Case Study One: Research and Evaluation Projects, Right Here Brighton & Hove

Young people-led research driving service improvements

http://right-here-brightonandhove.org.uk

Lead agency:

Sussex Central YMCA

 Partners:

  • Mind in Brighton & Hove
  • Brighton & Hove Children and Families Services
  • Brighton & Hove City Clinical Commissioning Group

Additional Funding and resources:

  • Brighton & Hove Clinical Commissioning Group (How Can I…?)
  • Brighton and Hove City Council (self harm study)

Aims and objectives of activity

  • To research the impact of Right Here Brighton & Hove interventions
  • To research specific mental health research topics of importance to young people and the people who support them

Relevance to Right Here’s national aims and objectives

This activity allies itself with the following Right Here ambitions:

  • To develop new approaches / structures which are participatory and able to engage with and be sensitive to the needs of young people
  • To develop closer co-operation between services, and particularly, between voluntary and statutory sector, youth and mental health services

What led to the activity being set up

It was an initial expectation of the Right Here initiative that each project would recruit Research and Evaluation volunteers to support the national evaluation of Right Here.

Description of activities

The Research and Evaluation Group (comprised of young volunteers from the project’s
research and evaluation and mental health promotion groups) have undertaken a considerable
programme of work since 2011, including:

  • Evaluating Right Here Brighton & Hove’s wellbeing guide – asking how young people and professionals viewed this resource
  • Research exploring 172 young people’s views and experiences of GP services in relation to emotional and mental health (2011). The research found that 48% of young people interviewed did not feel comfortable talking to their GP about emotional or mental health issues; and 41% did not know what was confidential when visiting their GP. See their website for details
  • Research exploring perceptions of self harm amongst young people and professionals who work with them
  • The Research and Evaluation Group were also runners up in the Independent Academic Research Studies Research and Leadership Awards (2012) for their GP services research

Target group

  • Young people aged 16 to 25 years.

Target group involvement

“from the go I was actively involved in the research, the first meeting I attended as a volunteer saw us developing the questions we would present to a series of focus groups in order to collect data for our GP research project. It was a great experience”

– (young person)

There are on average 6-11 volunteers within the group at any one time, who meet every week with the support of a facilitator. The Research and Evaluation Group actively encourages the participation of young people at all stages of the research process, including planning and design, data collection, analysis, reporting and dissemination activities. Members have taken on more responsibility for the running of the group over time as their skills and confidence have increased. They are now responsible for setting their own meeting agendas and completing their programme of work, with less direct input from the group facilitator.

Timescales

From 2011 – ongoing

Outcomes to date

“I have made friends as well – we go out frequently. Before this year I didn’t have many friends and all the friends I have now I’ve made through Right Here…so that’s amazing”.

– (young person)

“personally my confidence has definitely gone through the roof since I joined this team…”

– (young person)

As a result of their participation, members of the Research and Evaluation Group reported increased levels of:

  • general wellbeing
  • social connectedness amongst and between group members
  • self confidence
  • concentration levels
  • research skills including communication and listening skills and focus group facilitation
  • knowledge of mental health topics such as self harm.

The findings from the research undertaken by the group have also impacted on the wider work of Right Here Brighton & Hove through a number of subsequent developments:

  • ‘How Can I…?’ (2012) Short film for young people designed to answer questions such as
    • What are my rights when I visit my doctor?
    • Will they tell anyone what I say?
  • Training programme aimed at GPs, practice staff and student GP registrars, implementing the findings from GP services study (2012-2013) See their website for details
  • Awareness raising visits to GP practices and practice managers forum (2012)
  • GP Good Practice Guide (2013)
  • Doc Ready App, one of seven Innovation Labs projects, funded by Comic Relief, Nominet Trust and Paul Hamlyn Foundation. Doc Ready, developed by FutureGov, Enabled by Design, Neontribe and Social Spider, with input from RH Brighton and Hove, aims to help young people get the most out of their consultations with GPs around their emotional health and wellbeing. Visit DocReady

Published literature

‘How can I….?’

GP research report

Learning Points

“Some of the time young people can feel a bit isolated and alienated from adults. They’re like ‘I can’t be completely honest with you because you might be a professional and you might report it back to someone which might lead to me getting into trouble’ whereas with young people I think you can feel at ease especially if they’re from your local community… They’re a bit more comfortable with each other and a bit more honest.”

– (young person)

“[facilitator’s name] is a great co-ordinator, she ensures none of us are passive volunteers and we’re always completely active and involved with the project; together we decided how to collect and present our  research as a team whilst having a lot of fun in the process!”

