Getting users to shape a support service for young people was a tricky balancing act but worth the effort, writes Lizzie Neill
The Market Place project in Leeds is an independent sector service for 13 to 25-year-olds providing information, support and counselling for mental and sexual health and crises. It was set up nearly 20 years ago and has been committed to placing the young person at its heart.
We talk about a 'young person-centred' approach, where clients are encouraged to make choices about their support. The emphasis is on flexibility to meet individual needs, and on maximum choice. The ethos is that young people have the ability to explore choices, find solutions and take steps to heal themselves.
Following from this, the organisation now gives service users opportunities to voice their ideas and get more involved in service development - from grass roots up to a strategic and operational level.
The Market Place is one of the sites included in the Mental Health Foundation's report Listen Up!, which was launched in September. One of the thing it calls for is greater participation by users in running services, something the Market Place has clearly addressed.
A participation group of past and current service users - the Participation and Involvement Project at The Market Place - started this April to build on previous learning.
Another group, the Helping Young People through Experience group (HYPE) discusses aspects of the service and makes an input into decision-making.
The brief to the members is: 'You are the experts, you know how it feels to come here and get support, and we can really learn from you to make this service better in the future.'
This way of working might feel radically different from how things have been traditionally approached in the mental health field, especially with young clients who often feel, in many aspects of their lives, that power and control are not in their grasp.
There are two main objectives in this approach. The first is to provide service users with a space where they can grow and learn in a supportive environment, to experience being part of a group, grow in confidence, share their thoughts and opinions, debate and learn effective ways of communicating and reaching decisions. The experience can be extremely rewarding and empowering.
The second objective is to seek a young person's perspective and take on board the service user's experience when planning and developing services - a fantastic resource that helps the organisation keep on track with what young people really want and remain truly young person-centred. It can be a tricky balancing act between consulting young people and remembering what is in it for them. The answer, of course, will be different for different members of the group.
Taking into account these varying agendas, plenty of planning time is essential. It is crucial to think carefully about how to present new ideas and concepts to young people to try to make them interesting, and to use creative methods to allow participation to fulfil its potential.
Transferable lessons we have learned suggest that staff:
should not make snap judgements;
must understand that people who have had the same/similar experiences will not react or feel the same;
should not assume or patronise young people;
must recognise that societies, environment and pressures have changed;
need to get to know the person before offering help;
should remember that young people may not always want to talk and should not be pushed to do so;
must know about confidentiality;
should not force their opinion on others;
can share things about themselves.
It is essential that the work done with HYPE has a clear purpose, with real consequences. Young people will soon be put off if their input is not taken seriously or consulting them is just a token gesture. There needs to be real clarity about how much power is being given, what the limitations might be and transparency about the process for it to be successful.
It is hard not to slip into tokenism when working with a small group of service users on decisions that affect potentially thousands of young people. It is important to question the idea of 'representation' in these types of participative methods.
Imagine the pressure on a small group to represent the scope of service users and 'young people' in general, and the responsibility that holds. The members of HYPE are simply representing themselves, they are not necessarily a collective unit, with one clear message. This is a process of learning to communicate and reach decisions, in the group and within the organisation, alongside staff and other stakeholders.
It is our job to provide creative tools to enable this to happen in a considerate way.
Changing market: how HYPE helps
Helping Young People through Experience (HYPE) has been consulted through 'think tanks' on specific Market Place developments such as:
discussing and redesigning the layout of the one-to-one counselling rooms;
thinking about how crisis work should be prioritised in the counselling service;
discussion around the introduction of monitoring young people's sexuality/sexual orientation;
views on staff self-disclosure and discussion of boundaries.
More in-depth HYPE activities which allow more significant impact on service provision include:
designing young person-friendly images for the walls;
producing a DVD looking at the public perception of young people - and co-facilitating a public event to showcase participation work and screen the DVD;
ongoing input into the recruitment and selection of new staff - planning and running their own interview sessions, impacting on the decision of who to employ;
being involved in inducting new staff;
crucial input into the preparation for a move to new premises, including funding applications.
HYPE members have met professionals outside the Market Place, including the Mental Health Foundation in relation to its Youth Crisis work, which has fed into the foundation's Listen Up! report, and children's commissioner Sir Al Aynsley-Green's part in the 11 Million listening tour.