact of the Connexions service for young people with learning disabilities and their families. The resource pack was to be made available to local authorities, Connexions service, parents and young people.

5

2. Evaluation overview 2.1. Aims and objectives of the evaluation The overall aim of the evaluation was to identify the different models of peer advocacy developed by a sample of projects supported by the Diana Fund and to look at how effective these had been in terms of achieving strategic objectives. In order to guide the evaluation a number of specific objectives were set, which were as follows:

to investigate and describe the models of peer advocacy used in projects funded by the Diana Fund

to explore the ways in which a selection of the projects implemented models of peer advocacy in practice

to assess the relative success of each model (based on literature and evidence provided by projects / their own evaluations)

to explore the views of providers and recipients of peer advocacy in the selected projects

to explore how far each project had met the aims of the Diana Fund with regard to involving, supporting and advocating for young people

to identify any messages for practice in peer advocacy.

2.2. Methods It was envisaged that five of the most appropriate projects would be selected for in-depth exploration and evaluation, based on the extent to which they were utilising a peer advocacy approach in their work. A range of documents held by the Diana Fund2 was used to categorise the ten projects, and the most relevant five were selected. In order to model and evaluate the success of the peer advocacy used in each project a two-stage evaluation design was used. 1. Exploratory stage At the start of the study, a researcher visited the selected projects to conduct exploratory interviews and focus group discussions with relevant stakeholders in order to begin to model their approach to peer advocacy. At this stage it was found that two projects (Allsorts LGB Youth Team & CDCs Developing a Disability Rights Agenda) were not proposing to use peer advocacy models in the ways in which the evaluation had anticipated, and were eliminated from the study. To compensate, the next most appropriate project was selected, making a final sample of four projects. 2 Including funding proposals, end of year reports and other information supplied by organisations in support of their funding bids (e.g. annual reports, survey results and publicity materials)

6

2. Evaluative stage In order to evaluate the extent to which each project had implemented their proposed model of peer advocacy and to allow various stakeholders to reflect on what had been achieved, follow-up visits were made to each of the four projects approximately 10 months after the first (see table 1 for a summary of research participants).

Table 1 Summary of interview and focus group participants Project Interview/focus group participants

Project

coordinators Key workers Young people Other project staff

Exploratory stage

Allsorts 1 1 1 CROA 1 1 MHF 1 1 6* 13 HOV 1 4* 7* CDC 1 SCF 1 1 Evaluative stage CROA 2 14 MHF 1 1 1 HOV 1 1 5* 15 SCF 1 Total 9 9 23 3

*Focus group discussion

Where possible, interviews and focus group discussions were tape-recorded and transcribed verbatim. Notes were taken of discussions that were not tape-recorded. Transcripts and other documentation were imported into NVIVO (a qualitative software package) and analysed inductively to generate salient themes. Interview data was triangulated with documentary evidence to build up a detailed model of each projects approach to peer advocacy and to explore the data for key messages.

3 Programme manager 4 Childrens rights officer 5 Training officer

7

3. Four practice models A detailed description of the four projects selected for further exploration and evaluation is provided in this chapter. These are as follows: 1. Save the Children: Young Refugees Rights Project. 2. Hear Our Voice: Young Peoples Mental Health Project 3. Childrens Rights Officers & Advocates: Young Peoples Training Project 4. Mental Health Foundation: Youth Crisis Project 3.1. Young Refugees Rights Project Organisation Save the Children Location Hammersmith, West London Start date September 2000 Finish date September 2003 Background In September 2000, Save the Children (SCF) secured funding from the Diana Fund to develop a programme of activities to support young separated refugees in England. The objectives of this programme were as follows:

to carry out a systematic child-focused needs assessment of separated [refugee] children in a variety of locations across England

in partnership with children, statutory and voluntary groups, to set up a minimum of eight initiatives which will address the issues identified in the above assessment

to enable young people from the various initiatives to meet, share experiences and voice their concerns to those in power. (Where appropriate this will involve advocating for changes to policy, practice and legislation)

to actively encourage and support the participation of separated [refugee] children at all stages of project development

to develop child-focused systems for monitoring and evaluating the initiatives so that the issues raised and good practice can be shared to a national audience.

(Source: Diana Fund grant application form) Following SCFs needs assessment, eight pilot initiatives were set up across the country. One of these was the Young Refugees Rights Project (YRRP), based in West London. The initial impetus for the YRRP came from SCFs contact with a young separated refugee who was an award holder on their Saying Power Millennium Awards Scheme, a training scheme set up to promote young peoples participation in their local communities. This young person had wanted to do something about the problems he was experiencing as a young refugee separated from his family, such as gaining access to basic services and local support networks.

8

In September 2000, the young person who initiated the project became the part-time coordinator on the YRRP project (2 days per week). The aim of the project was to set up and manage a support group for young separated refugees living locally. (The project was to cover the three London boroughs of Hammersmith & Fulham, Ealing, and Kensington & Chelsea). The purpose of the group was to enable young separated refugees to share knowledge, experiences and ideas in order to identify and address the problems they were experiencing. As part of the project, a member of staff at SCF was appointed as a mentor. The mentor was to meet with the young-person coordinator on a weekly basis to discuss the weekly plan, to review the projects progress and to offer guidance and support. The development of the young peoples advocacy group The evaluation found seven key stages in the groups development, from the early planning stages through to its restructuring, each of which is discussed below. Project development

The young-person coordinator received training under the Saying Power scheme, which equipped him with the basic skills necessary to set up and manage a project. The content of the training programme ranged from tips on project development and management to training on how to devise and implement child protection, equal opportunities and confidentiality policies. After becoming appointed to set up and run the YRRP, the young-person coordinator worked with his mentor to develop an outline plan, which included a broad statement of aims and objectives (it was envisaged that a more detailed set of aims and objectives would be formalised after the formation of the group). It was proposed that the group would be set up for young refugees aged 14-20 living in the local area, which was to hold formal meetings twice a month. There would be provision to hold ad hoc meetings if and when important issues arose. Meetings were to take place at SCF offices in West London. The young-person coordinator was to be responsible for managing the group and would also offer individual support to group members on a more informal basis throughout the week. It was reported by the mentor that the project development process took about two to three months to complete. Recruiting group members

