My Mind Star | Triangle

CAMHS National Summit 2022: The power of listening

Posted on 28th October 202231st October 2022 by Donna

Speakers noted the UK is in the grip of a mental health crisis, with children and young people suffering in particular. Referrals to NHS Children and Adolescent Mental Health Services (CAMHS) have increased by 180% during the last five years, creating significant pressure on services and raising the threshold for support and treatment. The Adverse Childhood Experiences (ACES) model is routinely used to tot up all the trauma children have experienced, creating feelings of bleakness for support workers. Still, the CAMHS summit were determined we have hope and talked a lot about harnessing the power of listening to help support.

Speakers acknowledged it’s grim out there for young people who are suffering. As Dr Harriet Stewart said, “young people’s mental health was worsening at an alarming rate before the pandemic. In the aftermath of Covid, children present at CAMHS with more complex needs. Staff are exhausted, burnt out, and leaving the service”. When Dr Stewart said, quite bluntly, “if we don’t get it right, we’ll ruin their lives, their opportunities,” it was hard not to feel like we are, as a society, failing our young people. But as she said, “we need to think we can do this.”

I also heard from young people like Katie Hickson, who spoke up about her experiences. She is a young woman who gets involved in conversations with the government and campaigns, making me feel hugely hopeful. Katie so eloquently reminded us, “young people already have a voice; they don’t need to be given it. It’s the job of the professionals, the service providers, and parents to listen to their voice and provide opportunities for them to be heard”.

I also loved hearing Max Davie (who very impressively managed to squeeze in a reference to CBeebies’ Octonauts while debunking some of the myths around early help) talk about listening to the difficulties young people were experiencing as we’ve become a bit fixated on labels, but Max demonstrated the importance of listening first and diagnosing later.

Nicola Harvey, the author of Mindful Little Yogis, shows us how active listening can help young people feel psychologically safe and that without providing that psychological safety, we can’t expect young people to grow up resilient. Reiterating without listening first, we can’t expect better outcomes.

There was a lot of agreement around the need to fund early support hubs, that young people can access without needing a referral.

How can the Outcomes Star help your service?

The Outcomes Stars are listening and conversational tools helping services transform lives. They are keywork tools and measurement tools. If your organisation provides early intervention mental health support for young people, My Mind Star has seven key outcome areas designed to open up conversations between support workers and the young person about their life. My Mind Star doesn’t assess how severe a mental ‘problem’ is. It explores where the young person is now and where they would like to get to in the future. It is a holistic co-production tool involving listening and discussing a young person’s life, situation, priorities, hopes and aspirations. Together the worker and young person co-create goals and action plans. Using the scales to measure the distance a young person travels through the journey of change over a period of time. Star data also helps managers assess workers caseloads to help reduce burnout. Star data also provides service improvement insight to analyse if the support provided is working, individual progression data and aggregated service level data to report impact to funders.

What I personally like about the Outcomes Star approach is that it starts with listening and, when used well, puts young people at the centre of their journey. Rather than defining a young person by statistics, by how many ACEs they’ve experienced, or whether they are ‘unwell enough to warrant service or support, the Outcomes Star is a collaborative tool that supports and measures change.

Learn more about My Mind Star

Young people and mental health: How to make the conversation count

Posted on 7th February 20206th February 2020 by Donna

As Children’s Mental Health Awareness Week 2020 draws to a close, Joy MacKeith, co-author of My Mind Star, reflects on what the development process taught her about how schools and services can support real change for young people.

This week is Children’s Mental Health Awareness Week and there certainly is a lot going on. Yesterday a colleague attended a conference on mental health in schools in Manchester and next week Triangle will be hosting a stand at Oxfordshire’s Youth in Mind conference. This is all happening against the backdrop of a Government Green Paper on children and young people’s mental health and increasing concern in the media.

Catching up with my colleague after the conference yesterday, it is evident that the commitment to equipping schools to take a bigger role is certainly there, but thoughts about how to do this in practice are still developing. So it seems like a good moment to draw out some of the lessons from our work with Action for Children to develop My Mind Star, a tool for engaging and supporting young people around their mental health and measuring their progress.

After initial discussions and scoping in 2017, the development process began in earnest in 2018. Over the course of a year and a half we held a series of workshops with young people, front-line workers and service managers to find out what really makes a difference when working with young people. My Mind Star, a version of the Outcomes Star for mental well-being in young people, was then developed and piloted across 11 Action for Children services and also HeadStart Kernow.

Here are some of the highlights
from that process.

Recognising the need for help is a crucial first step

Talking about change with the people directly involved is always fascinating. What emerged early on in the workshops was that young people often don’t seek help because they don’t realise that things could be much better. Not recognising that what they are experiencing is mental distress, they cope as best they can on their own. So, a really crucial first step for many young people is reaching out for help. Interestingly, this year’s Children’s Mental Health Week theme is ‘Find Your Brave’ and a key message is to be brave enough to ask for help.

Don’t look at mental well-being in isolation

Another clear learning point was that we must look at mental well-being in the context of the whole of the young person’s life. The workshop participants identified eight key areas that should be part of the conversation. After piloting this was reduced to seven because it emerged that safety is an important aspect of all of these areas, rather than something that should be discussed in isolation.

