The Mindset Revolution Manifesto for Change in Youth Mental Health

The Mindset Revolution Collective:

Ali Coleman, Bolu Onalaja, Charlie, Cicka, Chimwemwe Chirwa, Dan O' Donnell, Destiny, Juliet Oduro, Lee Grant, Linton Rainford, Mahdiyyah Ahmed, MJ Changwereza, Oscar Greer, Prateek Gupta, Saira Ali, Sam, Ummay Shabbir, Zainab Maria, Zara

We are a group of young people who are empowering youth voice to better mental health services and policies for 16-25-year olds. We have used Legislative Theatre and a digital participation process to rethink mental health from the perspective of young people. Collectively we have developed ideas that can help change the way society thinks about mental health and the way mental health services, schools and colleges support young people.

Legislative Theatre is about creating a performance based on people’s lived experience to develop new policies and practices. Over the past year we created two plays representing our experience of trying to access mental health support: We are the ones we have been waiting for and Mask to Break. Through the performance we work with the audience and policymakers to challenge the rules that prevent us from getting the support we need and deserve, and we create alternative rules that we think can make a difference to young people’s wellbeing.

We also designed our own digital platform where we can create and share resources on youth mental health. We designed a participatory process online to gather more ideas from young people within and beyond our project. We mapped problems surrounding mental health that young people want to talk about. We invited ideas from young people to address these problems, and we facilitated two online dialogues to discuss and develop these ideas with young people and policymakers. 

This Manifesto is the result of this process of youth-led democracy. For us this is only the beginning. We want to see real change and for this to happen we need all young people in Greater Manchester to join us. We can keep developing these ideas together and add new ones. On the platform we also have a policy change tracker that can help everyone monitor progress and keep pressure on decision-makers. One thing is sure: we want to have more voice on the policies and decisions that affect our lives and our future!

This is the MINDSET REVOLUTION!

Inclusive and Accessible Mental Health Services

Accessibility of Young People’s Mental Health Services

Mental health services must be more accessible and varied at schools and colleges. Pupils should be able to access a wider range of services and support at schools and colleges. In addition to counsellors employed by schools, there should be joined up services with other professionals and opportunities (e.g. CAMHS, creative opportunities and group/peer support), and in spaces that are comfortable for young people (e.g. school fields).

Integrating and Improving Access to Care Services

Strategic groups to bring the NHS Innovation Transformation Agenda for 18-25 year olds into CAMHS to bridge the gap between youth and adult services

Advocate for an integrated mental health record or health passports across educational settings, ensuring a transfer of records.

Young People Led Training for Service Providers

Young people should be actively involved in designing training materials.

There is a lot of scope for collaborative action across various projects, including the peer research project on mental health that 42nd Street is leading, and participatory activities under Mindset Revolution and the Bee Heard Group. A participatory budgeting process could be organised to bring together these projects. However, clarity is needed on how much funding is available.

The Living Well steering group have a crucial role in influencing and informing the Living Well model in Manchester, which encompasses training for staff, and may be able to assist with pushing for young people-led training.

Progressing the influence of diverse cultures within mental health services

• We want to provide incentives and campaigns within schools so that people within the mental health service from marginalised backgrounds can support young people from marginalised backgrounds and help us raise awareness
• There needs to be cultural sensitivity training in schools and mental health services, and youth-led legislative theatre could be a way of doing this.

Diversity Experience Days, Training Series, and QAF Certification

• There should be established cultural competency training for all mental health professionals from non marginalised backgrounds. This can be done through educational programmes that focus on cultural sensitivity so that they understand how to support young people from marginalised backgrounds.
• Organisations running the diversity experience days will be those already working for or with that community (eg. Ukrainian Cultural Centre would run Ukrainian Experience Days). The days would provide a non-judgemental and open space for professionals to understand those cultures and the variety within them and deal with myths/stereotypes. Training would be introduced as a next step.
• Individual training packages and series would be designed by and focused on a specific community to equip professionals to get the skills and knowledge they need to work with people like them.
• The Cultural Competency QAF (Quality Assessment Framework) would be developed alongside relevant communities and organisations to establish formal standards/guidelines for working with various diverse backgrounds (culture, gender, sexuality, class, etc) and would give organisations a stamp to demonstrate their competency. This would allow communities to have more faith in and understanding of services before they engage (a common issue blocking engagement) and would give services a meaningful tool/deliverable for their reporting and marketing.
• Follow-ups would work with organisations, professionals, and service users to get an accurate picture of whether this training had any impact and identify areas for improvement. These follow-ups should be every 1-2 quarters after the training to establish long term data. We may also provide an informal communications line for orgs to follow up with their questions or concerns.