Once a coherent strategy had been devised, the young-person coordinators first task was to recruit young separated refugees to join the group. A flyer advertising the group was drawn up and posted on notice boards at a local FE college, where there was known to be a large population of young refugees. The young-person coordinator also gained consent from college tutors to address students in class, recruited young people through his network of contacts and made contact with the Asylum Team within the local Social Services Department. As a result of this recruitment process, a number of young separated refugees attended the first group meeting held in February 2001 (four months after the young-person coordinator

9

came into post). As a result of this initial meeting, the young-person coordinator reported that a core group of eight or nine members was formed. Developing a group identity

Because the group had been conceived as a peer advocacy initiative, it was decided that the groups first task was to develop an identity and to draw up a statement of its intentions. The group wrote a mission statement, set out a clear set of aims and objectives, outlined their intended activities and devised a group logo and motto. These were formalised and printed as a project leaflet, which was used to publicise the group and promote their activities. The aims and objectives devised by the group are set out below.

to provide information about rights, entitlements and services available for refugees

and asylum seekers and to support them to access those services to raise awareness in the community, local authority and nationally of issues facing

young refugees and asylum seekers to challenge discrimination to work together as a group and with other young asylum seekers and refugees to get

our voices heard and to influence decision-makers at a local and national level to encourage other young refugees and asylum seekers to participate in local activities

and to promote their integration in the society to campaign for equal rights and opportunities for young refugees and asylum seekers.

After developing their collective identity and formalising their aims and objectives, the group then began to identify the most important issues concerning young separated refugees in the local area. The main issues of concern centred on access to and quality of local services, some of which were described by the young-person coordinator:

the food that was being served in the hostels was really bad, and the food, it was all past expiratory date. The young people were getting ill. About visiting hours, that sometimes maybe they werent allowed to go out after a certain time or friends werent allowed to come in. They werent getting any travel assistance.

Local advocacy

In order to try to bring about change relating to the issues identified above, the group devised strategies to get their voices heard. They began by identifying the key officials responsible for the provision of the local services they wanted to change. These officials were contacted and invited to attend group meetings. As explained in the following passage, group members were encouraged to speak out about their concerns during these meetings:

one of my jobs is to encourage them, to give them confidence to bring their own stories from their accommodations, whatever. To tell the social workerstheyre afraid of social workers. First two to three meetings theyre really scared of them, they couldnt talk, but we managed to get them talking and tell that to the social workers.

(Young-person coordinator)

10

Using this strategy the group was able to express their concerns to representatives from social services and the local education authority. Local service providers, such as the Benefits Agency, housing department and youth service, were invited to group meetings to inform young people about their rights and entitlements. The group also devised ways to take their messages out into the local community in order to raise awareness about being a young separated refugee and to challenge discrimination. Again letters were sent to service providers such as schools and colleges to inform them about the project, which resulted in the group being invited to present at events and assemblies organised in schools.

So basically what we do is we just go and do a presentation, its not just more of the issues that these young people are facing, not official, not professional, but just in a personal and informal way: this is who we are, why were here, and these are the problems that we are facing in this country.

(Young-person coordinator) As a result of the groups activities, they became well known locally and were invited to join local forums and to contribute to local initiatives. For example, the young-person coordinator was invited to sit on the local strategic partnership board a multi-agency decision-making forum - as a young person representative and, along with other members of the group, became involved with a local youth forum. National advocacy

The YRRP became involved in a national campaign run by SCF and the Refugee Council to raise awareness of the problems faced by refugees in this country. The key issue of interest to the group was the governments turning 18 policy, when young refugees automatically lose access to many of the services and rights afforded to other young people. The young-person coordinators mentor explained that this was not one of the YRRPs planned activities:

because Save the Children had good links with Refugee Council, and you know, refugees and things was such a like hot issue and everybody wanted to talk about it, it was a really good opportunity. So a lot of efforts and time of the Young Refugees' Rights Project went in meeting, maybe politicians, ministers, lobbying on [the governments] White Paper, etc.

As part of their involvement with the Refugee Councils campaign, members of the YRRP were invited to put their views forward on the transition from childrens to adult services at a number of meetings with ministers from several government departments and gave interviews to the media. In order to raise awareness about the situation of young refugees and asylum seekers the group also produced a video, the young-person coordinator gave a presentation to the Labour Party conference 2001 and members of the group were involved in planning a national conference with the Refugee Council.

11

Doing crisis advocacy

In addition to the organised campaigning and advocacy work, the group members also provided support to their peers who were experiencing a variety of crises. This posed a particular challenge to the young-person coordinator:

We hadhousing crises everyday. Young people were being homeless, ringing, trying to get alternative accommodation. You have members who are part of the group, and suddenly they come and they've been thrown out of the hostel. You can't just leave them, you know.

Restructuring

After approximately two years, and following an evaluation exercise carried out to determine the effectiveness of the project, it was decided to restructure the group. It was found that there was a small group of young people who were committed to continuing with the peer-advocacy work and a larger group who wanted to be involved in a support group, with all the social benefits that that brought with it.

We needed to meet the needs of all members, all the young people, so one side of it was the social and emotional support and you know, finding out about entitlements and activities or just dropping in and spending some time, and the other side is advocacy.

