El conflicto funcional en comparación con el disfuncional

The outreach consultative form of provision is characterised by a team of mental health workers covering a large area. Often in this approach the area is divided between the professionals to ensure access. A key feature of this approach is that mental health professionals skill up youth justice workers to ensure appropriate referrals. A positive of this approach is that services can be tailored to meet the needs of the area. There is also the risk that the mental health workers are lone workers within their particular area and risk isolation. As this form of provision requires active consideration of what is needed in an area it was expected that this type of provision would be able to achieve a level of social justice.

One of the YOTs involved in the research used this approach. Three mental health workers were based within the area specifically for the YOT. They strategically split the area into three territories; north, central, and south, to ensure coverage. There were regular meetings for the three mental health workers which allowed them support. This YOT was not in a rural area as in Khan and Wilson’s description, but a large metropolitan city. The decision to split the area was based upon the size of the city, but also due to other services. The police in this area were split into three districts and the YOT had an office in each district (but was a centrally run organisation). The mental health workers also noted differences in the three districts of Newkirk which would affect working.

“I think they’re very different areas, the north, central, and south. The north is, erm, you know whenever you see those things on the news about the most disadvantaged parts of Britain, it’s always the north area and there’s all sorts. […] Central’s very, loads of LAC [local authority care] kids.” – Beth, Newkirk

This approach allowed much support for mental health workers, they were based in the YOT full time, but had regular supervision and interaction with CAMHS. Additionally, having colleagues from a similar background that were also seconded into the YOT was a source of support.

“So it’s, we don’t work out of the same base and I suppose if I was sat here and B was sat there and we worked out, [Beth: Yeah if we had more] if we talked to each other more, swapping ideas and supporting each other more than we do. And it’s just something we’ve developed around styles and experience I suppose. And we still often meet and share stories.” – Annie, Midcaster

As the outreach consultative form of provision applies to large areas, it was noted by the mental health workers that they cannot be a constant presence in the YOT offices. The mental health workers offered training for new YOT staff and gave guidance regarding assessment and referrals. This lessened inappropriate referrals. Additionally, the mental health workers were happy to discuss cases informally with youth justice workers. There was access to psychologists when needed and other services were available. Through having relatively high resource levels and support from both CAMHS and the YOT, the mental health workers were able to maintain

their professional approach and values. This allowed for a socially just approach to mental health work, which the staff were happy with.

Researcher: “Do you feel you get to maintain that [CAMHS] approach and ethos?” Beth: “Yeah.” Annie: “Yeah.” Mick: “As you said before, it’s the person centred approach, for me anyway.”

This format suited the mental health workers in Newkirk and they felt able to meet the basic needs of young offenders. There were some gaps in provision, specifically around learning difficulties and speech and language development that required further provision, but the resources were lacking.

“And actually there’s a massive unmet need, we have mild to moderate learning difficulties and actually you can’t access a clinical psychologist quickly here to be able to get a kind of analysis or assessment […] speech and language again, it’s massive. Some YOTs have got a speech and language therapy, at the moment our waiting list in the locality I work in it is over six months now.” – Annie, Newkirk

All three mental health workers in Newkirk YOT were previously full time, but recently financial cuts have made it necessary for them to each work one day a week in local schools, providing mental health care. It was felt that this was not appropriate for their skills and that their time could be better used.

“Yeah, it has been a cut. They had a full time schools worker, the post was withdrawn and we were made to give a day. So it’s increased our workload with no extra time and it’s reduced our capacity here.” – Beth, Newkirk

The outreach consultative form of provision gives mental health professionals a high level of agency and the flexibility to use their professional judgement. It was the mental health workers decision on how to split Newkirk into manageable territories, and their approach to their work is often unquestioned by those within the YOT, showing that the culture in Newkirk YOT is accepting of a variety of approaches. All of the mental health workers in Newkirk YOT were

strongly social justice oriented in their approach, actively seeking to separate their work from youth justice.

“Mick: We’re a bit different in terms of other agencies that come into YOS and do standout as we don’t do duty and most of the others do and things like that.” “Beth: and I think it’s always been pretty much like that.” – Mick and Beth, Newkirk

That the outreach consultative form of provision allows for this is positive, and it seems that it means mental health needs are met within this model and that socially just practice can occur.