MH:2K - Observatory of Public Sector Innovation

Mental health issues affect about 1 in 10 young people in the UK. MH:2K gives young people a leadership role in solving this most important of challenges. It empowers 14-25 years old to identify the mental health issues they see as most important, engage their peers in exploring these topics, and work with decision-makers to make recommendations for change.

Innovation Summary

Innovation Overview

Mental health conditions affect about 1 in 10 children and young people. 75% of mental health problems in adult life, excluding dementia, start before age eighteen. Given this, it is perhaps unsurprising that young people consistently identify mental health as a priority issue.

Through MH:2K we give young people a role in solving this most important of challenges. We focus on working with young people who have direct experience of mental health issues or who are from at-risk groups. Just as importantly, we also work with local decision-makers and researchers.

For the young people, we empower them to:
- Identify the mental health issues that they see as most important;
- Engage their peers in discussing and exploring these topics;
- Work with key decision-makers and researchers to make recommendations for change.

For decision-makers and researchers, we help them to harness young people’s experiences and views. They develop a deeper understanding of youth mental health issues, prevention, support and services in their area. They also gain new insights about effective solutions.

MH:2K builds on good engagement practice from within and beyond the youth mental health field. Specifically, it features:
- End-to-end youth leadership: Young people decide its focus, co-lead its events, and determine its findings and recommendations.
- Peer-to-peer engagement: By empowering young people to reach out to their peers, MH:2K creates a safe and engaging space for participants.
- Close collaboration with key decision-makers and researchers: By involving key figures in the project from its start, MH:2K builds trust, enthusiasm and commitment, and the implementation of its recommendations.

In each local area, MH:2K involves the following six activities:
1.Recruitment: We recruit a core team of young people as ‘Citizen Researchers’, including those with direct experience of mental health issues and from at-risk groups.
2.Design Days: We support this team to explore key national and local information about youth mental health, alongside their own views and experiences. The Citizen Researchers determine which mental health issues are most significant for their area. They receive training in facilitation and public speaking.
3.Roadshow: Citizen Researchers co-design and co-deliver workshops to engage at least 500 other young people in answering questions about their priority topics. The Roadshow workshops stimulate informal learning and gather young people’s views on the issues they face and potential solutions.
4.Results Day: Citizen Researchers analyse and extract key findings from the Roadshow data. They work with local decision-makers and researchers to develop strong, practical recommendations for change.
5.Big Showcase: Citizen Researchers present their findings and recommendations to key stakeholders at a showcase event, involving facilitated conversations about next steps.
6. A Local Advisory Panel of key local decision-makers, researchers and other stakeholders informs the project’s work throughout its lifetime.

MH:2K’s six-part design is intended to work in any UK local area.

From 2016 to 2017, Involve and Leaders Unlocked piloted MH:2K in Oldham (a metropolitan borough of Greater Manchester, England). MH:2K Oldham engaged over 600 local young people with diverse backgrounds and life experiences. Since then, the project has run in North Tyneside, Birmingham, Central Lancashire, Nottingham and Nottinghamshire.

The original evaluation in Oldham found evidence of significant impacts. It noted that:

Decision-makers and researchers identified “multiple potential impacts on research, decision- making and engagement practice” in Oldham and Greater Manchester, with “potential for significant improvements in health outcomes”. This included the setting-up of a task and finish group, reporting to Oldham’s Health and Wellbeing Board to drive forward implementation of the project’s recommendations.

Among other changes, Citizen Researchers and Roadshow participants reported increased knowledge about mental health. They reported learning or improving hard and soft skills, and some noted further impacts, for example, changes to their career plans.

One year later, MH:2K’s recommendations had been mapped against pre-existing plans to identify gaps and match actions to current activities. This has included on-going consultation with the Citizen Researchers to check the detail of their recommendations. Several quick wins had been implemented via existing activities, or plans were adapted or confirmed to fit with the recommendations. These include the development of primary school resources, training for schools, involving young people in creating accessible information about mental health, and new professional guidance for those working with young people.