(SCF mentor) The solution found was to create a core group who made decisions concerning the groups advocacy strategy and a main group, which became a drop-in for young people to meet, socialise and use as an access point for gaining information about their rights and services. The core group reported to the main group on a monthly basis. Impact of the YRRP As a result of the project an active advocacy and support group for young separated refugees was established. Membership of the group fluctuated due to the transient nature of the population group, but SCFs mentor estimated that numbers averaged between 16-20. The group included young men and young women from a range of countries including Afghanistan, Iraq, Kosovo, Somalia and Ethiopia. A number of impacts were identified during discussions held with the SCF mentor and the young-person coordinator. Due to the limitations of the study, there was no way to verify these claims, however, the following provides a flavour of the impacts the project had on members of the group, on local services and on SCF as the host agency. Impact on YRRP members

YRRP fulfilled its primary function of providing social support to young separated refugees, which, according to the young-person coordinator, had helped to reduce their social isolation and feelings of loneliness. It was reported by the young-person coordinator that the group had also raised awareness among young refugees of a variety of issues:

It benefited young people as wellfirst of all giving them confidence, giving them knowledge of the whole refugee and asylum system, the whole process, and their entitlements, what are their entitlements, services they can access.

12

With this knowledge and confidence, the young-person coordinators mentor explained that she felt that the project had empowered young refugees to put their concerns forward:

I think the project has been very successful in giving young refugees a voice, and asylum seekers a voice. It has been very successful in getting them involved, building their confidence, and working, you know, on their enthusiasm, and supporting them in doing what they want to do.

Impact on local services

The second type of impact the YRRP had was on the policies and practices of local services such as social services and colleges. Initially the successes were relatively minor, such as managing to get officials to attend meetings, including the manager of childrens services from one borough. This, the young-person coordinator explained, led to better outcomes:

In my first year it was really hard just to get in touch. I mean, most of them they were not even ready to talk. But the second year, once wed started working with them through some of the childrens social service workers, they were more open to young people. They wanted to really listen to these young people.

After the group had engaged with social services, a number of changes were made to the standards of care provided by the local authority, which were attributed to the YRRPs activities. For example, it was reported by the young-person coordinator that the quality of the food served in hostels improved and the rules governing visiting hours in residential homes were relaxed. The local authority also agreed to provide a weekly travel allowance to enable young people to get to and from college and provided young refugees with cash allowances rather than having to use local authority vouchers. Similar successes were reported with regard to the groups engagement with local education services. For instance, it was reported that a local FE college had responded to requests for additional support for young refugees in their ICT classes and had set up a befriending project, where staff members acted as personal mentors and a source of social support to young refugees. The group was also instrumental in setting up drama workshops for young refugees to raise awareness of their rights and entitlements. Impact on the host agency

Some important impacts were reported on SCF, the agency that hosted the project. The following passage illustrates how much the SCF mentor had learned through working on this project:

As workers we have learnt a lot about how to work and involve young people and asylum seekers and how to deal sensitively with issues. Its been a constant learning process, because when I started work with [the young-person coordinator] Id never worked with young refugee and asylum seekers.

With the aid of an independent evaluation, this learning has resulted in the publication of guidance on how to set up young refugee support groups (Save the Children, 2001b), and was said to have informed and influenced SCFs refugee strategy and future work in this area.

13

Outcome The young-person coordinator left the project in May 2003 to start a university course. The young-person coordinators mentor at SCF completed a number of applications to funding bodies in order to continue the project, without success. As a result the YRRP stopped functioning as an active support and advocacy group, although a number of young people who attended the group remained in contact with each other and with SCF. SCF did secure funding from the Diana Fund to run a three-year self-advocacy project based in three sites in Britain, called Brighter Futures, which incorporates many of the lessons learned from the YRRP project.

14

3.2. Young Peoples Mental Health Project Organisation Hear Our Voice Location Truro Cornwall Start date December 31st 2001 Finish date December 31st 2003 Background The Young Peoples Mental Health Project was run by a community-based organisation called Hear Our Voice (HOV), which was set up approximately eight years ago to offer advice and support to young people experiencing difficulties in their mental health. HOV had a staff team of 11, including a project manager, deputy manager & training officer, seven youth workers (one full-time, three part-time & three sessional), an administrator and a driver. (One of the youth workers was a specialist arts worker). The overarching aims of the organisation are as follows:

to investigate the mental health needs of young people aged 11-25 to target and work with specific groups of young people at risk of mental health

problems to develop a voice for young people on mental health issues to establish lines of communication in order to develop service provision to work in partnership with other agencies, particularly statutory agencies.

One-to-one support

HOV offers one-to-one support to young people who contact the organisation. Self-referrals are taken from young people and parents over the telephone (which was staffed between 9a.m. - 3.30p.m., five days a week). Young people can also refer themselves by dropping in to the office in Truro. Targets have been set to ensure that all self-referrals result in a visit by a member of the management team to assess young peoples needs. Referrals are also taken from other agencies, such as social services, which undergo a similar assessment. Initial meetings are arranged at a venue of the young persons choice. During these meetings, young people are informed about the organisation and have their mental health status and needs assessed. Depending on their perceived needs, they may be signposted to another service, allocated to a youth worker for one-to-one support or invited to attend one of HOVs young peoples groups. It was estimated by the project manager that by the end of the project HOV was receiving one referral a day, a ten-fold increase on the previous year, of which about half resulted in hands on youth work.

About the Young Peoples Mental Health Project The objectives of HOVs Young Peoples Mental Health Project (herein, the project) were as follows:

to work creatively with young people in small groups or individually to explore how mental health issues impose on their lives

15

to assist young people to develop skills to communicate their needs (e.g. through video, photography, creative arts, music, drama, assertiveness training and issue-based workshops)

to network and gain support of other agencies in the interests of young peoples mental health

to work in a creative style that is young person-friendly, empowering and which values their experiences and abilities

to explore how mental health impinges on young peoples lives and reduce attached stigma through a positive programme of informal education.

