Debating Mental Health is a project that is about empowering young people who have accessed mental health services to use their voice through debate. We deliver free debate coaching programmes for young people who have experience of using mental health services and empower young people to speak out on platforms that matter to them about the mental health issues that matter to them.
What We Did
Debating Mental Health is a project that is about empowering young people who have accessed mental health services to use their voice through debate. We deliver free debate coaching programmes for young people who have experience of using mental health services and empower young people to speak out on platforms that matter to them about the mental health issues that matter to them. The programme was developed for a number of reasons: 1) Young people were telling us that participation gave them exciting opportunities to make a difference, but that they didn’t feel equipped with the skills they needed to access these opportunities; 2) We wanted to empower young people to speak out. Speaking out is difficult for any young person, but this is especially true of young people who have mental health difficulties, who are asked to speak publicly about the challenges they have faced. 3) We recognised that traditional ways of working with young people through participation (traditional forums and consultations) weren’t always successful and, very often, weren’t exciting for young people and we wanted to change that.
Young people participating in the programme have learnt to find and use their voices through free-to-access debate training (provided by Mentors from the English-Speaking Union), delivered as a series of exercises aiming for balanced skills progression applied in selected dialogue and debate formats. Participants of Round 1 were encouraged to set targets for themselves and self-evaluate their progress together with their mentors.
The programme supported young people to find and use their voice to talk about the issues within mental health that are important to them, whether service experience, stigma, education etc. It has given young people a safe place to talk about these things, building their self-esteem and helping them to understand that their opinion matters and their voice needs to be heard. Young people reported feeling more confident in school, as well as in clinical settings and many told us that they kept coming to Debating Mental Health, even when they felt unable to attend other activities, or even school, because the programme provided a safe space for them to interact with peers with similar experiences.
The programme supported staff to engage with young people and have discussions about mental health that might not otherwise happen. It allowed staff to challenge themselves on what they thought they knew about young people’s opinions. An excellent example of this was at the programme launch event, which was attended by young people and professionals. The topic that was debated that evening was ‘This House Believes That: The future of children and young people’s mental health care lies in peer support.’ A floor debate was incorporated, to allow young people and professionals to share their thoughts and conversations continued after the debate, with staff seeking conversations specifically with young people.
The first round of this programme culminated in a final day of debate and celebration, hosted at Facebook’s UK HQ in April 2017. Over 60 participants of the programme came together with mental health professionals and decision-makers to discuss key mental health topics that matter to young people, so that young people can hold decision makers to account. All young people participated in at least one closed debate and two teams were also selected to compete in the public final debate (attended by family, friends and decision-makers). Young people also participated in a showcase event, to demonstrate to the attendees of the final what they had learnt during the course of the 12-week programme.
Wider Active Support
The programme was conceived by Laura Tyrrell, Participation Officer at South West London and St. George’s NHS Mental Health Trust. It is funded by London and SE CYP IAPT Learning Collaborative (housed by the Anna Freud National Centre for Children and Families). The English-Speaking Union created the bespoke training curriculum and excellent mentors (coaches on the programme). A free training session on ‘working with young people with mental health support needs’ was delivered to the English-Speaking Union mentors, by clinical staff at the Anna Freud National Centre for Children and Families. Round 1 of the programme was widely supported by numerous staff in each of these organisations and would not have worked without the expertise of the different organisations.
We also worked very closely with the participation officers in services who have groups participating in the programme, to ensure that training sessions run smoothly and are effective for the young people involved. These services are: South West London and St. George’s NHS Mental Health Trust CAMHS (in Merton, Richmond and Sutton); Central and North West London Mental HealthTrust CAMHS (in Harrow and Kensingston, Chelsea and Westminster); Barnet, Enfield and Haringey Mental Health Trust CAMHS (in Barnet); Anna Freud National Centre for Children and Families (in Islington) and; Minding the Gap (in Camden).
Facebook supported Round 1 of the programme by hosting our final event.
Now that Round 1 has ended and we are making decisions on our next steps, we continue to seek opportunities for young people who took part in the programme. On 1st November, young people from the programme will be speaking at the Royal College of Paediatrics and Child Health ‘Hot Topics in Child Health’ conference on mental health. We will also be meeting with Dr. James McCabe of King’s College London to explore involving young people from the programme in a ‘Maudsley Debates’ event.
The programme was developed as a result of conversations with young people in South West London and St. George’s NHS Mental Health Trust participation groups, who recognised that the culture within mental health service delivery is shifting to place greater emphasis on the voice of the service user, but that there was little opportunity for young people to develop the skills they felt they needed to be able to use their voice effectively. They felt that these skills were primarily soft skills, including public speaking and presentation skills, organisation and coherent presentation of their thoughts, research and understanding development etc. A decision was reached that debating would provide an excellent avenue to learn and develop these varied skills.
On the programme itself, young people set their own goals with respect to what they wanted to achieve/get out of the programme and sessions were tailored according to these needs. They monitored their own progress against wider goals every week, and more specific goals at the start, middle and end of the programme.
Young people were also involved in shaping their own learning as they informally fed back to mentors on what was/was not not working for them and what they would like to develop. They also choose the focus for discussions and debates within sessions and voted on the topics they most wanted to debate at the final event.
