A bit more understanding: Young adults' views of mental health services in care in Ireland

Children and young people in the care system typically experience very high levels of mental health difficulties, yet their views of these difficulties and of mental health services have rarely been explored. For this qualitative study we spoke with eight young adults aged 18 to 27 years with experience of the care system in Ireland about mental health challenges, service experiences, and how they felt mental health services needed to improve. Themes from the interviews illuminated young adults' views of their emotional well-being while in care, and the double stigma of being in care and mental health difficulties. In terms of services, young adults wanted these to be flexible and sensitive to level of need; to offer choice and more congenial environments; to provide more creative routes to engaging young people; and to offer honest, reciprocal, caring communication — treating children in care as one would any child. Recommendations highlight three key needs: an ethic of care in services as well as an ethic of justice; mental health training for all professionals in contact with children in care; and the need to listen, hear and act on what children and young people say.     

Finding Meaningful Support: Young People's Experiences of “Risky” Environments

This paper reports on the qualitative phase of a New Zealand study of young people who had been exposed to “risky” environments from a young age. These young people had experienced traumatic events such as abuse, violence, addictions, mental health issues, and many had been excluded from school. The young people (aged between 13 and 17) were users of multiple services (statutory and nongovernmental services including: child welfare, juvenile justice, remedial education, and mental health services). Qualitative interviews (n?=?109) explored young people's experiences in their families, communities, education, and their perspectives on support provided by services and their own support networks. Three thematic clusters emerged as central motifs in young people's experiences and are the focus of this article: navigating “risky” environments; services and support; and, working to find different pathways.     

Developing Responsive Preventative Practices: Key Messages from Children's and Families’ Experiences of the Children's Fund

As part of the prevention and social inclusion agenda, the Children's Fund, set up in 2000, has developed preventative services for children at risk of social exclusion. Drawing on a large qualitative dataset of interviews conducted in 2004/05 with children, young people and their parents/carers who accessed Children Fund services, this article analyses key practices and approaches valued by children and parents. These included: specialist support tailored to individual support needs, family‐oriented approaches, trusting relationships with service providers, multi‐agency approaches and sustainability of services. Finally, the article draws out key lessons for the future development of preventative services.     

Young people's views of children's rights and advocacy services: a case for ‘caring’ advocacy?

This paper looks at some preliminary findings from research with young people in foster and residential care in the UK who have received advocacy services from a range of local authority and voluntary agencies. The study also includes the views of professionals, from both children's rights and social services. The initial findings highlight the importance to young people of their relationship with rights professionals. They speak about the value to them of care and respect, aspects not always seen as fundamental to rights work. Caring, in its various guises is seen by young people as a vital component of their relationship with children's rights workers. They also see this as important within advocacy work itself since caring about the outcome is often key. A pure individual rights focus with an emphasis on challenge and ‘being heard’ may not take account of the complexity of their situation and may pose difficult dilemmas for young people, especially in dealings with their carers. This ‘caring’ advocacy is not the paternalistic approach of a professional who ‘knows what's best for you’ but is a model based on a strong awareness of ways that young people are excluded and oppressed. It is also about placing a positive value on their contribution as citizens and links to a view of society that gives importance to an ethic of inter‐relationship and care as well as an ethic of individual rights. Copyright © 2007 John Wiley & Sons, Ltd.     

Deaf Children and Young People’s Experiences of Using Specialist Mental Health Services

Deaf children have an increased prevalence of mental health problems compared with hearing children. Generic Child And Adolescent Mental Health Services do not have the skills or expertise to meet the mental health needs of this group of children. Three teams in England provide specialist mental health services for deaf children. This research explored children’s experiences of using these services. Twenty‐four deaf children participated in the study. Overall children valued and benefited from the service. The expertise of the staff and the presence of deaf clinicians were key to these positive experiences.     

