As Children’s Mental Health Awareness Week 2020 draws to a close, Joy MacKeith, co-author of My Mind Star, reflects on what the development process taught her about how schools and services can support real change for young people.
This week is Children’s Mental Health Awareness Week and there certainly is a lot going on. Yesterday a colleague attended a conference on mental health in schools in Manchester and next week Triangle will be hosting a stand at Oxfordshire’s Youth in Mind conference. This is all happening against the backdrop of a Government Green Paper on children and young people’s mental health and increasing concern in the media.
Catching up with my colleague after the conference yesterday, it is evident that the commitment to equipping schools to take a bigger role is certainly there, but thoughts about how to do this in practice are still developing. So it seems like a good moment to draw out some of the lessons from our work with Action for Children to develop My Mind Star, a tool for engaging and supporting young people around their mental health and measuring their progress.
After initial discussions and scoping in 2017, the development process began in earnest in 2018. Over the course of a year and a half we held a series of workshops with young people, front-line workers and service managers to find out what really makes a difference when working with young people. My Mind Star, a version of the Outcomes Star for mental well-being in young people, was then developed and piloted across 11 Action for Children services and also HeadStart Kernow.
Here are some of the highlights from that process.
Recognising the need for help is a crucial first step
Talking about change with the people directly involved is always fascinating. What emerged early on in the workshops was that young people often don’t seek help because they don’t realise that things could be much better. Not recognising that what they are experiencing is mental distress, they cope as best they can on their own. So, a really crucial first step for many young people is reaching out for help. Interestingly, this year’s Children’s Mental Health Week theme is ‘Find Your Brave’ and a key message is to be brave enough to ask for help.
Don’t look at mental well-being in isolation
Another clear learning point was that we must look at mental well-being in the context of the whole of the young person’s life. The workshop participants identified eight key areas that should be part of the conversation. After piloting this was reduced to seven because it emerged that safety is an important aspect of all of these areas, rather than something that should be discussed in isolation.
The final seven outcome areas are:
- Feelings and emotions,
- Healthy lifestyle,
- Where you live,
- Friends and relationships,
- School, training and work,
- How you use your time and
Participants emphasised that it was vital to cover all these areas when talking to a young person, even if they were not what was immediately presented as part of the problem.
Involve young people in defining what ‘good’ mental health and well-being looks like
Developing the scales for a Star involves in-depth discussions about what ‘good’ looks like. The scales for each outcome area or domain describe a journey from things being very bad to the desired outcome being achieved. This means pinning down what ‘bad’ means, what the desired outcome looks like, and what steps people take as they travel from one to the other.
When it came to the ‘How you use your time’ scale, there was an interesting conversation about time spent on screens. Questions raised, included, is time used this way always bad or can it also be a positive way of accessing support, information and entertainment? There was a definite difference of perspective between the generations and it was very important to have young people in the room to share what good looked like for them.
My Mind Star helps young people identify issues and set goals
My Mind Star was piloted over six months with 67 workers and 177 young people and the pilot was evaluated using feedback forms and a further workshop. Both workers and service users really valued the way that the visual Star Chart summarised their life and helped them identify priorities.
The vast majority (94%) of young people said that the scales helped them to describe how life was for them at that moment. While 85% said that the scales helped them to understand what they needed in the way of support. In the words of one worker: “I liked that it gave the young people the opportunity to see where their priorities are, not what someone else thinks we should work on. This gives them some ownership and increases motivation”.
Evidencing change is motivating for everyone
Three quarters of the workers valued the way that My Mind Star opened up better conversations. And both workers and service users found it encouraging to see progress when the second My Mind Star was completed. As one young person said, “I liked doing the Star because it reflects the improvements I have made in the past months”
Psychometric analyses showed that the outcome areas were coherent and the scale was responsive to change. Managers very much valued the fact that it enabled them to evidence the progress that young people had made.
Following the pilot, amendments were made to the tool based on the feedback and the final version was published in September 2019.
Take-aways for those working with young people and mental health
Based on our learning from this project, and on personal experience, just letting young people know about different kinds of mental illness isn’t enough and can even be counterproductive. Young people can mistake the natural highs and lows of the teenage years for a mental health problem or start to identify as being ‘anxious’ or ‘compulsive’. Rather than knowing the labels, young people need to know what mental well-being looks like in simple and everyday terms so that they know when they need to ask for help.
Also, when they do ask for help, schools and others need to make sure that there is ‘no wrong door’ and that everyone is equipped to have that initial conversation, to signpost them to others if needed and to keep a watchful eye. As in so many areas of life, prevention or early intervention is better than leaving things until there is a crisis.
Ultimately, the evidence from our pilot is that My Mind Star can really help make those early conversations count and give everyone working with young people a framework, a shared language and a way of evidencing the difference they are making.
Triangle will be at the Youth in Mind conference on 12th February at the King’s Centre in Oxford. If you’re attending the event and would like to arrange a meeting with us on the day, or if you have any questions about My Mind Star, other versions of the Outcomes Star for the mental health or young peoples sectors, or would like any information on the new Star Online, or anything else, please contact us on email@example.com or +44 (0) 207 272 8765.