Advocating for young people

Young people should be assigned someone to help navigate systems and provide relational support and continuity for young people, to help advocate for them and reduce the emotional impact of engaging with services.

Accessible and inclusive mental health support in educational settings

Mental Health Spaces Designed by Young People

• There should be an accountability process so that the end design of these spaces accurately reflects input from young people.
• Have college students and staff come to 42nd Street and look at their co-designed spaces, to replicate them.
• There should be a way for young people to grade mental health spaces and audit how welcoming and accessible they are, as a way of raising awareness that environment influences mental health.

Shift the focus of the education system to mental health and wellbeing

The education system should be designed for positive mental health and wellbeing, rather than rigidity, rules, and standardised academic success. The system should reflect and respect the lived experience of people living with mental health issues.

• There should be a compulsory requirement for every member of staff in schools, universities etc to be trained in mental health awareness, in order to identify issues towards early intervention.
• Look to schools that are already actively training staff and students in mental health awareness; their work should be highlighted to make the case to other schools and share training materials. 
• Education, in general, should take a more holistic approach, especially in mental health education. People learn in different ways, via arts, PSHE, etc, and different learning styles should be supported and resourced.
• Cultural artefacts such as video booklets, or a legislative theatre play, could be used as a way of communicating to young people and educational staff how to recognise and articulate their own and others’ needs around mental health.
• Mental health awareness should be integrated across the curriculum, through tools co-designed with young people, to help young people navigate mental health issues throughout their life, family and community.
• Mental health awareness implementation must be measurable and actionable: GMCA could design a workshop with young people to be implemented in a certain number of schools.  

Accessible support without diagnostic assessments in schools and colleges

Universal access to support normally provided to students with a mental health or neurodivergent diagnosis in educational settings (schools, colleges and universities), so that people who do not want to seek diagnosis or who cannot access diagnosis will not go without their needs being supported.

We suggest universally accessible support, such as:

• A break during exams/ bathroom passes when needed
• Having access to a quiet space/panic rooms in school
• More attention to the needs of international students who might need support but might not be able to have a diagnosis in a foreign country.

More co-production with young people at the forefront

Bring all the stakeholders in young people’s mental health services around the same table

• School staff members, medical and support service providers, parents, young people, and charities should be able to collaborate in a positive way to support young people seeking mental health support.
• Young people should get an art box to help them create their shared information care record, with an array of literary, digital and journaling options. They can then use this personalised record of their information in future encounters with mental health or medical professionals.
• Mental health professionals should be required to offer options for young people to record their sessions (in various ways) at every intake.
• There should be an option for young people to select to add this shared care record to their official records.
• There should be a joint annual review of notes / records, by young people, health professionals and advocates together.
• There is already work underway to develop a self-directed medical passport, but that will take time and resources to implement; this could be an intermediary step that’s applied across Greater Manchester. We could use tools that organisations such at 42nd St already have in place, as models. One model could be a timeline that young people can create at the beginning of their treatment to identify goals and mark progress. 

Co-design a more collaborative pathway through mental health support for young people

This requires sustainably resourced and appropriately funded advocates to support and empower young people seeking mental health support to use their voice. Advocates should also be trained in co-production and encourage the co-design of mental healthcare provision.

• Advocate roles that support the young person and help bridge the gap between young people and professionals should be created and funded across the system. This should be supported by ensuring that the system works together, rather than expecting an advocate to navigate a fragmented and siloed system.
• Advocates should be trained in shared decision making, co-production and supporting young people to make and share their care record tools.
• People with experience of the mental health system should be given priority to take these roles, as paid peer advocates.
• Young people should be involved in co-designing job descriptions for advocates; young people should also have choice in which advocates they work with: culturally appropriate, representative, etc. 
• The use of advocates in the mental health system should not become another bureaucratic barrier to young people seeking support.

Rethink the role of the police in addressing mental health emergencies

Transparency and Harm Reduction Around Policing Mental Health Crises

There should be thorough risk assessments conducted to consider whether police should attend a call-out. If they do attend, they should be in plainclothes (with covert body armour if necessary). Paramedics, on-call social workers, and other emergency responders should also receive personal safety training. 

Ensure that data and statistics around police intervention in mental health crises is made available to the public, to assess if police involvement in mental health call-outs is actually required. 

We would like to thank all the Mindset Revolution partners (Sonia Bussu from the University of Birmingham, Katy Rubin, Youth Focus North West, James Duggan and Zarah Eve from the Manchester Metropolitan University, 42nd St, Platoniq and Reform Radio), participants in the Legislative Theatre performances and the digital participation process, and all the policymakers and practitioners that helped us co-develop these ideas and supported this youth-led process.