(Source: Diana Fund grant application form)

Project plan

It was anticipated that HOV would set up five young peoples groups that were to meet on a weekly basis, including groups for young men, young women, young people leaving care, young people with eating disorders and young people with specific mental health problems. It was also hoped that a monthly group would be set up for lesbian, gay and bisexual young people in partnership with another local organisation. HOV planned to run consultation exercises using a variety of art-based techniques. The findings of these consultations were to be represented to decision-makers by young people themselves or through members of HOVs staff team. Developing and running groups Through the one-to-one work carried out as part of HOVs core activity, it was found that three types of group were needed: groups that were open to young people to access on an ad hoc basis, groups where access was restricted to young people with particular needs and workshop groups based in school. Open access groups

The aim of open access groups was to provide young people with an informal and supportive environment to help them deal with problems they were experiencing with their mental health. HOV had set up an open access group for young men and a weekly drop-in group for young people. The groups were held in community venues such as youth clubs and sessions lasted between two to three hours. Where necessary young people were brought to the groups and dropped off by HOVs driver. Young people were free to drop out and rejoin the groups as and when they needed to, as one youth worker explained:

we would never say we feel like your time is up or you dont need us anymore. It is their decision that they would say look, I have been coming to you every Monday night for six months, I feel loads better and I have got other things to do on a Monday night and I dont need your support anymore.

Group members had a certain degree of autonomy over the activities that they wanted to do and were allocated a budget to fund various activities. Closed access groups

Closed access groups aimed to provide young people with a safe environment in which to explore a range of issues, such as anger management, drugs, crime, sexual health and

16

bullying. One closed access group had been set up in a residential home, where meetings were held on a weekly basis. Workshops in school

One of HOVs youth workers had taken responsibility for managing a programme of awareness raising workshops delivered to schools and colleges in Cornwall. The workshops consisted of two sessions. During the first, a range of topics was discussed such as mental health awareness, eating disorders, stress and body image. Young people attending the workshops were asked to provide feedback, which was evaluated by the youth worker. The results of the evaluation formed the basis of the second visit, when issues that arose were discussed. It was estimated by the project manager that during the past year (2002-3) around 1000 young people had attended these workshops. Consultation In order to promote the voices of young people involved with the project, HOV had run a number of specific consultation exercises. These involved young people from across the organisations range of work. During these consultations young people were encouraged to express their views on specific issues through the use of art-based workshops, such as photography, video, painting and poetry. Consultations have been organised in response to requests from service providers such as the Child and Family Psychology Service, Youth Enquiry Service, Child and Family Centre and Early Intervention Service. HOV were also working with Young Farmers groups to produce a video of their experiences for dissemination at local events. For these consultations, it was general practice for young people to receive expenses and a small payment for their time. HOV had also organised consultation exercises aimed at improving their own services, exploring the ways in which groups worked and looking at various aspects of HOVs identity such as their website, literature and logo design. Dissemination There were two ways in which young peoples views were disseminated to wider audiences such as local decision-makers. Firstly, through the formal consultation work described above, where part of the consultation involved presenting their artwork and stories at local events. For example, young people exhibited their artwork at a local caf, and invited representatives from a range of agencies to view the work. For another consultation exercise, young people produced a video of their experiences of mental health services, which was shown to the Child and Family Centres management committee. The second way in which HOV tried to get young peoples voices heard was through staff contact with various forums, such as conferences, meetings with local officials and training events. HOVs training officer has delivered staff training at the local Child and Family Centre, in which young people were involved, and is a member of the Mental Health Implementation Team, which is the body that makes recommendations about the nature of service provision in the county.

So sitting on that, you know weve got a good direct route feeding back up to this [management] group and feeding back down to our young people.

(Training officer) Impact From the discussions with staff it was clear that the main impact of the project had been on the status of the organisation itself. As a result, HOV reported that the organisation

17

had received many more referrals and had been short-listed for the Health Impact Award, a national award which assesses the relative impact organisations have made to the health of their communities. The spin-off in terms of young peoples advocacy was that HOV had gained credibility within the statutory sector and had therefore become involved in the development and delivery of local mental health services.

Were beginning to be seen as a young persons user group and people ask us about different aspects of young people, what do young people want?

(Training officer) One example was HOVs involvement in the planning and delivery of a young peoples resource due to built in the county for young people with complex needs, for which the organisation had been consulted on the building design and staffing.

18

3.3. Young Peoples Training Project Organisation Childrens Rights Officers and Advocates Project location The Childrens Society, Leeds Start date September 2000 Completion date August 2003 Background The Young Peoples Training Project (YPTP) was a component of CROAs6 National Development Project, which was launched in June 1999 to work towards meeting the governments targets to promote user participation in the development and delivery of services for looked after children and young people and those in need. As part of the National Development Project, CROA developed a set of training materials for social care professionals called Total Respect (Willow & Plowden, 2000), and recruited and trained a small group of young people who had experience of being looked after by local authorities to deliver these materials in a training context. Due to the perceived success of this approach, CROA sought funding from the Diana Fund to recruit a training officer to develop a training programme for a larger number of looked after young people and care leavers and to help them gain accreditation for their work. Aims and objectives The principal aim of the YPTP was to mobilise young people to participate in the development of childrens rights services within their local authority. It was hoped this would be brought about by raising young peoples awareness of the ways in which they could become involved in planning services, by providing them with some basic skills and by encouraging them to participate in this process. In order to achieve these aims, CROA planned to deliver a programme of peer-delivered training, largely based on the Total Respect training pack. It was proposed that CROA would recruit fifteen young people with experience of the looked after system, train them to deliver training to young people in local authorities around the country, who, it was hoped, would then work with staff at their childrens rights service to deliver Total Respect. Implementation of the YPTP The evaluation identified five main stages in the projects development, which are briefly described below. Developing materials

The first stage of the project was to devise two short training courses. This was done by the training officer with the help of two young people who had been involved with developing materials for the Total Respect training pack. A brief overview of each course is given below. Training Young People for Active Participation was a two-day course aimed at encouraging young people in local authorities to participate in the development and delivery of services. The course content included examples about how young people could become involved in service development, some practical skills work (such as doing presentations and confidence