The final seven outcome areas are:

Feelings and emotions,
Healthy lifestyle,
Where you live,
Friends and relationships,
School, training and work,
How you use your time and
Self-esteem.

Participants emphasised that it was vital to cover all these areas when talking to a young person, even if they were not what was immediately presented as part of the problem.

Involve young people in defining what ‘good’ mental health and well-being looks like

Developing the scales for a Star involves in-depth discussions about what ‘good’ looks like. The scales for each outcome area or domain describe a journey from things being very bad to the desired outcome being achieved. This means pinning down what ‘bad’ means, what the desired outcome looks like, and what steps people take as they travel from one to the other.

When it came to the ‘How you use your time’ scale, there was an interesting conversation about time spent on screens. Questions raised, included, is time used this way always bad or can it also be a positive way of accessing support, information and entertainment? There was a definite difference of perspective between the generations and it was very important to have young people in the room to share what good looked like for them.

My Mind Star helps young people identify issues and set goals

My Mind Star was piloted over six months with 67 workers and 177 young people and the pilot was evaluated using feedback forms and a further workshop. Both workers and service users really valued the way that the visual Star Chart summarised their life and helped them identify priorities.

The vast majority (94%) of young people said that the scales helped them to describe how life was for them at that moment. While 85% said that the scales helped them to understand what they needed in the way of support. In the words of one worker: “I liked that it gave the young people the opportunity to see where their priorities are, not what someone else thinks we should work on. This gives them some ownership and increases motivation”.

Evidencing change is motivating for everyone

Three quarters of the workers valued the way that My Mind Star opened up better conversations. And both workers and service users found it encouraging to see progress when the second My Mind Star was completed. As one young person said, “I liked doing the Star because it reflects the improvements I have made in the past months”

Psychometric analyses showed that the outcome areas were coherent and the scale was responsive to change. Managers very much valued the fact that it enabled them to evidence the progress that young people had made.

Following the pilot, amendments were made to the tool based on the feedback and the final version was published in September 2019.

Take-aways for those working with young people and mental health

Based on our learning from this project, and on personal experience, just letting young people know about different kinds of mental illness isn’t enough and can even be counterproductive. Young people can mistake the natural highs and lows of the teenage years for a mental health problem or start to identify as being ‘anxious’ or ‘compulsive’. Rather than knowing the labels, young people need to know what mental well-being looks like in simple and everyday terms so that they know when they need to ask for help.

Also, when they do ask for help, schools and others need to make sure that there is ‘no wrong door’ and that everyone is equipped to have that initial conversation, to signpost them to others if needed and to keep a watchful eye. As in so many areas of life, prevention or early intervention is better than leaving things until there is a crisis.

Ultimately, the evidence from our pilot is that My Mind Star can really help make those early conversations count and give everyone working with young people a framework, a shared language and a way of evidencing the difference they are making.

Triangle will be at the Youth in Mind conference on 12^th February at the King’s Centre in Oxford. If you’re attending the event and would like to arrange a meeting with us on the day, or if you have any questions about My Mind Star, other versions of the Outcomes Star for the mental health or young peoples sectors, or would like any information on the new Star Online, or anything else, please contact us on info@triangleconsulting.co.uk or +44 (0) 207 272 8765.

We may not live in Hawkins, but young people face stranger things than you or I had to deal with!

Posted on 24th January 202018th March 2020 by Donna

Ahead of attending Oxfordshire Mind and Oxfordshire Youth’s Youth in Mind conference next month, Tom Currie, Outcomes Star’s local Implementation Lead, reminisces and reflects on his adolescence and how it compares to that of today.

Kids sitting on a wharf, with ominous colours

If you were an adolescent in 2020, how would you be coping? I, for one, am not so sure I would be doing as well as I did in my decade of pubescent angst – the ‘80s. From my 15 years working in youth sector organisations, it is clear to me that helping young people develop the skills and resources to maintain good mental health is of the utmost importance. In this blogpost I look at a couple of the challenges we face and present a solution that could help.

There is an ever-increasing number of challenges to good mental health invading the space young people inhabit. These include: the multiple platforms on which they relate to others, the growing complexity of gender, sexuality and identity, a rising awareness of the challenges facing the world in their lifetime and the depleting natural resources with which to face those challenges. And all of this sits within a backdrop of rapidly changing political and social landscapes. The children and young people I talk to are more informed about the environmental and political crises they face, yet, as a society, we have less to offer them by way of a vision for the future to sustain their spirits in overcoming these challenges. So, I am thrilled that in February I am spending a day with experts talking about how best to support young people to develop emotional intelligence and strengthen their mental health at the Youth in Mind conference. It looks like a fantastic line up of presenters and delegates.

Third sector organisations play an important role in supporting young people’s mental well-being. Continuing cuts to council budgets and the already decimated youth service provision across the country means that many local authority Youth Services are simply no longer able to meet that growing need. Young people need healthy relationships with caring and interested adults to help them navigate the challenges of adolescence and enter adulthood successfully. So, relationships that see and support the whole person, their strengths and capabilities as well as the challenges they face, are key ingredients for services helping to maintain good mental health. First challenge: how do we support holistic, client-centred, relational keywork?