– (young person)

“I was going through depression and anxiety but everyone has been really supportive and everyone has known…and I have felt really accepted by everyone”

– (young person)

Success factors of the project include the following aspects:

  • Young person led research has enabled research with young people to be more of an open and honest dialogue
  • Providing training to volunteers has enabled participants to develop and feel confident about their research skills (e.g. 6 week course “Seek and Solve”, self harm training)
  • The facilitator has been key to the group’s success, providing guidance, keeping the group on track and giving the group confidence to undertake research activities
  • The perceived supportive and friendly atmosphere of the group has fostered an environment where participants  feel they can be open about their own experiences of depression and anxiety without feeling stigmatised
  • The group has offered an opportunity for participants’ negative experiences of services to be used constructively to achieve positive change
  • Peer support between participants enabled newer members to learn research skills from more experienced members
  • The research has been used to inform  service development, such as the development of the How can I…? film, GP training programme and the Doc Ready app
  • Facebook group adds as a mechanism  for keeping volunteers up to date

A reflective process has ensured that the group learns and develops on an ongoing basis. Some of the challenges the group have experienced over the years have included:

  • Making sure that the research is a group project and no one takes over in terms of suggesting tasks or research topics
  • Setting the research aims and objectives from the outset of the research project
  • Ensuring that the research is focused and does not go off at tangents
  • Keeping motivated throughout the lifespan of a lengthy research project
  • Time constraints – working within limited timescales

What we know

Empowerment is an important factor in promoting wellbeing for young people1 Wong (2010) suggests that models of participation where young people share control with adults, such as that employed by Right Here Brighton and Hove, may provide the optimum means for empowerment. This enables the adult participant to act as a source of support and encouragement for young participants, which in turn allows the young people to grow in confidence and autonomy over time2 Research also indicates that supporting young people to  research the views and opinions of their peers increases the sense of empowerment experienced by both researchers and research participants3.

Being highly engaged in activities such as learning or volunteering can also have positive impacts on individual wellbeing, particularly with regards to self esteem and self worth, social connections and anxiety levels4 5. Volunteering and learning activities, such as those within the groups responsible for the projects’ research and campaigns, lay the foundations to support  the individual psychological state of flow,which positive psychologists describe as full immersion in a process resulting in a sense of focus, enjoyment and fulfilment6.

About the topics the volunteers researched:

In keeping with the findings of the Research and Evaluation Group, the wider evidence base suggests that young people experience a range of perceived and actual barriers to accessing mental health support, including judgemental attitudes, perceived lack of confidentiality, unhelpful responses in the past, professionals being “out of touch” with young people, and service inaccessibility7.

Many health professionals in contact with young people also lack awareness about self harm, which populations of young people are at particular risk of self harming, and the links between self harm and suicidal ideation. There is an identified need for further training amongst health professionals on self harm and young people8.

What this project adds

The work of Right Here Brighton and Hove’s Research and Evaluation Group adds important evidence on the effectiveness of young person led research, particularly with regards to the processes which enable meaningful participation to take place and some of the individual outcomes for the young researchers involved. In turn the research  produced by the group and their dissemination activities add to our understanding of service barriers for young people and recommendations as to how they may be addressed. Collaboration with professionals benefits both young people and adults and creates new ways of working that others can learn from.

Areas for future research

It would be useful to explore the longer term impacts of participation in the Research and Evaluation Group on the volunteers, to assess whether any of the outcomes achieved have any lasting effect. In terms of their own research, evidence about the impact of their research and training activities on GP services and other services for young people in Brighton and Hove would also add considerable value.

Examples of similar Right Here activities

Young people from Right Here Newham have evaluated the strengths and weaknesses of their project through the medium of film. See the project here. In Sheffield young people from the STAMP group have worked with CAMHS to help implement the ‘You’re Welcome’ Standards and are currently involved in a consultation about Children and Young People’s IAPT.

Footnotes

  • 1 Wong NT, Zimmerman MA, Parker EA (2010) A Typology of Youth Participation and Empowerment for Child and Adolescent Health Promotion, AM J of Community Psychology, 46, 100-114
  • 2 Wong NT, Zimmerman MA, Parker EA (2010) A Typology of Youth Participation and Empowerment for Child and Adolescent Health Promotion, AM J of Community Psychology, 46, 100-114
  • 3 Kellett, M. (2011) Empowering children and young people as researchers: overcoming barriers and building capacity, Child Indicators Research Journal, 4(2)
  • 4 Kirkwood T, Bond J, May C, McKeith I, Teh M (2008) Mental capital through life Challenge Report (London: Foresight Mental Capital and Wellbeing Project, 2008) pp20–21.
  • 5 Volunteering in particular has been found to increase peoples’ sense of purpose, improve self-worth and wellbeing, and reduce anxiety
  • 6 Nakamura, J., & Csikszentmihalyi, M. (2009). Flow theory and research. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 195-206). Oxford: Oxford University Press
  • 7 Gulliver A, Griffiths KM & Christensen H (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review, BMC Psychiatry 2010, 10:113
  • 8 Crawford T, Geraghty W, Street K, Simonoff E (2003) Staff knowledge and attitudes towards deliberate self harm in adolescents, Journal of Adolescence, 26, 5, 619-629