Acting on mental health

The Wraparound project in Ballymun is taking a novel approach to young people at risk

AS A SENIOR civil servant who had a pivotal role in drawing up the Government’s Vision for Change mental health strategy three years ago, Barbara Nic Aongusa had something of an epiphany recently when confronted by her teenage son.

They had been listening to a programme on the radio about teenage suicide and her son went on a “bit of a rant” about how useless the Government was and how they never did anything about suicide prevention, she recalls.

“I was sitting there as the person responsible for the Government’s national action plan on suicide prevention which has just been published in a blaze of publicity.

“I asked a few questions and he replied, ‘it doesn’t matter how many big publications there are. What happens to me if one of my friends is upset and I want to do something about it?’”

The conversation got her thinking about the nature of youth mental health services and how they invariably are of a medical nature when teenagers, in particular, could benefit just as well from other forms of intervention.

“It occurred to me my son was a young, articulate, middle-class boy in a pretty good school and he did not know what to do. What must it be like if you are coming from a less-advantaged background?

“It is a really big issue that we have not cracked. The mental health services we have so far, the exclusively medical model, really isn’t meeting the needs of our young people,” she told an audience at the presentation of certificates to professionals working in the area of youth development last week. They had completed a rigorous training programme on youth mental health and wellbeing in Ballymun.

Though not directly involved, Nic Aongusa, who is director of the office for disability and mental health at the Department of Health and Children, has described the Wraparound project in Ballymun as “groundbreaking” and “blazing a trail” for youth mental health services.

“We will always need the specialised mental services. Only about 2 per cent of teenagers need a specialised service, but virtually all teenagers need some kind of level of support at some stage to help them get over the general stresses and strains of being a young person in Ireland,” she explains.

A total of 42 people from 18 different organisations including teachers, parents, youth workers, gardaí and social workers were given certificates for taking part in the Wraparound programme in Ballymun’s Axis Centre last Wednesday.

The programme is named after a “wraparound” approach to dealing with young people and their problems. It is based on approaching mental health problems from the perspective of the child and his or her family rather than imposing a solution based on a professional diagnosis of the problem.

Wraparound also means the different agencies which deal with young people such as teachers, social workers, gardaí and health professionals adopt a co-ordinated approach to dealing with individuals,

The six-module training programme which focuses on youth mental health and how to spot and deal with signs of mental stress is designed by Youngballymun, which is funded by American businessman Chuck Feeney’s Atlantic Philanthrophies and by the Government, Headstrong, the national centre for Youth Mental Health, and CAN.

Initially, Youngballymun planned a training programme for just 12-14 people but instead received 44 applicants, such was the interest in it.

Six teachers in the local secondary school, who participated in the programme, have been trained to recognise the signs of mental stress in their pupils and how to intervene along with having direct access to 30 other people with different areas of expertise who can help them.

“In the past, we sometimes did not know who was working for who and what they were doing. There was a lot of overlapping,” says Nicola Byrne, a Ballymun resident and social worker who completed the programme

“With the WAF [wraparound facilitation] we are linking together. We’re all on the same hymn sheet so to speak.”

She has pointed out that 120 different agencies work in Ballymun, traditionally one of the most deprived places in the State though now being transformed by regeneration. Few until now have sought to use families in dealing with the problem of young people.

“If we don’t involve the family, then that is a natural resource that is not being used. This is a big amazing thing for me as a mother and a resident and a youth worker to see this happening because the advice and choices of families are now being explored,” she says.

Senior probation officer Rachel Lillis cites the example of a young person on the pilot programme whose brother is on probation, but has not fallen foul of the law himself.

“It shows the preventative merits of the WAF programme. With this systemic approach we can work with the mother and the older brother and that will have a knock-on effect for the younger siblings,” she says.

“Our remit is around offending behaviour and addressing that. We do need the other services to come on board such as the schools, the addiction services and the job centre.

“We would have done that informally before, but WAF co-ordinates a structured approach to that. It very formalised and there is accountability. We all know what we are supposed to be doing.”

The launch in Ballymun last week was a joyous event reflecting the belief that participation in the project was a worthwhile endeavour and it could act as a template for similar schemes elsewhere.

The results of the wraparound pilot project are being looked at by five similar community-based schemes in Ireland.

With mental health being a key issue, the number one health issue for young people in Ireland, the success or otherwise of the Wraparound programme will be closely watched.

About 70 per cent of the health problems of young people and most of the mortality is due to mental and substance use disorders.

Youngballymun chief executive Eleanor McClorey says she is confident that the Wraparound programme will show the way forward for many organisations which work with young people.

“We have one model of work and a structured approach. We will be implementing it across Ballymun wherever young people congregate such as youth clubs and schools.

“Where previously we have young people who slip through the cracks and get into early brushes with the gardaí, we now have juvenile liaison officers trained, we have social workers trained,” she says.

“Our wraparound approach is smart thinking about young people’s mental health needs.

“Because people from a huge variety of organisations and backgrounds are following the same practice model, we can, for the first time, provide teenagers and young adults with a structured and seamless system of support that is the best in the country.”