A Child‐inclusive Family Intervention in a Community Adult Mental Health Service

In this paper we describe an intervention that focuses on the needs of children in families where a parent has a mental illness and attends a community adult mental health setting. After a brief outline of the literature, we present a family approach that includes children and young people, their parents and grandparents. Case studies then illustrate the work as a ‘best practice’ for parents who are clients in community adult mental health services.     

SAME‐SEX EXPERIENCE AND MENTAL HEALTH DURING THE TRANSITION BETWEEN ADOLESCENCE AND YOUNG ADULTHOOD

Previous research has demonstrated that people who report same‐sex experience tend to have poorer mental health than heterosexual people in adolescence and adulthood. Yet, little is known about how same‐sex experience is associated with changes in mental health between the two life stages. Using data from the National Longitudinal Study of Adolescent Health (n = 12,056), this study assesses patterns of same‐sex experience between adolescence and young adulthood and their consequences for changes in depressive symptoms, binge drinking, and drug use. Compared to people with no same‐sex experience, those who report such experience only in adolescence show greater levels of mental health problems in adolescence, but they do not show any worse mental health changes during the transition into young adulthood. People who develop their first same‐sex experience in young adulthood, however, tend to show worse changes, consistent with the argument that entry into a stigmatized role is psychologically harmful. Among females, those who report same‐sex experience in both life stages also show worse mental health changes, indicating that the continuity in minority status contributes to their cumulative disadvantage. However, these differences are modest, and substantial amounts of variations in mental health changes are observed within each group. Findings are used to address the dynamic aspect of mental health disparity linked to sexuality.     

Adult’s Involvement in Children’s Participation: Juggling Children’s Places and Spaces

While children and young people’s participation is a well‐established research field, much less has been written about the roles that adults play in supporting this participation. This article examines the involvement of adults within participatory forums in English schools and local authorities. Drawing on empirical data from research on children’s participation in pupil and civic councils, the article discusses the complex and sometimes contradictory pressures on adults in their advisory roles with young participants. The article goes on to explore these roles within a broader conceptual framework that counterposes children’s ‘places’ with children’s ‘spaces’.     

Lessons learned from children who have experienced homelessness: what services need to know

Children who accompany their parents or guardians during a period of homelessness make up 37% (more than one in three) of all people accessing the Supported Accommodation Assistance Program (SAAP) services. This paper describes an Australian qualitative study that explored the experiences of children who accompanied their families during periods of homelessness. It focuses particularly on what children and young people say they want from the services that they come in contact with; particularly specialised homelessness services such as housing support services and refuges. Key themes that emerged from the research include: the need for services to engage with children as individuals in their own right, to listen to and acknowledge their stories, to have services that meet their individual needs, to act and respond when children feel unsafe and for workers who can provide support to children to talk to parents about what is going on. Children and young people wanted workers to know that they felt their parents were doing their best to keep them safe. They focused on what their parents could do and did do rather than what they were not able to provide. They called on the human service system to do the same.     

Out‐of‐Home Placement of Children Exposed to Violence

There is growing concern about the increasing number of children in the USA who are exposed to community violence and the need to remove some of them from their families. This study examines risk factors for out‐of‐home placement among a large pool of children and adolescents who were referred for general clinical assessment following exposure to violence and/or psychological trauma in their communities or homes. Children with greater familial and environmental support and children exposed to incidents involving a non‐parental personal threat were associated with a significantly lower risk of out‐of‐home placement. A greater likelihood of being placed out of home was associated with older age (adolescents), history of mental health service use, involvement with law enforcement agencies, higher clinical ratings of depression or impaired thought processes, lower clinical functioning and greater exposure to traumatic events. Evidence of maltreatment and a threat to life was associated with 13.6 times greater likelihood of being placed out of the home. This study raises an important issue in respect to the children's past use of mental health service and current symptoms. It is not just the risk of violence but also evidence of psychiatric problem that trigger out‐of‐home placement. Further studies are needed to assess the quality and effectiveness of mental health services provided to children exposed to violence. © 2007 The Author(s). Journal compilation © 2007 National Children's Bureau.     