6 CROA is a membership organisation for childrens rights officers and advocates working in England and Wales.

19

building) and advice about how to behave in a professional way in a variety of training situations. Training the Trainers for Total Respect was a three-day course, which it was hoped would prepare looked after young people to work alongside adult trainers and/or childrens rights officers in their own local authority to deliver the Total Respect training pack. This course covered the topics described above with an additional day about delivering Total Respect. Both courses were to be delivered at events organised by local authorities by a small team consisting of one or two adult trainers and two young people. It was hoped that young people who had been trained to deliver these courses would receive accreditation from the Open College Network. Recruiting the young trainers

In order to recruit a group of young people with experience of the looked after system, a two-day residential event was organised in Manchester during March 2001. Young people were nominated to attend this event by their local childrens rights officer. Care was taken to ensure that their childrens rights officer accompanied the young people to the event on the first day and that two young people who were working with CROA at the time (known as Pioneers for Childrens Rights) were on hand to welcome them. Following this initial recruitment and introductory event, young people who were judged to have possessed suitable credentials to become young trainers, and who had shown an interest and commitment to participate in the project, were invited to attend two further events to prepare them for the forthcoming training. Training the trainers

In order to prepare young people for a variety of training situations, two team-building weekends were organised. These were run by external facilitators and attended by the two Pioneers for Childrens Rights. Seventeen young people attended the initial recruitment event in Manchester, from which a core group of six young people was recruited and trained to deliver the training materials. Of these, four young people (all of whom were female) became regular peer trainers, with the other two (one male, one female) becoming involved occasionally. Delivering the training

In order to promote the training to local authorities, CROA organised a programme of taster days on Total Respect in venues around the country, based on a workshop format. These involved teams of up to three adult trainers and up to three young person trainers visiting local authorities to introduce the training pack to staff and to describe what participation in the full course would involve. Local authorities were then invited to opt to receive the full training. The full training was provided at cost to local authorities. The team delivering the training arrived at the local authority the night before the first days training to plan it out so that everyone was clear about their respective roles and responsibilities. The young trainers were paid an agreed per session rate.

20

A total of 12 taster days were delivered to around 40 local authorities across the country, which resulted in the delivery of the full training programmes involving young people to 28 local authorities. It was estimated by the training officer that around 200 young people were reached through these training programmes. Participation

Once the training had been delivered, CROA had very little contact with the local authorities. It was expected that the childrens rights officers would organise subsequent training in collaboration with looked after young people in their local authorities. Impacts Two main types of impact were identified by the evaluation: there were clear impacts on the core group of young trainers and the training impacted on the young people who attended the courses. Impacts on the core group of young trainers

The project had an extremely positive impact on the personal development of the young trainers. It has offered them the opportunity to learn new skills and to build a CV. The young people were in the process of having their work accredited. Two of the young people have become members of CROAs management committee and active members of the organisation. The young people spoken to as part of this evaluation reported that the project had increased their self-confidence:

Ill do anything there, doesnt bother me, and my self-esteem, its given me so much confidence and its given me a lot of other things, like friendships with the other young trainers.

(Young trainer)

As a result of their involvement in the project, the training officer reported that some young people had made significant changes to their lives. One of them has gone on to work for the NSPCC and two have gone to work for local authorities. Impacts on young people who received training

It was not known exactly how many young people were reached through this training programme, but as part of this evaluation the work was followed up at a local level. The childrens rights officer at one London borough where the training took place said that young people had become very involved in the design and delivery of childrens services. The future Although funding for the National Development Project ceased in March 2002 and the Young Peoples Training Project finished at the end of August 2003, CROAs training officer was confident that the peer-delivered training programme would continue for as long as local authorities requested it, as it was explained that this element of the programme had become reasonably sustainable because CROA made a charge to local authorities to cover costs. Work on developing the initiative further would, however, be put on hold until further project funding became available. Developing the skills and ability of young people in local

21

authorities who had received training to become more active in the planning and delivery of services was identified as a potential area for future development. CROA has secured additional funding from the Carnegie UK Trust, over and above the sum earmarked for evaluation through the Diana Fund, to carry out an independent evaluation of the project.

22

3.4. Youth Crisis Project Organisation Mental health Foundation Location Barnardos Marlborough Road Partnership, Cardiff Start date January 2002 Finish date January 2004 Background The Youth Crisis Project was part of a Mental Health Foundation (MHF) work programme, which was set up to address shortcomings identified in local services for young people experiencing crises in their mental health (MHF, 1999; Smith & Leon, 2000). MHF wanted to explore different ways of involving these young people in the development and delivery of local mental health services. The stated objectives of this work programme were as follows:

to develop replicable models of facilitating the voices of young people aged 15-25 experiencing mental health problems and who are at risk of experiencing severe crises in their mental health

to develop ways of using these models to influence the development of community-based services which are responsive to the young peoples needs

to ensure that these services can then provide appropriate support in the transition to adulthood in a way that is empowering to young people

to disseminate these models to service providers nationally. (Source: Diana Fund grant application form)

Project plan

MHF devised a two-stage strategy to be completed over a four-year period. Stage one was to address the first objective, which was to explore ways of consulting young people with mental health problems about mental health services. Funding for this stage was secured from the Diana Fund. It was hoped to secure further funding to implement stage two on the basis of the success of the first stage. In stage two, MHF wanted to put what it had learned from stage one into practice in order to influence the development of young-person focused community mental health services. It was envisaged that in the early stages of the project, the consultation workers would map out local mental health service provision, which would then provide the contact points for recruiting young people to take part in the consultation work. In year two, it was planned to carry out consultations with these young people and to present findings of these consultations at national events run by MHF. In order to develop ways of consulting young people, MHF proposed to employ four part-time consultation workers who were to be based in a range of host agencies. In each host agency a manager would be responsible for the day-to-day supervision of the worker and coordination of the project. The four host agencies selected were MIND in Brighton and Hove, Streetwise in Newcastle-upon-Tyne, The Mental Health Foundation in Glasgow and Barnardos Marlborough Road Partnership in Cardiff.

23

Implementation of the project at Barnardos Barnardos Marlborough Road Partnership is a generalist agency, providing support to vulnerable children and young people in the Cardiff area and a range of services such as supported housing and family support. The way in which the MHF project developed at Barnardos is described below.

