P-05-842 Give young people a voice when commissioning local services in Wales – Correspondence from the petitioner to the Committee, 17.10.18

Dear Sirs,

Thank you for your response to our Petition, including the letter dated 30 September 2018 from Mr Gething AM.

Having read the correspondence, we are disappointed by the response given. We feel that the letter only regurgitates generic replies and has not addressed the Petition with sufficient specificity.

Therefore, we wish to take this opportunity to voice a number of comments on the letter.

Firstly, regarding the Mind Over Matter Report (the Report), this is an excellent first step in exploring the impact of mental health services on young people, alongside recommending continued initiatives. As contributors to the Report, National Mind has already adopted some of the recommended initiatives contained within, in particular the Whole School Approach (WSA). While we can testify to the efficacy of the WSA – the pilot was successful enough to continue to full scale roll-out (the reports can be found in full on Mind’s website Mind.org.uk) – this does not address the main point of the Petition.

The main thrust of the Petition revolves around the notion of enhanced participation of young people within the commissioning process of mental health and youth services. Therefore, we wish to question what initiatives, if any, are being implemented in order to further this objective?

Secondly, the T4CYP is another theoretically effective initiative. The High-Level Working Board’s stipulation of the engagement with children and young people as a workstream is undoubtedly in line with the Petition’s objective.

However, there are again concerns we must raise. In the first instance, this project runs until 2019. This is a short time away. Post the terminus, what will be put in place in order to continue the push for inclusion of young people in mental health and youth service provisioning?

In addition to this, some investigation of the T4CYP website suggests that there has been no board meeting since September 2017, no newsletters since August 2017, and there has been indication that a lack of personnel and appropriate resources has hindered the project. Further to this, the T4CYP Twitter account has been inactive since June 2016.

While we understand there may be times where there are extended hiatuses between meetings and the flow of information, we find the length of these unacceptable for an initiative that claims to be in operation with a close terminal date.

As a further point to note, many young people within the Campaign Group have found accessing this information particularly difficult. This refers not only to finding the information from the relevant sources, but also in terms of understanding the content. While the need to use context specific and technical wording is clearly important, the abundance of content with inaccessible wording is detrimental to the inclusion of a broad swath of young people.

Another point regarding the T4CYP regards empirical evidence. We have noted that within the board meetings it has been highlighted that there is a lack of reliable data and data collection methods (T4CYP Board Minutes Sep. 2017). As this was indicated in the last set of board minutes, we have to assume that this status has not changed.

A lack of testable, empirical results leaves the outcome of the project in the realms of a priori statements at best, or sweeping theoretical assertions at worst. Therefore, how can it be possible to deem the project a success without a posteriori knowledge that young people are being included within the mental health and youth service commissioning process?

Again, this is the point of the Campaign: to include young people in this process via a standardised, measurable inclusion framework across Wales.

The final point regarding the T4CYP is the creation of the Making Sense report by Hafal, part of the High Needs Collaborative. This report highlighted a number of key recommendations put forward by a panel of young people. Of particular note are suggestions one and ten.

The first suggestion is that young people indicate that they would prefer an informal, non-medical (i.e not CAMHS) approach to mental health and wellbeing. Despite this, the Welsh Government has seen fit to spend many millions of pounds on the expansion of CAMHS.

This clearly shows that the Welsh Government has disregarded the voices of young people. Ironically, this is in contradiction to suggestion ten of the report – listening to young people.

Regarding the task and finish group for the Mind Over Matter report, we have concerns history may repeat itself. The outcomes of the Making Sense report show no indication of continued young people’s participation and the recommendations went unheeded. Therefore, how can we be sure that the task and finish group for the Mind Over Matter report will not follow suit? How involved will young people be in the group? Will this simply be another high-level board, disconnected with the voices of young people?

We therefore call for young people to participate in this working group for a minimum of the duration of the Mind Over Matter consultation. This would be a welcomed first step to increase the level of youth participation in the provision of mental health services.

Thirdly, as touched upon above, the methods for engagement of young people are inconsistent or, at worst, lacklustre. The Welsh Government is itself guilty of failing to include the voice of young people in significant programmes, most recently the allocation of £1.4 million for a CAMHS in reach pilot into schools. The development and rollout of the initiative had no engagement with young people. In addition to this, the programme is the opposite of the non-medicalised interventions that young people asked for in the Making Sense report.

Thirdly, as touched upon above, the methods for engagement of young people are inconsistent or, at worst, lacklustre. The Welsh Government is itself guilty of failing to include the voice of young people in significant programmes most recently the allocation of £1.4 million for a CAMHS inreach pilot into schools had no engagement with young people and actually the programme is the opposite of the non-medicalised interventions that young people asked for in the Making Sense report.

To address a positive, the engagement of ABMYouth is certainly of benefit to furthering the voices of young people. Engagement in this manner is something that the Campaign Group would welcome. Indeed, this falls in line with the model utilised by the Changing Minds Campaign.

However, there is still a concern with this panel. While engagement of any young person is good, we question exactly how representative this panel is of marginalised groups. A lack of transparency in the appointment of this panel has served only to raise further questions amongst the Campaign Group and the wider youth demographic.

Additionally, we question the efficacy of a newsletter. While certainly one important way of informing young people, it is by no means the only way. Further, the newsletter itself is not particularly well publicised and it is mentioned that it is circulated to a wide range of stakeholders. Again, who are these stakeholders and how does this actively inculcate a culture of youth inclusion in the commissioning processes?

We believe that a simple, one sided newsletter is an insufficient modality through which to engage young people. There is little scope in this medium to reply to the comments made within, especially for those young people who, through their mental health or otherwise, find it difficult to effectively engage and express their opinions.

Finally, regarding the inconsistency, there is a distinct lack of standardised engagement methods across Wales. While we have seen engagement on a broad roots level (such as via the ABMYouth panel), we also see a light touch engagement method (such as through mere provision of a newsletter) plus strata of other levels of engagement in between. Our experience arising from working across five local authorities in Gwent has highlighted the variation in opportunities for participation of young people in decision making, such as via youth forums and councils. Many initiatives are local in scope and are not representative of provisions in Wales as whole. Our Petition is calling for this to be addressed.

We believe that the Welsh Government should introduce a mandatory, baseline level of engagement for Wales. This may be more than a newsletter but perhaps less than weekly panel meetings, with scope for local authorities to develop extra initiatives alongside the mandatory baseline. This semi-hard approach mandates a minimum level of youth engagement while encouraging continued innovation of further engagement methods via a soft-law guidance framework.

While much of this letter has been critiquing the programmes the Senedd is conducting, we also wish to point out that we, and young people as a whole, are extremely appreciative of the effort the Welsh Assembly is putting in to improving the standard of young people’s mental health. The Petition is only trying to help the Government guide their propositions and initiatives to promote a more equal, economic and efficient commissioning process.

To this end, the Campaign Group has significant experience of the utilisation of young persons’ participation modalities. For example, the young persons’ advisory panel, implemented at the beginning of the Project, has ensured that young people have had a voice consistently throughout the service delivery. This has since developed into further working groups such as the #Changeit Campaign Group. It is this kind of delivery model that cultivates a transparent and inclusive participation framework.

Other engagement methods could include a greater digital presence amongst young people. This could, for example, take the form of a webpage. It would simultaneously increase both participation and accessibility of key information for young people in their local areas. In addition, it provides a less formal platform for young people to voice their opinions, informality being a key outcome of the Making Sense report.

We believe that this is a model of engagement that has potential for inclusion into the overall commissioning process in Wales.

Again, we wish to wholeheartedly thank you for taking the time to read this letter.

Kindest regards,

The Changing Minds Campaign Group