Experiences of Young People with Harmful Sexual Behaviors in Services: A Qualitative Study

ABSTRACT

Young people are responsible for a significant number of the sexual offenses that are committed every year. These young people are generally referred to specialist services for treatment. This article explores the health characteristics and service experiences of 117 young people with sexual behavior problems, and the issues that services face when working with them. The study is based on analysis of 117 case files, identified from nine specialist services in the UK. The case files were thematically analyzed. Case files provided information on the following topics: the reasons why the young people were referred to harmful sexual behavior services; the young people’s personal characteristics; their medical and mental health problems; the young people’s interests and aspirations; their attitudes toward services and interventions; continued problematic sexual incidents in services; progress in services; and post-service experiences. Overall, the findings of the study indicate that these young people have a number of strengths, but often have problems across a range of personal and health domains. A number of them continue to remain sexually and generally violent in services, particularly in residential settings, which has risk management implications for staff.     

Children and Young People Living Through a Serious Family Illness: Structural,Interpersonal and Personal Perspectives

This study explores the experiences of children and young people in Britain living through a serious family illness. The study considers the interplay between social structures, social relationships and individual agency. We draw on data from the Millennium Cohort Study to estimate the number of children and young people affected nationally and on seven in‐depth interviews to understand young people’s experiences and the effects on their daily lives. Living through a serious family illness impacts on young people’s educational achievements, mental health and social relationships over long periods. Policy and service responses are suggested.     

Police encounters among a community sample of children and youth accessing mental health services

Generally, within the Canadian context, scholarship on police encounters with persons living with mental illness has focused on the experiences of adults and not children and youth. In this article, we present preliminary work of a secondary data analysis of intake statistics collected over a 5-year period (2009–2014) and a thematic content analysis of qualitative intake notes collected over a 2-year period (2009–2011) about police involvement among a community sample of children and youth accessing mental health services. Of 8,920 intakes completed, 1,449 children and youth, birth to 24 years old, had had police involvement at the time of accessing mental health services. Over the 5 years, the average number of young people with police involvement at the time of accessing mental health services was 16%, or one in six children and youth. Analysis of the qualitative intake notes revealed two main reasons for police involvement: (1) support in the home for a distressed child, and (2) concerns about a child’s conduct and behaviors in the community. The implications for social work practice and future research are discussed.     

Inter‐professional working in child protection with families with long‐term and complex needs

Within the United Kingdom there is growing awareness of the need to identify and support the small number of children who are living in families experiencing multiple problems. Research indicates that adverse experiences in childhood can result in poor outcomes in adulthood in terms of lack of employment, poorer physical and mental health and increases in social problems experienced. It is acknowledged that most of these children are known to child welfare professionals and that some are referred to social services, subsequently entering the child protection system. This paper reports research conducted with 28 experienced child welfare professionals. It explores their views about families known to the child protection system with long‐term and complex needs in relation to the characteristics of children and their families; the process of intervention with families; and the effects of organisational arrangements on practice. The research indicates that these families are characterised by the range and depth of the problems experienced by the adults, such as domestic violence, mental health difficulties and substance misuse problems, and the need for professionals to have good inter‐personal skills and access to specialist therapeutic services if families are to be supported to address their problems. Copyright © 2008 John Wiley & Sons, Ltd.     

‘It’s the way they do it’: Expressions of Agency in Child–Adult Relations at Home and School

This article examines children's (8–9 years) and young people’s (14–15 years) views about their own participation in decision‐making processes with adults, within the context of home and school in Norway. A difference‐centred theoretical perspective is used to identify children’s participation as expressions of agency embedded in intricate child–adult relations, in which children and adults are positioned differently. It is argued that children not necessarily ask for increased independence from adults, but rather to be recognised as ‘differently equal’ partners in shared decision‐making processes, where children are being treated with dignity and respect as valuable persons.     

