listenup!Chapter 7 | 51“… when young people access the service, ofteninitially for condoms, they are also fully informed ofall other aspects of the project.”Project worker, Streetwise, NewcastlePrevention and early interventionThe project sites considered prevention in terms ofeither stopping a situation, such as a mental healthcrisis, from happening in the first place, or preventinga situation from happening again or getting worse.Many of the approaches offered by the project sitesaid both these types of prevention:“CBT [cognitive behavioural therapy] aims to helpyoung people develop helpful thinking patternsand show how these may influence emotional andcoping responses in future difficulties.”Project worker, Aberdeen Foyer, AberdeenSome of the prevention work carried out by theorganisations did not have a specific mental healthfocus, but took the form of practical support, helpingyoung people to develop a range of life skills andcoping strategies.“A young person might, for instance, want someoneto accompany them on the bus to college for twoweeks while they learn the route, or come shoppingwith them to find clothes that are trendy and yetcover scars caused by self-harm.”Project worker, Caterpillar Service,Barnardo’s Marlborough Road Partnership, CardiffEarly intervention is a term often used to describeworking with young people aged 14 to 35 whoare presenting with symptoms of psychosis (DH,2001) and The Zone in Plymouth had a specific earlyintervention in psychosis programme (Insight). Thisconcept of providing support at the early stagesof problems was used by all the organisations,including The Zone, to help not just with psychosisbut with a wide range of emotional and mentalhealth problems.Case StudyIcebreak at The Zone in Plymouth is the onlyservice in the country for young people withemerging personality disorder.“Icebreak is designed as an ‘earlyintervention/preventative’ project… Theaim is to work to prevent young peoplefrom either developing the label ofpersonality disorder, or, if they have beengiven that label, to prevent them fromdeveloping secondary problems associatedwith the stigma and social exclusionthat often accompanies a diagnosis ofpersonality disorder.”(Project worker, IceBreak, The Zone, Plymouth)The project has an official partnership withPlymouth Primary Care Trust (PCT) andcurrently sees approximately 90 youngpeople. Another unique aspect of thisproject is that the trust staff are seconded into work with staff at the Zone, so the serviceis based in a youth organisation rather thanin a statutory mental health service.“Through interaction in settings such as schools andyouth clubs, Community Links are able to engageyoung people before they reach the point of crisisand require specialist mental health services – thusproviding an opportunity for early intervention.”Project worker, Community Links, Canning Town
listenup!52 | Chapter 7The emphasis is on supportingthe young people to gain the skillsto improve their life, and part of thisprocess involves the young peopledefining what ‘getting worse’would involve – in a sense, definingwhat it is they wish to prevent.Project worker, The Market Place, LeedsSensitivity to young people in distressPart of a holistic approachAlthough the organisations worked with youngpeople to help prevent them from developingproblems or to prevent problems getting worse,there were times when it was not possible to preventa crisis. Additionally, some young people accessedtheir service for the first time at a time when theywere already in urgent need of help. Services weretherefore sometimes faced with young people whowere contemplating suicide or self-harming. Theyworked to support young people through thosetimes, and often continued to work with them afterthese periods of extreme distress.Case Study“We offer intense support over 24-48hour periods for young people goingthrough a crisis who do not wish to involveother agencies. We also offer support toindividuals in custody who may be in crisis.“In all instances of crisis support, weensure that the follow-through of the crisisis sustained and maintained until suchtime that there is mutual agreement withthe young person that they are happy tocontinue without.”Project worker, Community Links, Canning TownSome organisations provided this support as part of anongoing programme working specifically with youngpeople who were experiencing severe difficulties:“IceBreak concentrates on young peoplecontemplating suicide, talking about self-harm orwith attachment difficulties.”Project worker, IceBreak, The Zone, Plymouth