TACKLING HEALTH INEQUALITIES IN HOMELESS YOUNG … · 2017-03-23 · tackling health inequalities...
Transcript of TACKLING HEALTH INEQUALITIES IN HOMELESS YOUNG … · 2017-03-23 · tackling health inequalities...
TACKLING HEALTH INEQUALITIES IN HOMELESS YOUNG PEOPLE WITH THE MENTAL SKILLS TRAINING FOR LIFE™ PROGRAMMEJENNIFER CUMMING1, SAM J. COOLEY1, MARY L. QUINTON1, BENJAMIN J. PARRY1, MARK J. G. HOLLAND2, JANICE L. THOMPSON1, & KAREN SAUNDERS3
UNIVERSITY OF BIRMINGHAM1, NEWMAN UNIVERSITY2, & PUBLIC HEALTH ENGLAND3
@drjenncumming
Email: [email protected]
© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS
COMPLEX & MULTIPLE BARRIERS TO INDEPENDENCE
Homeless Link, 2015© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS
Young People who are NEET with complex & co-occurring problems
Male, 22
years
Depression & anxiety
Cannabis user
Offending history
Anger issues
Learning difficulties
© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS
© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS
NEED FOR HOLISTIC APPROACHES TO INTERVENTION
“young people’s mental and physical health are intertwined, and at the heart of health and wellbeing are their relationships with others” (p.6)
Public Health England. (2015). Improving young people’s health and
wellbeing: A framework for public health.
DEFICIT CYCLE
Negative experience
Lower expectations and
affirmation of labels
Negative behaviours
Focus on deficits
Labels and negative
expectations
Prescribed interventions & opportunities
blocked
McCaskey (2008)
TRADITIONAL DEFICIT-FOCUSED APPROACHES ARE DISEMPOWERING AND DISAFFIRMING
© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS
The Helping Professional
Young Homeless
Person
TRADITIONAL APPROACHES ALSO CREATE A POWER IMBALANCE
“If the only tool you have is a hammer, then most of your clients will look like nails.” – Milton Erikson
DIFF ICULT TO RE ACH, ENGAGE, & MAINTAIN
Slesnick & Letcher, 2007© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS
INTRODUCING
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A whole systems approach
• Explicit framework and expectations
• Development of a shared understanding and language
• Integrated NOT add on
• Youth Voice and engagement
• Physical spaces
• Partnership with Mental Health Services and University of Birmingham
Training & Support
• PIE Foundation Training
• PIE Managers & Champions Workshop
• Reflective Practice Strategy
• Mental Skills Training for Young People
• Surround support for young people
• PIE awareness for Parents and employers
• Evaluation to measure outcomes
In-house Psychologist
• Strategic development and delivery with MST4Life team
• Case consultation and reflective practice
• Targeted PIE in areas of higher need
• De-briefing support following serious incidents
• Bridging with Mental Health Services
• Extending our reach to other partners
St Basils’ PIE…
8
Assets
Resources
Mental techniques and skills
We believe that “there’s nothing wrong with you thatwhat’s right with you couldn’t fix” (Baruch Shalem)
© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS
MST4Life™ helps young people to develop mental skills to thrive and successfully engage in EET
Education
Employment
Training
↓
Unhealthy/risky behaviours
↑
Thriving
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Phase 1: 10 weekly sessions
Phase 2: Residential OAE course
Post-Intervention:
Transfer to EET
Pre-Intervention:Preparation
EET = education, employment, and training
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© 2016 UNIVERSITY OF BIRMINGHAM AND ST BASILS
PARTICIPANTS (N = 274)
16 – 25 years (Mean = 20, SD = 2)
56% Female, 43% Male, 1% Transgender
Lived at St Basils for between 1 week and on/off for 2 years
63% NEET
18% learning disability
58% White British/European, 18% dual, 18% Black/African/British/Caribbean, 5% Asian/British
Physical activity: 30% inactive, 50% sometimes, 20% regular
Smoking: 30% non-smokers, 43% between 1 and 10 per day, 27% 10+ per day
Drinking: 36% don’t drink, 24% ~3 per month, 14% ~10 per month, 10% ~20 per month, 9% ~40, 7% 40+
Physical activity: MET (N = 30)
10
15
20
25
30
35
Pre Post
Exer
cise
MET
uni
ts
Change in leisure time physcial activity following MST4Life
* p = .04Government guidelines
© 2016 UNIVERSITY OF BIRMINGHAM AND ST BASILS
THRIVING NOT JUST SURVIVING
10.56%
8.45% 8.23% 7.55%
4.39% 4.39% 4.35%
0%
2%
4%
6%
8%
10%
12%
% PRE-POST PROGRAMME CHANGE
N = 48; * = significant difference
*
*
**
“I’m actually a lot stronger than I thought I was, both
physically and mentally in the sense that: I climbed a
mountain today and I didn’t think I’d ever be physically
able to do that” - YP
“It's kind of helped me get my fitness back into shape as well. So even though
it's a course about learning and everything, obviously it's kinda given
me kick up the bum… Like ask support workers about the gym and that” - YP
“climbing up the [mountain] today, we could have all easily
just given up half way… but obviously we’ve pushed as a
team, we’ve helped each other, and like as a leader
again, I’ve helped people up and down the rocks and
managed to get to the top” -YP
SOCIAL INCLUSION (N = 99)
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56.3%
32.1%23.2%
65.2%
0%
10%
20%
30%
40%
50%
60%
70%
NEET EET
Before MST4Life™
At follow-up
https://www.youtube.com/watch?v=vV3VE_5h300
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St Basils PIE Model
Staff
Foundation PIE
PIE Champions
PIE Managers
MST4Life™ Co-Delivery
Reflective Practice
Groups
Young People
Foundation MST4Life™
Advanced MST4Life™
MST4Life™ Peer mentoring
Parents/Carers
Parenting Young People™
Employers
PIE4Work&Training™
© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS
Thank you!
Funding gratefully received from:
Edith Murphy Trust Private donations
@drjenncumming
Email: [email protected]
© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS