‘See Me’: Exploring unmet need among young adults in Bristol A consultation exercise by Caring in Bristol

Presentation Outline Why bother? Project background Methodology Selected Key findings: Barriers to accessing services So what? **Could exclude the list of the key findings**

WHY BOTHER

Project background Initial group consultations with 15 young adults (aged 19-25) Indicated existing unmet need among … … young adults facing ‘severe and multiple disadvantage’. The results of these initial consultations suggested that they may be a group of young adults in Bristol who are experiencing a range of complex support needs and problems which are currently not being addressed.

Project Background Defining ‘Severe and Multiple disadvantage’ … ‘“Disadvantage” captures risks such as family conflict, addiction, poverty, or lack of resources. Disadvantages increase the chance – the risk – of serious and lasting damage to health and development. The word “severe” indicates that the amount of risk being faced is more than is ordinarily encountered, even by those who live on the edges of society. “Multiple” is a reminder that it is not one risk but many (Dartington Social Research Unit, 2015).

Methodology 4 Key questions Participants Ethics and planning Methods 31 professionals 26 young adults Participants 1) Nature of unmet need 2) barriers to accessing services 3) effective engagement methods 3) new service design 4 Key questions Semi-structured one-to-one interview format Audio recorded Methods Possible impact on young people and key-workers as interviewers Ethics and planning Thematic analysis Analysis

Structural Barriers Single needs focus Appointment based access Opening Hours Engagement requirements Problems of self-referral Access criteria Single needs focus Structural Barriers

Structural barriers: engagement requirements “As they move into adult services there’s more expectations to attend appointments, to engage in resources we know are really limited…Which means if you’re not engaging in a service or you’re not answering your phone, it’s very likely that they’re gonna close quite quickly for that reason.” (Professional #4) “As they move into adult services there’s more expectations to attend appointments, to engage in resources we know are really limited…Which means if you’re not engaging in a service or you’re not answering your phone, it’s very likely that they’re gonna close quite quickly for that reason.” (Professional #4)

Structural barriers: single needs focus “There’s those who are complex in nature but perhaps individually, when you break down their level of need, don’t meet the threshold for specific services. For example, their mental health needs don’t meet thresholds for the recovery team or any kind of specialist mental health involvement, but actually when you combine all the needs that they have, they’re very complex young people who do have a need for services.” (Professional #3)

Structural barriers: problems of self-referral “Quite often the young person might not necessarily be aware that they had a legal problem, so I think the ability to have somebody who can identify that rather than leaving it to the young person’s devices is critical I think.” (Professional #3)

Perception & awareness of services Individual barriers Confidence Perception & awareness of services Ability to ask for help Fear of stigma Lack of trust Lack of resources Previous experiences

Individual barriers “In theory everybody has the same point of access, but certain people have to jump through more hoops to get to that universal service; therefore if you don’t target resources at them, even though services appear universal, their capacity to access them is not.” (Professional #5)

Individual barriers: ability to ask for help “I’m working with quite a few young people who won’t leave the house. I’ve got one person who’s got severe mental health problems, and to even go to the GP to get a proper diagnosis is really difficult, and to get her housed is really difficult because you need to have the evidence. It’s almost like her mental health is preventing her from getting help with her mental health.” (Professional #21)

Individual barriers: perception and awareness of services “The pressure of what are they gonna ask me, what are they gonna do? There’s a pre-conceived notion possibly from young people about what’s expected of them and that’ll keep you away just because you’re not sure what happens there.” (Professional #11)

“Someone may have traumas in their life, some may just feel sad for no reason, some may have problems at home, some have to grow up too fast, it could be anything but they all share one thing; they need someone to talk to that they believe cares about them. If they had someone they could turn to, someone they could trust, who they feel cares about them as an individual, someone they could relate to they would feel much more comfortable and on the same level, and therefore [would] be likely to engage and build a positive relationship.” (Young Person #15)

SO WHAT