We are hoping to run further rounds of the programme and would like to provide opportunities for young people who took part in the first round to co-design and facilitate future sessions, provide feedback on the curriculum and help us explore other opportunities for speaking engagements.
Looking Back/Challenges Faced
Some of the services we worked with initially struggled to recruit and retain participants on the programme. In future rounds, we would hope to have some trial sessions to help young people decide whether this is the correct prorgamme for them before they sign up. We will also be looking to offer a range of opportunities beyond the initial training, so that young people are able to realize tangible outcomes as a result of the programme, if this is of interest/motivation to them.
The core programme was initially designed to run once a week for 12 weeks. A number of young people really enjoyed this model, but some told us that this length of commitment was difficult for them and wasn’t something they felt able to commit to. As a result, we looked at our resources and offered the same number of hours of teaching, in condensed periods e.g. a number of half day sessions, rather than weekly hour long sessions. This flexibility enabled even more young people to participate and we hope to be able to offer the programme with this flexibility to choose session times and length in future models.
The curriculum was designed so that it could be delivered in services by participation staff, although during Round 1 it was delivered by English-Speaking Union mentors, as participation workers decided they would like to see the programme in action before embarking on delivering it themselves, so that they could grow their skills and confidence.
During subsequent rounds of the programme, we hope to be able to offer opportunities for young people who participated in Round 1 to co-facilitate sessions, if they would like. We hope that, in some areas, this will mean that young people could eventually deliver sessions without a mentor or participation officer present, which would ensure continuity and not be reliant on staff having or clearing space in their diaries.
Additionally, as this programme was been built on partnership, there are a number of staff involved in different ways, which means that if any members were to move on, there are plenty of other staff members who have supported this first round and could fill in any gaps.
Evaluation (Peer or Academic)
Young people set their own goals at the start of the programme. One of these was a broad goal such as ‘To improve confidence in public speaking’. Young people ranked their progress against this goal on a weekly basis (0-9 score). They also set three further goals linked to specific public speaking and debate skills, such as ‘I would like to put order into my thoughts and turn them into a clear argument (sic).’ Progress made against these goals was scored at the beginning, middle and end of the programme and, in most cases, as a result of feedback and discussion between the young person and their mentor or participation officer. We are not able to include this raw data, as we do not have consent to share it in this format.
We are currently collating a range of feedback from participants, parents and mentors, which will be published in our final evaluative report. This report will be circulated to participants, their families, partner organisations and other interested organisations and we will welcome feedback on the report.
During the programme all of our young people completed self-evaluation of skills that they wanted to develop. All of these reports demonstrate an increase in skills, with examples being ‘speaking confidently’; ‘being able to gather and express my thoughts’ and; ‘To have more confidence in myself’.
We would like to highlight one particular case study to demonstrate the impact of our programme. This is one example that particularly stood out, but is by no means the only example. X is a young lady who joined the programme hoping that she would grow her confidence. She has a diagnosis of ASD (Autism Spectrum Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) and attends an Autism unit in a mainstream school. When she joined the programme, she found being in the room with a new group quite challenging. She would fidget a lot and not always provide a well-thought out response to questions in the session. She went on to win the prize for ‘Best Individual Speech’ at the Grand Final at Facebook HQ.
In her own words: “Before my first session I had very low self esteem and didn’t feel confident speaking up for myself. I was anxious about going along as I thought that everyone there would be cleverer and better communicators than me. But as soon as I got there I realised I was wrong. I felt that I could be myself and I wasn’t going to be judged. And there were lots of other people who were just like me and who I now count as friends. This is a big deal for me as I find it really hard to make friends because I don’t really know how to have a conversation and I feel really awkward around people my age.
I’ve also learnt a lot. Debating involves a format where you structure the topics you want to talk about. This has helped me a lot at school as I find essays very hard to write. I normally answer a question in a few sentences and struggle to think of what else to say. Learning how to debate has shown me how to structure arguments and this has helped me in a lot of my subjects at school as my exam questions have a similar format.
I feel much more confident in myself as I now see that I don’t have to keep quiet about my opinion on things I can say whatever I like and it won’t be silly or stupid because in debating there is no right or a wrong answer. You have no reason to feel bad about what you say.”
To date, we have shared our work through a variety of outlets. We invited a range of professionals, parents and decision-makers to both our launch event and our Grand Final, so that they could both see the programme in action and have meaningful conversations with the young people involved.
We are currently drafting a report covering Round 1 of the programme and, once this has been approved by the various organisations involved, we will be sharing this with everyone who has already been involved in the programme to date (including services, young people and local commissioners etc.). We will also share it further with anyone else who is interested.
In September we presented at the International Association for Mental Health Conference in Dublin, where we made strong links locally and with teams and services overseas (including Canada).
We are keen to look for further opportunities to share our work and will strive to accept opportunities as they are offered to us.
Is there any other information you would like to add?
We are currently taking a break from developing the second round of the programme, as we want to ensure that the next stage adequately reflects feedback we have received from all of those involved. While we do this, we continue to provide the young people who were involved in Round 1 with speaking opportunities and are active in our presence online.