Online Peer Support Programs for Young People with a Parent Who has a Mental Illness: Service Providers’ Perspectives

Young people with a parent or parents who have mental illness are at a higher-than-average risk of experiencing emotional and behavioural difficulties. Notwithstanding the difficulties experienced by these young people, opportunities to interact with and obtain support from peers living in similar families can be beneficial. While young people face several barriers to participating in face-to-face peer support programs, online approaches potentially provide a different way of obtaining peer support. This paper aims to explore service providers’ perspectives on current Victorian peer support programs, as well as the strengths and weaknesses of online approaches to peer support. Semistructured interviews were conducted with 17 mental health professionals who work with families affected by parental mental illness. Participants recognised that many young people miss out on face-to-face peer support programs, and were highly supportive of the idea of online programs. This study suggests that online peer support programs for young people could occupy an important position in the evolving suite of services for Australian families affected by mental illness.     

‘Someone of Your Own to Love’: Experiences of Being Looked After as Influences on Teenage Pregnancy

Previous research has shown that children and young people who are looked after are vulnerable to poor life outcomes, including early pregnancy. This paper examines how experiences of being looked after may contribute to teenage pregnancy. Using in‐depth interviews, data were collected from 63 young people recently looked after who are aged 15–24 and 78 professionals, across four research sites. The young people reported feelings of loneliness, rejection, stigma and not being able to trust others, emotions which seriously influenced their decisions about becoming parents. The findings suggest that such young people may benefit from a greater degree of emotional and practical support throughout their lives in care. Copyright © 2006 Institute of Education, University of London.     

Symptoms of Mental Health Problems: Children’s and Adolescents’ Understandings and Implications for Gender Differences in Help Seeking

Amidst concerns that young people’s mental health is deteriorating, it is important to explore their understandings of symptoms of mental health problems and beliefs around help seeking. Drawing on focus group data from Scottish school pupils, we demonstrate how they understood symptoms of mental health problems and how their characterisations of these symptoms as ‘rare’ and ‘weird’ informed participants’ perceptions that peers, teachers and parents would respond to disclosure in stigmatising ways. Consequently, participants suggested that they would delay or avoid disclosing symptoms of mental health problems. We highlight subtle gender and age differences and outline implications for policy and practice.     

Children’s Concerns about their Parents’ Health and Well‐being: Researching with ChildLine Scotland

This paper reports on collaborative research conducted with ChildLine Scotland, a free, confidential, telephone counselling service, using their database. We focussed on children’s calls about parental health and well‐being and how this affected their own lives. Children’s concerns emerged within multi‐layered calls in which they discussed multiple issues and problems in their lives such as alcohol misuse, drug misuse, domestic violence, family relationships, depression, mental health problems and bereavement. We discuss how children were making sense of these experiences; how they were trying to get by in difficult family circumstances; whose help they valued; and conclude with implications for policy and practice.     

Harnessing Resistance in Interventions with Young People

This article draws on the findings from the qualitative phase of a New Zealand longitudinal study concerning vulnerable young people’s transitions to adulthood. The young people, aged between 12 and 17 at the time of the first interview had sustained exposure to harm (abuse, violence, addictions, disengagement from school and mental health issues) and were clients of statutory and non-governmental services including: child welfare services, juvenile justice services, remedial education services and mental health services. Qualitative interviews explored young people’s experiences of services, their key transitions, their coping capacities, and the strategies they used to locate support and resources to mitigate the effects of harmful events and environments. There were three stages to the qualitative phase of the study; this article draws on the interviews from stage one and two. It explores the idea of resistance which emerged as a key theme in the data analysis. Three thematic clusters are presented: the nature of young people’s resistance; practitioner responses to resistance; and harnessing resistance in interventions. The article concludes with a discussion of how social workers and other practitioners can understand resistance and build more responsive and meaningful relationships with vulnerable youth.