Recruiting young people

During the projects first six months, the consultation worker visited voluntary and statutory mental health services and agencies on the local Mental Health Forums mailing list. During these visits each agency was informed about the projects aims and objectives. At the same time, the consultation worker explored the nature of services provided at Barnardos Marlborough Road Partnership. At Barnardos, contact was made with a number of young people attending groups and/or receiving services. With their help, flyers publicising the project and inviting other young people to participate were designed and sent to local service providers. These were also circulated via local newsletters and handed out at local conferences and events on mental health. As a result, a number of young people from Barnardo's and other local agencies responded. One-to-one meetings were held with these young people to determine what their needs were and to discuss ways in which to develop the project. From these discussions it was decided that is was necessary to set up two consultation groups based at Barnardos: a presentation group and a girls group. The presentation group

The presentation group was set up for young people who were interested in telling their stories about their experiences of mental health and the quality of service provision and to get them to think about how these services could be changed to better meet the needs of young people in crisis. As its title suggests, the group was organised specifically to prepare young people to present their thoughts, views, experiences and ideas to service providers (and anyone else who was prepared to listen) at various forums, such as meetings, workshops and local conferences. Membership of this group fluctuated over the course of the project (at around six young people), with new people coming in and others dropping out. Meetings were held every fortnight during the afternoon. From the outset, the aims and objectives of the group were discussed and clarified and boundaries about how the group would operate were set. These included statements about the groups aims and objectives, ethical consent, confidentiality and rules governing acceptable behaviour within the group (for example, it was agreed that group members would listen to and respect each others viewpoints at all times). Once a clear set of aims, objectives and rules had been worked out, the consultation work began. The consultation started with a brainstorming session to look at ideas related to each of the groups objectives. For instance, one of their objectives was to ensure that mental health services respected young peoples rights, so work revolved around what this meant and how this could be achieved. The group decided that in order to get their messages across to a potential audience, it was necessary to develop a visual display and a verbal presentation. For the visual display, young people produced pieces of artwork that represented how they felt about the standard of care they had received from mental health services. For the presentation,

24

young peoples ideas were listed on big pieces of paper laid out on the floor so that everyone could see each others ideas and felt able to put down their own. Young people were also given the opportunity to put forward suggestions in confidence, at the end of meetings or over the telephone. This exercise was completed for each of their objectives. From the materials produced during these brainstorming sessions, the young people worked with the consultation worker to produce a script for their presentation. The consultation worker collated all the ideas and printed them out onto separate pieces of paper. These were sorted by the young people into a hierarchy, based on how relevant they felt each idea was to achieving the desired objective. As a result of this process, some ideas were discarded and others added. The process of adding and removing ideas carried on until the last possible moment before the work was to be presented publicly. Once the content of the presentation had been agreed, the young people then discussed how to present the material. It was decided that each member of the group would choose selected passages to present. The girls group

The girls group was devised for a number of young women who were identified by the project as wanting to speak out about the quality of services, but who did not want to represent their views outside of the group. The purpose of this group was to look at issues around self-esteem and to explore ways in which services could be made to make young women feel better about themselves. Again, like the presentation group, boundaries were set over the activities and rules governing the content and conduct of the group. In order to structure the consultation work, the consultation worker devised a variety of informal activities, one of which is described below:

The last time we met we played pass the parcel and in each layer they had like little sparkly hair slides or a sweet or something and a question and it wasnt specifically meant to be about mental health it was just a question like where is your favourite place in the world? or where do you feel safest? or who is your favourite person in the world and why?. But they focused it all on mental health and my write up for the group for that session was brilliant because when Id written where is your favourite place in the world I was expecting someone to say Florida but the answer that was given is well, my bed is the safest place because its the only place people cant get at me.

(Consultation worker, MHF)

Young peoples views were recorded using feedback forms and a diary kept by the consultation worker. The girls group met on alternate weeks to the presentation group and was regularly attended by five to six young women. Dissemination

Young peoples views, experiences and ideas generated through the consultation work were disseminated in two ways. Firstly via the MHF, where young people from the presentation group met up with young people from the other three sites involved in the MHF project at national events held in St Albans, Brighton and London to explore the issues arising out of the consultation work. These events have enabled the young peoples work to be fed into the

25

development of the second phase of the project. The work done in the four sites has also been closely monitored through an evaluation being carried out by Barnardos Policy, Research and Influencing Unit (an interim report was produced in July 2002 and a final report is due to be completed by April 2004). Young people have also presented their ideas at a local level. The young people were initially asked to present their artwork and presentations at a meeting with various mental health professionals arranged by the local health authority. The ideas generated by young people were also disseminated at conferences attended by the consultation worker. This resulted in the group being invited to present their materials at a number of subsequent conferences and events. To date, the presentation group have developed presentations on a number of topics such as their general experiences of mental health care, services for one- to four-year-olds, homelessness and mental health, relaxation techniques, young offenders and mental health and the MHF project itself. Presentations have been made to the following audiences:

National Service Framework meeting, Cardiff Commission for Health Improvement meeting, Cardiff Young Minds conference, Cardiff World Mental Health Day, Cardiff Young offenders conference, Cardiff MHF Bright Futures conference, London Barnardos Health Team conference, Birmingham Young Peoples conference, Leeds Barnardos National Committee meeting Barnardos Annual General Meeting

The young people involved in the Youth Crisis Project also helped to set up and deliver their own conference in Cardiff, which attracted around 150 people representing a range of service providers. This consisted of formal presentations with a question and answer session, followed by workshop sessions. The presentation group were also involved in developing a piece of coursework for the Open University, which involved producing a CD with an accompanying booklet of their experiences of mental health services. Impacts Through the Youth Crisis Project, Barnardos set up two consultation groups, which, through a number of dissemination activities, promoted young peoples voices concerning the quality of mental health services to various audiences. A number of impacts of this process were identified by this evaluation: on the young people involved in the groups and on local mental health services. On the young people involved

Barnardos staff felt very strongly that the project had empowered an otherwise disenfranchised group to speak about their experiences:

Theyve never ever had the opportunity to talk about mental health, they may have had experiences of in-patient and out-patient care as provided by statutory services,

26

but nobody has ever asked them and I think for some of them its been the first time theyve actually really been able to explore how they feel and what mental health means.

