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From out of reach to back in the loop

A pioneering project to address mental health problems in young men from African-Caribbean backgrounds is being piloted in Birmingham. Up My Street uses ‘street therapy’ to help mental health professionals and lay workers engage with young people.

Picture credit: Alamy

When charity worker Nathan Dennis learned that two young men he was working with had committed suicide, he struggled to come to terms with it.

Mr Dennis knew the men through Bringing Hope, a charity in Birmingham that works with the city’s African-Caribbean community. News of the deaths, within a short space of each other, hit him hard.

Shortly afterwards, Mr Dennis’s work with the charity brought him into contact with men accused of domestic violence, and these events left him feeling disturbed for months.

‘I wanted to find a better way to engage men in talking about and looking after their mental health,’ he says. ‘The macho, hard-man image perpetuated by black men in particular can mean they are not honest with themselves.’

Determined to do something to encourage young men to open up about their emotional struggles, Mr Dennis set up a local discussion forum using an activity many of them loved – music.

Young black men need empathy and someone to share emotions with – Nathan Dennis

The sessions culminated in the creation of a 16-track CD, released last year, that addresses issues such as bereavement, relationship difficulties and absent fathers.

‘The initiative was called Silent Scream because men often internalise their feelings,’ says Mr Dennis. ‘They suffer in silence, which then manifests itself in anger and confusion. A silent scream is far louder than anything you will ever hear.’

He says the initiative was successful in getting men to open up in a way they had never done before, but it would never have happened had they approached local mental health services first.

‘Sometimes, young black men don’t see the difference between a police officer and a mental health nurse. As far as they are concerned, they’re all part of the same system, which they don’t trust, so they would rather suffer with whatever they are going through,’ says Mr Dennis.

‘The cognitive behavioural therapy methodology used by many service providers also doesn’t help. It is all about: “I’m the professional, you’re the patient,” and a lot of the people we’re trying to reach don’t need that. They need empathy, and someone to share their emotions and feelings with.’

The success of the forum got Mr Dennis thinking about how he could reach men at a much earlier stage. Through his community engagement company – First Class Legacy – he created Dear Youngers, a peer mentoring scheme that will use social media to deliver video and audio content aimed at empowering young people to start talking about mental health.

‘Research suggests young people cannot go ten minutes without checking social media on their phones,’ he says. ‘So what better way to try to equip them with the practical skills to build their mental health resilience than meeting them where they spend most of their time?’

Dear Youngers, and the street therapy approach it adopts, is part of a pioneering two-year pilot project called Up My Street. The project – launched in Birmingham in June by mental health charity Mind – aims to support African-Caribbean boys and men between the ages of 15 and 25 who need therapeutic help, but might shun traditional service providers.

Mind is also working with two other local organisations that will run innovative schemes based on street therapy: homelessness charity St Basil’s will run a black history project, and the Birmingham Repertory Theatre will set up a drama initiative.

The three organisations will each receive £24,000 from Mind and the Centre for Mental Health. One of the reasons they were chosen for the project was their willingness to adopt co-production – an approach to designing youth mental health services in partnership with young people themselves. The Centre for Mental Health has awarded Comic Relief £50,000 to carry out an external evaluation of the project.

Sharing sessions

Staff will take part in ‘street therapy labs’, idea-sharing sessions where they will discuss effective ways of engaging young people about mental health.

The sessions are aimed at equipping non-mental health professionals with basic treatment skills so that they can deliver the first stage of support. Local social workers, mental health nurses and community psychiatric nurses will join the sessions, sharing their expertise and learning about innovative approaches to working with disaffected young people.

Street therapy

Former NHS clinical psychologist Charlie Howard pioneered street therapy in 2008 to reach young people in the criminal justice system with unmet mental health needs.

Nathan (kneeling) with youth workers

She created the charity MAC-UK and worked successfully with youths at risk of gang crime in north London. The method builds trust by engaging young people through an activity they enjoy and then allowing a young person to self-refer for mental health worries.

If a young person decides they need further support from a trained professional, a youth group staff member can help arrange this, and act as an advocate for that person.

More than any other group, evidence shows people with African-Caribbean backgrounds access services disproportionately through the criminal justice system. They are detained under the Mental Health Act twice as much as any other group. Mind equalities improvement manager Alex Storer says the need for discussion about how to reach this disaffected group was behind the charity’s decision to set up the project.

‘By bringing mental health professionals into the labs we wanted to help challenge thinking about how to build trust between primary care providers and young people,’ he says. ‘We also wanted to highlight how professionals need to see young people as experts in their own mental health, and should be listened to when designing services.’

Sinem Cakir, director of youth participation at social enterprise The Integrate Movement, which will run the street therapy labs, agrees new treatment approaches are needed to reach excluded young people, but acknowledges this will not be easy to achieve.

‘It is often the small, community-based organisations who feel they have a licence to blur some of the boundaries between the person offering help and the person receiving help,’ she says. ‘Mainstream agencies are often resistant to this as a way of treating someone, and that will take time to overcome.

‘Services are stretched, so you can see how it is possible to be content with not going the extra mile, to work out why it is that the people who most need you might not be the ones coming through your door’.

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