This article contains information about self-injury that may upset some readers.
Alongside an extended universal offer, HeadStart Blackpool have provided four programmes to support the mental health and wellbeing of vulnerable young people affected by transitioning from primary to secondary school; self-harm; school exclusion; and children under the care of Blackpool Council, described as ‘Blackpool’s Children’. Blackpool’s approach to supporting Looked After Children is discussed in a fuller output about how HeadStart programmes have addressed the needs of vulnerable children, which can be found here.
HeadStart Blackpool’s decision to design programmes of support for these identified cohorts of children and young people was coproduced with young people and supported by a Joint Strategic Needs Assessment (JSNA) of Lancashire (2020), which identified prevalence in Blackpool of self-harm and school exclusion at three times higher than the national average. The 2020 JSNA reports that children and young people aged 10-24 in Lancashire are admitted to hospital and A&E for self-harm related reasons at a rate of 492.4 per 100,000 young people, which is significantly more than the national average of 433.7 per 1000,000, as reported by Public Health England.
Moving on Up
Moving on Up is a support service designed for children and young people in years 6 and 7 as they transition and settle in to secondary school. Young people are referred to the service by any member of school staff who identify them as benefitting from some emotional wellbeing support to manage the transition. The intervention is managed b a HeadStart-trained Resilience Coach, and they provide one-on-one support to a young person from October/November in Year 6 until the same time of year in Year 7. Meetings between young people and Resilience coaches take place on a weekly basis, and Resilience Coaches also work with the family to identify if there are any problems that may make the transition to secondary school difficult, such as difficulties with sleep or practical issues, such as transport.
Young people complete a Resilience Questionnaire They set regular goals each week with their coach, which are assessed to track a young person’s progress.
‘When I knew HeadStart were coming to see me it made me feel incredible. I wish I could see them every day’ – young person
‘I feel happier about going to High School. You have helped me to feel more confident’ – young person
Between June 2017 and August 2020, 243 young people were supported by Moving on Up, with a further 135 young people still receiving support through the programme in 2021. A sample of 70 young people was used to evaluate the programme, using progress across different ‘Resilience’ categories including empathy, problem solving, goals and aspirations, family connection, in addition to ‘School Education Statistics’ categories of school absences and fixed term exclusions.
Self-harm support programme
HeadStart Blackpool’s self-harm support programme works with young people aged between 10 and 18 and their families across a period of 8 weeks in the community.
The support provided aims to:
- Develop a relationship between the young person and their trusted adult
- Gain a comprehensive understanding of the young person’s current situation
- Find activities that support young people to build resilience and develop coping mechanisms
- Liaise with families, schools and services where appropriate
- Follow up assessment of a young person’s situation if needed to help identify relevant future support.
The service is child centred and based upon the recognition that as each young person is different, their paths to recovery will be different too. Co-production of support between the professional and the young person is therefore central, and the young person guides the adult to what it is they need to improve, build resilience and find coping strategies. The service was piloted by Blackpool Victoria Hospital, which found that engagement with youth and play workers correlated with positive improvement in wellbeing of young people admitted to an adolescent ward for self-harm related reasons (Self-harm interim report, 2020). HeadStart Blackpool have worked in partnership with Blackpool Victoria Hospital, who have support with assessments and referrals. The hospital used distraction boxes, which patients used to distract and ground themselves when experiencing impulses and thoughts of self-harm, and this is something that has been continued by HeadStart Blackpool. Distraction boxes are created by young people with the support of their practitioner to use throughout the 8-week intervention and beyond.
As of April 2020, Resilience Coaches had supported 105 young people via the A&E Department at Blackpool Victoria Hospital. 65% of these young people were female, and the average age at referral was 13 years and 7 months. Practitioners have observed that boys tended to be referred due to relationship difficulties, communication difficulties, particularly around emotions. Girls tend to report challenges such as having problems in friendships, with body image and pressures from trying to ‘fit in’. The service has been evaluated using the Strengths and Difficulties Questionnaire (SDQ, 2001), which assesses pre and post emotional symptoms, conduct problems, hyperactivity and peer relationship problems. A sample of 25 young people receiving support from the programme in 2019 found that 59% of young people reported improvement in emotional symptoms, 60% of young people reported improvement in peer relationships, and 50% of young people reported that the impact their difficulties had on their lives had reduced, with an average decrease of 29%. Follow-up evaluation of 89 young people showed that 82% had not returned to A&E with self-harm injuries or risks after the intervention.
‘She [a young person receiving support] uses her distraction box when she gets upset or angry, she uses it as a way of calming down and has not since said that she feels suicidal. It has helped her to realise what she can use to calm down and soothe herself, to stop thinking about negative thoughts and distract her mind’ – HeadStart Blackpool practitioner
Back on Track
Back on Track is a service that supports young people who are at risk of being excluded from secondary school and who may have had frequent fixed-term exclusions, to remain in mainstream provision. In its first year of delivery, Back on Track ensured that 14 young people had remained in education, saving £8,000 in school charges and Blackpool council £15,000 per year at a Pupil Referral Unit (Blackpool Council, 2018). Since the service began, 39 young people aged between 10 and 16 have received support, with an average length of 16 months.
Back on Track deliver one to one sessions in a setting agreed between the young person and their HeadStart Blackpool practitioner. The intervention is grounded in co-production, with the young person leading conversations around strategies to remain in school and the support required to make this a reality. Referrals are usually from schools or social workers, and practitioners work collaboratively with other professionals, such as pastoral staff in schools, social workers, and with the family. This joint, young person-led approach means that practitioners are better able to identify creative and innovative ways to support young people, such as by creating scrapbooks with them to help them cope with difficult memories.
The service aims to join up information and improve attendance whilst looking at the reasons behind disruptive behaviour and coaching young people to manage their emotions and see how their behaviour impacts upon other people.