Innovation Description

What Makes Your Project Innovative?

MH:2K is the biggest youth-led project on mental health ever undertaken in the UK. It has seen 127 diverse young people from five areas of England become Citizen Researchers and engage over 3,400 of their peers to find out what more can be done to prevent and tackle youth mental ill-health.

MH:2K combined end-to-end youth leadership with a local advisory panel and elements of co-design. This helped ensure the project was grounded in the reality of young people’s experiences and created a safe space for them to participate, whilst also achieving very significant influence on local decision-making.

Unusually for projects on this issue, MH:2K takes a holistic view of mental health and emotional wellbeing, covering prevention, support and services.

What is the current status of your innovation?

Five diverse areas of England have hosted MH:2K to-date: Birmingham, Central Lancashire, North Tyneside, Nottingham and Nottinghamshire and Oldham. The local recommendations for these areas have had significant impact, influencing work including Local Transformation Plans, cross-organisational strategies and work in schools.

We brought together the local work for the first time at a national event in Parliament and launched a report with national recommendations. MH:2K’s national recommendations highlight the key themes emerging from local areas for national attention and action.

Innovation Development

Collaborations & Partnerships

We developed and ran the project with social enterprise Leaders Unlocked.

The project was two-thirds funded by the Wellcome Trust and two-thirds funded by participating local areas (via the council and/or local NHS).

The project had local advisory panels in each area it worked in (council, NHS, community groups, research bodies, schools, young people). It also had a national advisory panel (NHS, civil society, public bodies, researchers, funders, young people, local government).

Users, Stakeholders & Beneficiaries

MH:2K engaged over 3500 young people, & over 300 stakeholders (from councils, NHS, community groups, research organisations, other public bodies).

98.5% of participating decision-makers & researchers say they'd do something new or differently following MH:2K. One year later, decision-makers in Oldham continue to consider youth mental health a high priority & look more at schools’ role in supporting emotional wellbeing. 82% of those who co-led MH:2K reported increased feelings of wellbeing.

Innovation Reflections

Results, Outcomes & Impacts

Initial results from the 2017/18 evaluation suggest significant impacts on decision-makers, researchers, & the young people involved. Across four local areas:
92.8% of decision-makers and researchers who attended a Big Showcase event said that the recommendations are very useful;
98.5% agreed or strongly agreed that they would do something new or differently as a result of the project;

Citizen Researchers reported experiencing significant benefits. Among other examples, 91% said that their knowledge of mental health issues had increased. 89% identified improvements to their presentation skills, 86% to their confidence & 82% to their feelings of wellbeing. 86% said that they now felt more optimistic about their future.

MH:2K’s recommendations have had significant impact, influencing work including Local Transformation Plans, cross-organisational strategies and work in schools.

The project was independently evaluated using a mixture of quantitative & qualitative techniques.

Challenges and Failures

The project went very smoothly in all areas.

Our main challenge was that in some areas not enough young men applied to take part. In future, we are going to specify a gender balance when we reach out to statutory and community organisations as part of the recruitment process.

Going forwards we need to make the project financially viable for local areas to commission without support from Wellcome. This is a challenge given the current funding context for local councils. Economies of scale and the fact we have developed materials we can reuse means that we have reduced the cost of the project by one third since we originally piloted it.

Conditions for Success

The issue the project focussed on – youth mental ill-health - was of real concern to local decision-makers. They were looking for new ways to tackle it.

We chose to work with local areas who were serious about listening to young people’s recommendations.

The Local Advisory Groups ensured buy-in from multiple local institutions. The fact the young people presented their recommendations to stakeholders themselves was also powerful.

We were committed to youth leadership throughout the process.

We provided the necessary atmosphere and support for the young people to thrive.

Replication

Since the original pilot programme in Oldham, MH:2K has been hosted by four diverse areas of England: Birmingham, Central Lancashire, North Tyneside, Nottingham and Nottinghamshire. We plan to work with more local areas in the future.

There is potential for MH:2K’s six step methodology and citizen researcher approach to be used to tackle other issues, beyond mental ill-health.