In discussions with mental health professionals about their work, practice is highly likely to be a common theme within the discussion. In this research practice was of interest regarding how both provision and social justice affected it. There is no attempt here to be prescriptive about how mental health work should be carried out; this theme relates to how practice differs across YOTs, how this is affected by the provision of service and what effect this has upon social justice.
There were a number of aspects of practice that stood out from the interviews, all of which were mentioned by all the mental health workers interviewed. The way in which they were discussed differed though; this may be due to factors such as the provision in that YOT, the approach, identity, and background of individuals, and the workplace culture. Resources also seemed to relate to how practice was discussed. The YOTs with lower levels of resources talked about practice in very concrete terms, concerning how to get the work done. The teams with higher
levels of resources used more abstract terms when discussing practice, considering how the work should be done. Woodshire had a comparatively high level of resources, with three mental health workers, all qualified to a high level. Whereas in Westley, the focus was upon meeting basic need.
“we’re kind of trained to understand, erm, the differences between different cultures and how you work with it. Erm, more importantly how power is kind of distributed in relationships, who holds it, who doesn’t, erm, what does, what do your kind of physical characteristics say about the way about how you might be positioned and how you position others. These are all themes that are up for discussion all the time. And it should be.” – William, Woodshire
“it’s very much about their offending behaviour and that risk of re-offending and the risk of any harm to others is reduced, and the mental health part is kind of secondary to that.” – Dan, Westley
This isn’t surprising; when there are fewer resources, having the ability to meet the basic needs of young offenders takes priority over more abstract issues such as if there is a power imbalance in the relationship. There is a basic hierarchy of need which has a strong impact upon youth justice services, particularly regarding questions of priority. Physical safety will often take priority over mental health for example. When these basic needs are met, others can be considered, which means that YOTs with higher levels of resources are more likely to be able to progress through the hierarchy.
Regardless of provision and resource levels, one factor that occurred in all the YOTs was that mental health workers were asked to take on “extra” duties or aspects of work. This involved school visits, duty on self-harm or emergency rotas, and general YOS or CAMHS work. Only those in the external-one-stop-health-shop were exempt from this; which is an advantage of non-seconded models. Whilst some of the mental health workers found this useful in some ways, such as maintaining professional practice or identifying local need, all the interviewees felt it was not the most appropriate use of their time.
“Yeah, it has been a cut. They had a full time schools worker, the post was withdrawn and we were made to give a day. So it’s increased our workload with no extra time and it’s reduced our capacity here.” – Beth, Newkirk
“Erm, you know I do feel, I know that [having a YOT caseload] is an unusual arrangement, erm, it’s something that, you know, I think that would probably work [pause] probably towards, not doing in the future.” – Dan, Westley
One of the aspects of the practice theme was the ability of mental health workers in the YOT to practice in a way they felt was appropriate and to challenge aspects of practice they did not feel were appropriate, like the ‘extra’ tasks and duties. Again, the teams with higher resource levels were more accommodating of this than those with lower resources. Often, interviewees who felt more able to challenge practice and state their opinions felt better able to excise professional judgement. The managers interviewed also echoed this sentiment.
Researcher: “Do you get asked to consider things in terms of a criminal perspective?” Beth: “No.” Annie: “No. I wouldn’t have it! [laughs]” – Beth and Annie, Newkirk
“And we just had to say look, it’s going to take up all my time to do that and it’s going to be no value whatsoever. And the response was, “well yeah, but it’s all part of it” and I had to turn around and say actually, no. This isn’t part of the agreement and we’re not going to do anything that is outside the agreement and they had to accept it.” – William, Woodshire
Brookshire YOT was about to undergo a period of change due to funding cuts. Sarah, the lone mental health worker within the YOT, took this as an opportunity to change aspects of practice she felt uncomfortable with that she was unable to change previously.
“in a way it’s quite exciting really; I can use it as an opportunity to look at the referral process and try and get better referrals […]So erm, I’m seeing it as a bit of an opportunity really, I think it’s going to be hard and they’re gonna do it and it might not be workable. It might all be too much, but at least we’re giving it a shot I suppose.” – Sarah, Brookshire
Other YOTs involved in the research had previously gone through periods of re-structuring and change due to outside factors like funding cuts. The changes were generally positive in these YOTs, although they had higher resource levels than in Brookshire. Additionally, in those instances managers were more heavily involved in the process of change and prioritised mental health. This may not be the case in Brookshire as Sarah had spoken of a lack of support previously; Sarah’s drive to create change may not be as effective without support from management.