(Project coordinator) Through their participation, young people said that they had made new friendships and contacts with their peers, who they said they would not normally associate with, and that they had developed a number of social skills such as communication, negotiation and presentation skills.

One of the young people in particular when I first met them they couldnt look at me and if they were in a room full of people they would sit facing the wall and they didnt really interact with anyone very well at all and now to see that young person kind of phoning up regularly with ideas or turning up regularly or emailing me or saying look at this Ive seen or bringing in newspaper articles that hes seen and seeing the change in him from when I first met him is amazing. And those changes in all of them is, I think, a big achievement.

(Consultation worker) There were several reported impacts on the health of young people who participated in the groups, such as increases in young peoples self-confidence and their ability to cope. For example, the therapeutic benefit of being involved with the presentation group was explained by one young person who had participated from the beginning:

This makes me happy and helping other people makes me more happy than taking pills every day. So Id sooner be doing this and different forms of making yourself feel better instead of throwing things down your throat all the time.

On local mental health services

Clearly the project was successful in putting young peoples voices forward to various service providers. It was beyond the scope of this evaluation to find out whether their voices were heard or indeed listened to. However there were some important consequences of the project with regard to service provision for young people with mental health problems that are worth reporting, the main one being the impact of the project on the way in which services were organised by the host agency. MHFs programme manager, for instance, felt that the project had stimulated Barnardos to think about how it could provide better services, which took young peoples mental health issues into account.

I think to have a mental health worker in a generalist agency like this is really beneficial because it opens up mental health as being just another service. So you can come here for parenting advice or for first aid advice, or if you need help with accommodation, then you can also come here if you have things to talk about mental health or you want to meet other young people with mental health issues.

(Project coordinator) It was also felt that the project had informed the work of the MHF and had pushed the provision of community mental health services up on the MHFs agenda.

Finally, there was some evidence to suggest that the project had made some progress locally.

27

There is an inpatient unit locally that Ive tried for the last two years to be able to do workshops within and Ive really battled and tried and its been a nightmare trying to get in therefinally, it was a couple of months ago, at one of the conferences, two workers from that unit did approach us and say weve been thinking about it and we would like you to bring the young people in to work with the young people in the unit. So I see that as a success.

(Consultation worker) The future MHF have made a commitment to fund the project for a further year in the first instance with a view to working towards achieving stage two of the programme. This funding is due to be released in April 2004. Barnardos has agreed to support the work of the two groups for a further three years.

28

4. Discussion: messages from the research A number of themes emerged from the discussions held with project coordinators, project workers and young people, that offer some insights into the difficulties of doing peer advocacy work and which highlight some potential strategies to overcome such difficulties. 4.1. Recruitment and group membership As the four case studies indicate, one of the fundamental problems encountered by projects setting out to develop groups of young people to do peer advocacy was recruitment. A second difficulty, in some cases, was maintaining stable group membership. Recruitment

For most projects the process of recruitment was time-consuming. This was especially the case for new projects. SCFs Young Refugees Rights Project and MHFs Youth Crisis Project took between three to six months to recruit young people to participate in their groups. Projects that were already well established in the community, such as HOVs Young Peoples Mental Health Project, found it much easier to recruit young people to take part in consultations and to get them involved in advocacy work as they already had a base of young people to work with.

In addition to overcoming practical recruitment problems such as finding locations to recruit from, gaining access to young people, explaining to young people about the project and motivating them to take part, the evaluation found a number of other barriers to recruitment. One of the main difficulties was overcoming the stigma young people felt was attached to being identified with certain groups, as the young-person coordinator on SCFs Young Refugees Rights Project explained:

First of all I find it really difficult to get them inbecause most of them didnt want to be labelled as refugees or asylum seekers, they didnt want to outgo themselves who they are.

There was a feeling among the workers that the best way to overcome this was to be clear about the groups identity and purpose and to bring young people along with them. The young people spoken to during the course of the evaluation found this upfront approach liberating, especially those taking part in the mental health projects. Some of the project coordinators highlighted the problem of recruiting young people with as wide a range of experiences as possible. As the MHF project coordinator explains, the projects that were attempting to engage with mental health services found it very difficult to involve young people who were using statutory services because of difficulties engaging with these services:

29

a third issue was getting the balance right between looking at young peoples experiences within statutory services and community-based servicesit does worry me that we have less clear material emerging from [statutory] services.

Membership

Group membership, for most projects, was in a constant state of flux, with members leaving and new ones joining all the time. In addition to disrupting the groups progress in terms of young peoples ability to develop positive working relationships with each other, this posed problems to those projects that were working to achieve specific strategic objectives.

three or four of the group members who through this process gained the confidence are not with us any more: two have been sent back, two have been dispersed. When theyre ready to [advocate] unfortunately we lose them, which also has an impact emotionally on [the young-person coordinator] and the other members, you know, you build relationships and they become your family.

(Mentor, SCF) One of the main difficulties of this constantly changing group membership was that, due to the induction process needed to introduce new members, the groups found themselves going backwards, revisiting their aims and objectives and having circular discussions about how the group was to develop. For some of the groups it was found that this led to a loss of interest, where young people wanted to progress but were being held back. Two solutions were found to address the problems of disruption caused by changing membership. One of the youth workers from HOVs Young Peoples Mental Health Project explained how they dealt with this problem:

I generally bring them in and bring one of the other young people who is involved in the work in and then the three of us will have a talk about it so they know what they are coming in to. Weve been introducing people in, in ones and twos so if youve got an established group and you just bring one new person or a pair in then its not really going to disrupt anything.

