Supporting young people who are experiencing mental health challenges can be complex and stressful for workers. Statutory mental health services are under a great deal of pressure. Young people who are moving from child to adult mental health services may find they no longer meet the threshold for receiving a service, even if their condition has not changed. Those who do qualify for a service may find themselves waiting for long periods before they are assigned a worker.

All of this means that support workers who are not trained in mental health often find themselves being the main point of contact for young people who are extremely distressed and at risk. In this situation, being able to access support and advice from a mental health professional provides a ‘safety net’ for both the worker and the young person.

Case Study

Simon is a coach in 1625ip’s Reboot West team. The team support care leavers with their wellbeing and their education and employment goals.

Kevin is a mental health specialist employed by 1625ip.

Jess is a young person on Simon’s caseload.

Jess was diagnosed with emerging emotionally unstable personality disorder. Her behaviours were very high risk. She mismanaged her diabetes as a form of self-harm, as a result she was in and out of A&E every 2 weeks.

Simon would visit Jess when she was in the hospital, seeing it as a good opportunity to build relationship, show support at a difficult time and create trust. His aim was to develop a relationship that introduced and reinforced honesty and was consistent. Simon’s hope was that establishing this trust relationship would provide a secure foundation for Jess to make some genuine changes in the future.

However, Jess’ condition and learnt behaviour in childhood resulted in her trying to mind read what other people wanted. She was incredibly pliant, mirroring back whatever responses she thought Simon was expecting or wanting. In the hours he spent in conversation with her, he felt there was little genuine connection.

Simon was aware of the dangers of slipping into a rescuing role by visiting Jess in hospital at these times of crisis. He sensed that his presence at the hospital was not building the relationship as he had hoped; in fact it was reinforcing some of Jess’ unhealthy behavioural patterns.

It wasn’t helping the client and it wasn’t helping me, because ultimately all that was happening was she was continuing to avoid, and I was continuing to get more anxious about her safety"

Simon sought support and advice from Kevin. They discussed the nature of Jess’ diagnosis, and how best to work with her. In particular, Kevin helped Simon to think through what was and wasn’t his responsibility. Kevin shared his understanding of mental health, and of the legislation and statutory responsibilities surrounding it.

Simon and Kevin also had conversations about mental capacity relating to the client. This helped Simon understand why it is problematic to look to reduce people’s liberty even if they are making very risky decisions about their lives.

when I was very, very worried, as I continue to be about this young lady’s safety and the levels of risk surrounding her, talking through the case with Kevin allowed me to get a really clear grip on what fell within my remit and what fell within the statutory duty

Talking to Kevin helped Simon to be more proactive. Simon was supported to take action by sending concerned emails to the right people with the right tone. Simon’s intervention led to multi-agency meetings being arranged. As a result, professionals from health, social services and other support agencies were able to work together to formulate unified effective safeguarding plans for Jess.

Jess has since chosen to disengage from all professionals. The door to support has been left open to her.

Learning summary

Timely access to specialist mental health advice and support enabled:

  • The young person to be appropriately safeguarded.
  • All relevant agencies to be informed about the case.
  • Simon’s own mental wellbeing to be supported.
  • Simon to make most effective use of his time on the case.