How to commission better mental health and wellbeing services for young people

This new guide, which shares learning from the Right Here programme, offers practical tips for commissioners to address the mental health and wellbeing needs of young people (16-25 years of age). Young people are often overlooked and can suffer as a result of poor transition from child to adult services. A failure to connect with this group can leave them feeling isolated and unsupported.

There is a pressing need for commissioners to improve engagement with young people, as adolescence and early adulthood are considered to be the peak age for onset of mental health problems. This is a critical time and early intervention now may help to improve longer term outcomes.

Ideas for commissioners

The guide recommends a co-production approach to commissioning, highlighting opportunities to involve young people throughout the commissioning cycle – which will help to improve uptake, empowerment and engagement with more relevant care and support services. Creative thinking is encouraged and this can be best achieved by working with the people who will be using the services commissioned.

Needs assessment: Commissioners should consider how they can effectively gather information on the needs of young people. Often, needs assessments will focus on children and adults and neglect to consider young people separately. The guide recommends that Joint Strategic Needs Assessments (JSNAs) explicitly include a focus on this age group. Traditional methods of engagement may not work with young people so commissioners will need to develop or strengthen relationships with third sector organisations, e.g. youth agencies, to find new ways of reaching out. Taking a co-production approach by involving young people in assessing needs is advised. The Right Here programme in Brighton and Hove engaged young people to undertake research into service user experience and present their findings to local commissioners.

Partnerships with relevant third sector organisations are critical to help commissioners reach young people

Planning services: The gap between child and adult mental health services can present a significant gap and it’s often said that many young people “fall off the cliff edge” at the age of 18. A different approach may be needed at this transition stage – what works for children or for adults will not necessarily work for young people. New models are needed including early intervention services. Right Here works in partnership with Innovation Labs, funded by charitable donations, which has worked with young people to develop apps and websites around specific needs, for example, how to have a conversation with a GP.

Tendering and procurement: Multi-agency working is essential to ensure a range of services to meet health and wellbeing needs. Commissioners will need to get to know providers of “youth-friendly” services within their geographies. A case study of Right Here Newham is provided, where young people were given training in shortlisting and decision making and then given the opportunity to commission the services they felt would meet the needs of their peers.

The STAMP project involved young people in undertaking evaluation and analysing results.

Monitoring and evaluation: A co-production approach would enable commissioners to work alongside young people to determine the outcomes by which new services should be monitored and evaluated. To enable performance management, service providers should be required to provide data specifically related to this age group, so commissioners can track uptake and outcomes. Young people can also take an active role in evaluation, through interviewing other young people or acting as ‘mystery shoppers’ for example. The STAMP (Support, Think, Act, Motivate, Participate) programme in Sheffield has recruited Young Evaluators who assess mental health services in the city.

Commentary

The guide acknowledges that this level of involvement takes time and energy and suggests a longer term view will help, starting with some small steps. It will be important to sustain momentum, commitment and continuity; this can be a challenge in the current environment of financial pressures but it could damage credibility if commissioners are not seen to be fully engaged.

In light of this guidance, commissioners may wish to consider:

Does your mental health strategy consider young people specifically?
Have you assessed the needs of this age group?
What mechanisms do you have to engage with this age group?
Do you know what groups and organisations (possible partners) are already working with young people in your area?
Do you current monitor uptake of services by young people, and their outcomes?