The second solution was to organise young people into two groups, which was the way in which the Young Refugees Rights Project solved the problem. One group was a core group of established young people who had honed their advocacy skills and were in the process of actively engaging with policy-makers. The other, main group, was for new members and those seeking social and emotional support, which the core group would report to in order to inform them of what they were doing. In principle, once members of the second group had got up to speed, they could join in with the activities of the core group.

30

4.2. Creating a supportive environment The second key theme, creating a supportive environment, was identified as a prerequisite for enabling groups to develop and run successfully. Again, like the recruitment process, it was stressed that this takes time: I think at your peril you underestimate how much time it takes to work with the young people so that theyre safe, so that they feel comfortable to do things (project coordinator, Barnardos). There were several ways in which the projects worked to create supportive environments.

A trusted key worker

The approach taken by all the projects was to have a key worker to lead the groups or team and to manage the consultation and advocacy work. All the key workers were paid and were roughly the same age as the young people in the groups they were working with. The extent to which the key workers were young peoples peers differed from project to project. The young-person coordinator who ran the Young Refugees Rights Project was the closest to the young people in the group, being a separated refugee himself and of a similar age. The key workers from the other projects were more akin to youth workers. Either way, having young people leading the projects was seen as a great benefit, particularly in terms of engaging with other young people in similar circumstances:

the fact that weve got a group of workers who can quickly and actively engage with young people, who are vulnerable young people, and young people who are experiencing difficulties. It is youth work practice, good practice that makes young people access the project because it is informal.

(Project coordinator, HOV)

It was found that, in some cases, especially where key workers had very little prior experience of doing advocacy work, the young people leading the projects needed support, training and ongoing supervision in order to carry out their role successfully.

its not easy for a young person just to turn up at a meeting with a minister, they need to be prepared and supported, or dealing with the press, and I think when youre working with young people in any advocacy work one has to remember the process that is involved in preparing the young people.

(Mentor, SCF)

A safe environment

It was also recognised that in order to make young people feel safe and to work well as a group it was important to create an accessible environment. At a basic level this meant situating the project at a suitable venue. The project coordinator from Barnardos explained how important she felt this was to the success of the project based there:

somewhere thats openly accessible alreadyIf you had the additional thing of having to find an environment or find a placethat would make everything so much harder to do and would have lengthened the whole process I think.

31

In addition to locating the projects in safe venues, it was also stressed that it was important to find or to develop a safe space within venues where young people were able to freely express themselves.

we always make sure that the room that we use is the drop-in room at the back and its always really cosy and we push the settees in so they are quite close so its more like a living room and not such a big room and no one else is allowed in so that they know its private and they can get up and down to make cups of tea or go out for cigarette breaks.

(Consultation worker, MHF)

While it was found to be important to make groups and activities as informal as possible, it was also recognised that for young people to feel safe, it was necessary to lay down some clear rules and boundaries in order to govern interaction between young people. A good example of this was the Youth Crisis Project, where the group developed a confidentiality policy and drew up a code of conduct that meant that the group were required to listen to the viewpoints of each of its members with equal respect.

Social support

One of the most challenging factors to setting up and running the young peoples peer advocacy groups was managing the tension between providing individual support to young people in need and working towards specific objectives. It was the general view among project coordinators that in order to set up a successful group it was necessary to provide a certain degree of social support.

You cant just go and ask young people [to become advocates] without offering something back particularly if they have got mental health problems, particularly if they come from the groups that we are saying they need to target, you cant just ask them and say oh thanks, ta.

(Training officer, HOV)

This was especially the case for the mental health projects, in which key workers were in some cases requested to provide a certain degree of therapeutic support, which was felt to be an inevitable part of the process.

When someone phones and says Ive cut myself and I just want to talk to someone about it, you cant say this isnt a therapeutic service Im not going to do it because they will never come to your group again and they will decide that youre not the person that you told them you were.

(Consultation worker, MHF) Encouragement

In addition to providing social support and, in some cases, therapeutic support, it was also found that the role of the key worker was the groups motivational force too. Again, this was particularly the case for the mental health projects. It was found that it took a good deal of encouragement to get young people to attend group meetings in the first place.

32

I have to do a couple of phone calls in the morning to remind them what day it is, what the group is, what its all about and to persuade them to come because if they dont come for a bit then they will think oh, Im not sure if I want to go back.

(Consultation worker, MHF) The key workers found that there was a need to keep young people motivated especially when the young people began to feel that their efforts were in vain.

I keep saying its really important to have a voice and you have to keep trying and give all kinds of example, we know were going to die but that doesnt mean we stop living.

(Young-person coordinator, SCF) 4.3. Running peer advocacy groups A number of practice points were raised regarding ways of running successful and productive peer advocacy groups.

Facilitation

The facilitation skills of the key workers was highlighted as one of the most crucial factors in the process of getting young people firstly to work together and then to develop their self-confidence to such a degree that they felt able to put their views forward to people outside of the groups. In terms of group facilitation it was stressed that the key worker needed to work out how to gain young peoples trust: you have to gain everybodys trust first before they will start opening up to you (youth worker, HOV). Evidently there was no single recipe for doing this, although many of the factors discussed above played a part. In addition, it was generally agreed that it was necessary for the facilitator to show that he/she cared both about the issues being addressed and for the young people themselves, and also that they held a certain amount of credibility in terms of understanding the situation of the young people involved. This was obviously easier the closer the key workers were to being the young peoples true peers. It was also important not to let the young people down. Take this extract from an interview with one young person who felt that the group had been let down due to the cancellation of an event organised to promote the groups work:

Its now also made us not trust people as much now because our trust has been built up and now its been smashed back down again and so its a bit disappointing when youve done all that work and then you are just told sorry you cant do it now.

(Young person, Youth Crisis Project) Some of the key workers also said that they needed to put a lot of effort into getting the young people to trust each other, which, as the following illustrates, was not easy:

We had to do quite a bit of groundwork in terms of, you can disagree with someones opinion but it doesnt mean that you hate them, you can still be friends and you can still work together or you