Charlie Howard



Charlie Howard: Mental Health with Young People at the Heart

I’m a Consultant Clinical Psychologist and I was delighted when The London Mayor announced a Violence Reduction Unit for London. It was a bold move by Sadiq Khan and he should be applauded. It had been wanting for a while. But it was of course the start. The challenge for all of us remains how we make this happen.

Years ago, when I talked about mental health as a solution to the violence on our streets, I was the lone voice in the room. This is no longer the case (thank goodness) but the question remains how to do mental health well. Many of the young people bedevilled by the complexity of violence, won’t fit into the ‘traditional’ mental health service model. They might not recognise that they have needs. They might not be able to get to the place where they have to go for help, service might move too slowly, or their lives might simply be too chaotic for anyone else to join them.

Working from the ground up, co-delivering mental health interventions with and for young people, has taught me one overriding thing: we have to create the solutions with young people. And I don’t just mean the front of house but the back of house too: the policies, the risk assessments, the whole lot. Working in this way gives us structures that work better but more importantly, we foster trust with young people and we erode power. These are powerful ingredients for a healthy mind.

When we take the time to listen, young people describe wanting mental health support that is highly flexible and creative. It’s about going to where they are, delivering what they want, when they need it. The bigger thing we need to get our heads around is how to recruit and train the staff to deliver this work. It’s not as simple as buying in mental health clinicians and relocating them on the streets. In fact, this entirely misses the point.

A Violence Reduction Unit that takes a good approach to mental health in London will invest in the training of mental health staff and their organisations. It will help them to ‘get it’ and to adapt how they work. But above all, it will do this with young people. They are the ones who taught me to adapt my clinical practice. Nothing else came close.   Without them we won’t succeed.

Mental health has to be about them, with them and for them. And it has to be about changing what’s in their worlds (the wider systems) as well as what’s in their heads.

Charlie Howard is a Consultant Clinical Psychologist and Founder MAC-UK