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: J.Cumming@Bham.ac.uk

© 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

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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

© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS

© 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)

© 2016 UNIVERSITY OF BIRMINGHAM AND ST BASILS

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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18

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: J.Cumming@Bham.ac.uk

© 2017 UNIVERSITY OF BIRMINGHAM AND ST BASILS