The South Asian Young People’s Mental Health Project is being undertaken to implement sustainable systems to improve the mental and emotional wellbeing of young people in the South Asian community of the Hodge Hill Ward in the city of Birmingham.
The research conducted that led to this project’s existence showed that there is a large number of young people in this diverse and youthful city, who are not accessing early intervention services to support their mental health and wellbeing. This leaves them at risk of crisis, and potentially has long-term implications on their life chances. The research also found that there was a deep-rooted stigma associated with mental health in this community, particularly among young men.
This project works with 5 Secondary schools in the Hodge Hill ward
You are able to see the location of those schools on the interactive map below.
The primary aim is to improve community attitudes to mental health and wellbeing, and forge lasting relationships between schools, community organisations, and families to ensure continued support for young people in the area and will run from 1st April 2021 to 31st March 2023.
The Research, Design & Development and Proposal
For several years, concerns have been expressed locally (CCG Commissioners 2018) and nationally (Chief Medical Officers Report 2013, CYP Mental Health and Wellbeing Taskforce 2014) regarding the under representation of Muslim Young People within the service populations of mental and emotional health services. This is of particular significance within Birmingham given the large proportion of the population that has a Pakistani Muslim heritage within a context of a young and super diverse population.
The Research
Local research was undertaken that involved surveys, consultation and interviews with young people, their parents and other stakeholders including service providers. This was combined with a review of research and an examination of service data. The research identified the challenges experienced by a largely Muslim and Pakistani population of young people resident in the Hodge Hill ward area of Birmingham in accessing and engaging with services.
The Children’s Society research published in 2018 was commissioned by Birmingham and Solihull CCG it identified both the issues and possible solutions for South Asian Young People emotional and mental health. The research had adopted an iterative approach where the perspectives of different stakeholders were relayed to others to inform their discussions. The research began with a web-based survey of young people from a South Asian background, which in turn informed the work with focus groups of young people in schools, with parents (largely mothers) in the community and interviews with significant reference points including clinical and nursing staff, community leaders and voluntary and community groups. This material was collated, and the themes played back to young people and parents who had recently graduated from a parenting programme delivered in the community.
The responses from young people, parents and other were consistent there is significant stigma associated with emotional and mental health that is rooted in the attitudes of the community, relating to ‘Izzat’ (concept of family honour or respect in Pakistani populations) which influences both the young people and their parents. As a result, all young people identified seeking help as contrary to their communities’ expectations of them and young men in particular saw seeking help as a sign of weakness inconsistent with their ideal image. Young people’s health seeking behaviour was impaired by a lack of understanding about the nature of the available services and a lack of belief in the efficacy of them. Young people also had a lack of confidence in their parent’s capacity or willingness to seek help – In short Young people loved and respected their parents but felt that fathers were more likely to consider an emotional or mental health problem something to be dealt with in the family, not an external agency and that mothers were not aware of the services offered. This was consistent with the parent’s estimation of their capacity and capability to help which when surveyed was lower than national surveys of all parents and of BME parents (DFE 2017).
Design & Development
School selection
All of the schools are within the Hodge Hill Ward of the city and are members of the East Network of secondary schools in the city. As a network, these schools collectively purchase an Alternative Provision for pupils who are at risk of exclusion (known as East Birmingham Network 1 and 2 – EBN 1 and 2).
The Schools are:
Hodge Hill College
Washwood Heath Academy
Saltley Academy
Hodge Hill Girls’ School
Rockwood Academy
Working with and through schools across a community in this way is also developmentally informed as we know that adolescent health-seeking behaviours are influenced most strongly by peers.
For this reason, the cohort for this work will largely be based within that defined geographical area, and the schools will serve the area defined in the map on this page.
It is important to recognise the diversity within that area but also work with the reality that is the predominance of Pakistani Muslim young people and families. The programme’s focus is on achieving the desired impact on the cohort of young people who told us their story, through the services they designed. Services within the workstreams will not work exclusively with Pakistani Muslim young people and will need to respond to a wider population. However, Islam and a sensitivity to faith will influence the delivery of the workstreams as this was felt to be important to the young people in our research. Many young people felt that their faith was an important part of their identity and therefore needed to be reflected in any service offer.
Green Lane and Central Jamia Mosque Ghamkol Sharif have been generous with their time to assist the partnership to develop service designs that are sympathetic to the requirements of the community and sensitive to Islam through which we have created more detailed service designs, costed delivery models. We have bene assisted in thinking through how a model of governance might be structured that allow and encourages the engagement of the Mosques.
Schools identified how the programme can interface with the life of the schools and make use of their assets to amplify it’s benefit e.g. by interfacing with the School Leaders programme. The process for identifying how the vulnerabilities of young people are identified has also been discussed. There is a focus on ensuring that the young people who are quietly in need are not overlooked by the project.
What the work showed
The original work with young people and parents generated a set of design principles which have been extended an improved by our further consultation:
They wanted to be part of the service and able to influence their path to wellness.
They have confidence in schools and delivery through or including schools is more acceptable than alternatives.
Young people saw a link between mental well-being and activities – including sport but also other positive activities. The views of parents regarding their daughters was more nuanced – linking this to positive activities.
Safe social networks- virtual and physical were required by young people and parents.
Mosques and community services were seen as both part of the answer and part of the challenge.
All those consulted identified community assets that could contribute to the solution.
Schools could be a venue for service and signpost / refer.