On top of this, in order to gain funding and win commissions, charities and other organisations providing these services need to be able to prove the value of their work to funders or commissioners. Success often looks like the aversion of a mental health episode or other tragic event, like self-harm or suicide. Which brings us to the next challenge: how do you measure and demonstrate what did not happen as a result of your intervention?

One useful tool to consider for addressing these challenges is the My Mind Star. Published in September 2019 after a two-year process of design, development, piloting and refining, this new Outcomes Star is the result of a creative partnership between Triangle, Action for Children and Headstart. My Mind Star is designed to be used with young people who are experiencing poor mental health, including low mood, stress, anxiety, anger, sleeplessness or self-harming, or who have a diagnosed mental health condition. It is intended for use in early intervention services that aim to prevent the onset or development of a mental health condition wherever possible, and to fill the gap in mental health services before one is diagnosed. This Star may also be used to support young people in managing a mental health condition.

My Mind Star meets the first challenge of supporting holistic, client-centred, relational work because it is essentially a key working tool designed to be used as part of a supportive relationship. The seven holistic outcome areas of My Mind Star help young people explore how the different parts of their life affect or are affected by their mental health:

Feelings and emotions
Healthy lifestyle
Where you live
Friends and relationships
School, training and work
How you use your time
Self-esteem

The second challenge, of measuring what your service prevented from happening, is addressed by My Mind Star’s scale. All the Outcomes Stars use the five-stage Journey of Change to measure changes in attitude and engagement. This makes them effective at evidencing hidden, intrinsic outcomes, like shifts in attitudes, beliefs and thinking patterns, as well as measuring the more visible, extrinsic outcomes like improved engagement at school or college. All the Outcomes Stars are available on Star Online, our web-based platform for recording and analysing the data provided by the Stars, so it makes reporting and representing your impact a much quicker and easier task.

I’m attending the conference with my colleague Marie Buss, so if you are interested in finding out more about My Mind Star or any of our other Outcomes Stars for young people then come and find us in the exhibition area. We may not be able to remove all the triggers and challenges that young people are facing around maintaining strong mental health, but we can give them the tools to take an active role in overcoming those challenges together.

The Youth in Mind conference takes place on 12^th February at the King’s Centre in Oxford. Tickets are available until 3^rd February. If you’re attending the event and would like to arrange a meeting with Tom or Marie on the day, or if you have any questions about our new Stars, or would like any information on the new Star Online, or anything else, please contact us on info@triangleconsulting.co.uk or +44 (0) 207 272 8765.

Safeguarding Students: Two key questions

Posted on 31st December 201923rd December 2019 by Donna

Sara Burns, co-creator of Triangle and the Outcomes Star, explains how she learnt more than she set out to at the Safeguarding Students conference in Manchester

I had two main questions when I registered for the Safeguarding Students conference: what aspects may be relevant in a Star for university students with mental health issues and is My Mind Star – published earlier this year – a good fit? Those questions faded into the back of my mind by lunchtime and further in the afternoon.

Throughout the morning, one speaker after another talked about the factors behind the sharp increase in mental health problems for young people and difficulty accessing the right services. 100 student suicides a year are the tip of the iceberg[1]. Like most of the people in the room (confirmed by a show of hands) I was listening as a parent as well as a professional and despite already knowing much of what was said, it was impossible not to find the presentations poignant and disturbing. My son and daughter are now young adults and I have witnessed one negotiate university and the other struggle without access to the right mental health support. I imagine there were many other parents in the room with similar experiences; one speaker talked about the loss of his son to suicide.

In the afternoon we heard about the student mental health crisis as a symptom of much wider problems within universities and society; the takeaway phrases for me were ‘persecutory perfectionism’ and ‘university as an anxiety machine’ – how ‘anxiety at university is inherent in a neoliberal Higher Education sector that distorts the student experience into a value-for-money exercise’. We also heard about the emphasis on metrics and performance in a marketized environment. Student speakers throughout the day stressed the pressure to perform, to be perfect, to succeed – that ‘failure is not an option’.

Answering my questions

After 15 years of developing versions of the Outcomes Star I’m still fascinated by the process and my mind is so used to engaging in this way that it even though my original questions were far from front of mind, I still answered them. I concluded that My Mind Star is a good enough fit to be worth piloting in a student welfare and support service, but there are key differences, such as money and the roles of family and peers, which we would include if we produced a tailored variant.

I didn’t get a strong sense of need or fit for the Star within student support, but that may be my lack of knowledge. The Outcomes Stars are most helpful within one to one, holistic support over months or years, which some students may need and receive but support appears to vary a lot. However, if you support university students with mental health, do look at My Mind Star and contact me if you think it – or a variant for students – might support your work; I’d love to find out more.

To talk to Sara Burns and share your thoughts, call 020 7272 8765 or email info@triangleconsulting.co.uk.

[1] Safeguarding Students Conference 2019, Manchester