Emotional support aligned with positive activities and embedded in a support pathway.
Community Organisations could deliver more specific interventions.
Parenting support – offer of programmes to develop the emotional wellbeing and capacity of parents.
Mosques and others had a public health role that extended into the family network to address health seeking behaviour issue.
NHS open access service – could be landing points for young people.
During the focus groups we asked a number of questions, provided a marketplace/graffiti wall to gather their thoughts, and used case studies to work through the journey.
Questions asked of the young people included:
What does mental health mean to you?
What happens when you leave school each day?
What does social media mean to you?
What/who will help you make the journey? (This question related to a young person acknowledging they need to access a service to support their mental health, to gain an understanding of what/who they will need to engage with support services)
What skills would you want a peer mentor or buddy to have?
Prioritisation exercises within focus groups on nearly all occasions highlighted the importance of supporting the parent with parenting capacity at the same time as supporting young person.
Governance Design
The governance of the project changes as it moves from application to implementation from the single task and finish group to a structure that reflects the split between oversight of the project through the SAYPMHP Project Board and Deliver, the SAYPMHP Delivery Group. This structure itself has been designed by the members of the Task and Finish Group with the following in mind:
It provides a focus on delivery of the services as described in the application.
It maximises the improvement of outcomes through the partnership represented at the Board
It informs service developments across the widest definition of Emotional Wellbeing
It avoids the conflict of interest of commissioned providers also being represented on the Board.
It Incorporates commissioners and providers not providing services funded by the Big Lottery or the CCG’s into a wider productive partnership for the delivery of the aims of the Project.
Design Legacy
Even in this early research stage, the project was already bringing community organisations together that were not previously connected or working together are now doing so:
Birmingham Impact Football Club, for example, is a small independent organisation which provides professional coaching and sports opportunities for Young People in the Washwood Heath.
Its founder member was invited to join the stake holder group and the club were involved throughout the service design process.
Through this relationship Birmingham Impact FC now work with Norton Hall to engage and support a wider group of young people including those with various learning and physical disabilities.
This has helped to raise the profile of club and support sustainability of a service which engages young people in the community through sports.
The Children’s Society worked in collaboration with a consultant from BEP to lead the Task and Finish Group, and move towards the design and development of the project.
You are able to visit their website by clicking on the logo.
The 5 organisations below were part of the Design Group and instrumental to finalising the design of the project. Norton Hall is the only member of the design group to have been commissioned as a delivery partner.
You are able to visit their website’s by clicking on the logo’s.
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The Proposal & Submission
In March 2017 following the consideration of this research the Birmingham Education Partnership, a charity led by Head Teachers which champions improved educational outcomes in Birmingham through partnership working, has led the development of a proposal building on the solutions put forward by young people and their parents that will tackle this issue in a sensitive way that has long-lasting, sustainable impact.
This proposal has been informed by further work with young people and parents to add additional detail to the service models and to reflect on the design work completed by the community organisations and other partners.
You are able to view the final submission document, plus associated appendices below:
logic model – pupil peer support
logic model – mentoring support
Adjusting the project to current needs
The COVID-19 Pandemic led to some re-evaluation of how aspects of the project would be run. While the overall aims of the project have not changed, some adjustment was required to meet the needs that came to present during the pandemic as a result of the lockdown measures taken.
The Emotional Support workstream will now be a Masters-Level Post Graduate Diploma with the Carnegie School of Education Leeds Beckett University. 1 member of the staff team from each of our 5 schools can be nominated for training as a School Mental Health Specialist.
- The SMHS will take on the face-to-face work with the pupils and be trained to deliver low-level, early-help-interventions to offer support. They will be supported by a senior lead within the school
- By comparison, a Mental Health Lead would focus on strategic implementation of support and focus on ensuring a whole school approach is reflected in the school’s policies.
- Candidates can be any school staff member that can meet the necessary criteria to begin a postgraduate course.
- The course is over 2 years, online tuition and assessment through a range of webinars and tutorials.
- The role would leave a legacy for the school by reinforcing the whole school approach, adding to the schools’ resources and ensuring that this learning can be passed on.
- It will be stressed that this role is in relation to a specific cohort in our society who are under-represented in the uptake of mental health services and that it is not duplicating the work of the city-wide early help offer.
Governance
To oversee our work, the South Asian Project has a Steering Group made up of representatives who are committed to improving access to Mental Health support and services for the community served by the project. The Steering Group is chaired by BEP’s Director of Operations, Mr John Garett. The Steering Group includes representation/feedback from our 5 secondary schools. The group is made up of:
- A community advocate,
- A Mosque,
- Representatives from the University of Birmingham
- Forward Thinking Birmingham.
- A community engagement lead for the Commonwealth Games Birmingham 2022
The group meet at least 4 times during each academic year for the life of the project, to ensure that the project is in line to meet its anticipated outcomes.
These organisations have been instrumental in helping to deliver this project. All delivery partners have been selected through a rigorous commissioning process.
You are able to visit their website’s by clicking on the logo’s.
Economic and Social Research Council (ESRC) Doctoral Studentship.
We are inviting applications for a highly talented and dedicated PhD student with a 1st class or 2:1 degree in the field of sport psychology/exercise sciences/public health/or similar subject. The community-based project that the successful candidate will work on aims to develop a physical activity intervention for adolescents from socio-economically disadvantaged Black and Minority Ethnic and Refugee communities to improve mental health by enhancing more adaptive coping with stress.
