‘You Don’t Get Ditched’—Young People’s Mental Health and Youth Work: Challenging Dominant Perspectives

Round 1

Reviewer 1 Report

The paper delves into a crucial subject, exploring the application of the Youth Work approach to address mental health issues in young people in the SW of England. It effectively outlines the goals of this approach, emphasizing the improvement of overall well-being, the cultivation of resilience, and the identification of coping mechanisms.

The study's purpose is clear and compelling, with well-articulated context and introduction sections. The problem under analysis is presented with clarity and is evidently of significant importance. The description of the Youth Work approach is compelling, offering a clear and detailed explanation. The case study is also effectively presented, showcasing an intervention that centers on establishing one-on-one relationships through 1-2-1 Youth Work, supplemented by Wellbeing-Based Group Work involving up to 8 young individuals participating in community-based activities or trips to the National Park.

The qualitative comments provide a rich description of the Youth Work approach's value in assisting young people with their mental health issues, emphasizing the associated benefits and outcomes. The conclusions section is clear and effectively summarizes the advantages of the Youth Work approach.

However, a notable absence is the limitations section. Given that the Youth Work approach represents a novel practice in addressing young people's mental health, it is imperative to include a dedicated section to better comprehend this approach. This inclusion would assist researchers, policymakers, institutions, and parents in understanding not only the advantages but also the risks, limitations, and potential areas for future research.

The paper acknowledges two important limitations: the lack of funding. This limitation led to the cessation of services by the Youth Work organization in 2014 due to government cuts. Subsequently, in 2015, the organization reinstated services as a charity. The second limitation included in the study is the risk of dependency from youth workers and young people. To mitigate this risk, the case study uses group work and referrals to other organizations. While these limitations are highlighted, it would be beneficial to explore and elaborate on additional challenges or constraints associated with implementing the Youth Work approach.

Aside from this aspect, the paper is substantial, addressing an important topic with meaningful insights.

One minor typo (a period) was observed in lines 179-180. ("At the very least alternative perspectives to working with young people.in distress need to be explored and evidenced.”)

Author Response

Many thanks for the thoughtful and supportive review.

We have added the following limitations section to the paper ( as well as resolved the typo pointed out)

Limitations

As outlined above there certainly appear to be many positive reasons to consider adopting a youth work approach to addressing a range of young people’s mental health issues However, there are some caveats. Firstly, this is one case study and care needs to be taken in not over-generalizing the findings. Whilst there appears to be much to merit, more research is needed to further explore the role of youth workers and the youth work approach in the realm of young people’s mental health and well-being. For example, one area that requires further exploration is the relative merits of 1-1 approaches compared to group environments.

One of the potential risks alluded to earlier was the possibility of creating dependency, whilst this study identified that the youth workers introduced young people to groups (and made referrals to other agencies) to encourage the formation of additional relationships to mitigate this. Whilst this appeared to be successful it should be acknowledged that this is always a potential problem in 1-1 approaches. Endings are also potentially problematic and can cause relapses for young people, and further support or the possibility of follow-up should also be considered to alleviate the potential problems of ‘painful’ endings. Referring young people to other services or projects within the existing organisation (as well as other agencies) is also a possibility to alleviate any difficulties.

As also alluded to earlier funding is also a potential problem as many youth work organisations are small voluntary sector projects with limited long-term funding or sustainability and this has the potential for ceasing provision and cutting short a valuable service. Finally, there is a potential problem with the grading or assessment of mental health. Whilst many of the benefits of the approach are grounded in a non-medicalising approach, which begins with a referral by a professional or parent who does not have a mental health background (or through self-referral). It could therefore transpire that a young person had a much more serious mental health condition that required medicalisation and their condition could potentially worsen as a result of inappropriate interventions. It could also exacerbate the other young people’s well-being in the group they became a part of. Whilst there was no evidence of this in this study this is a potential limitation and care needs to be exercised in assessing the severity of the young people’s mental health at the outset.

Reviewer 2 Report

Ample theoretical backing for the findings and recommendations can be found in different sets of literature.  One is John Dewey's notions of Progressive Education that was the start of student centered learning and founded on the processes of continuity and interaction that fits with the program and suggests ways this can be integrated into current schooling, through project and/or place based learning, group based learning, and other means of allowing students more input and control over their learning process as a social experience, working with others in groups that allows them to see and utilize each others abilities, strengths, and perspectives as collaborative efforts that not only allows them to show their abilities and strengths, but encourages open communication and building of social ties and shared problem solving.  These encourage a problem solving approach to tasks, self-efficacy, support networks and resiliency.  From a Sociological viewpoint if we look at Hirschi's Social Control Theory, he applied it to deviance, but the flip side is it shows how to increase social engagement and sense of belonging, which the Youth Work program does.  White's work on Identity and Control also provides a theoretical basis in the sense of identities as means of exerting or asserting control, not in the sense of power, but as defining situations mutually to increase predictability and sense of control as normal and using identities as a means of situating oneself within social contexts, which has been seen as especially problematic for adolescents.  The medicalization approach has had the long recognized problem of defining people as deviant or deficient, and sometimes preventing getting help as diseases are not ones' fault, hence not one's responsibility for treatment.  This relates to labelling theory and how we alienate and ostracize people through diagnoses and labels as "ill" which can make getting services more problematic and separating them from their peers.  Inclusive classrooms are often more effective as they minimize this separation and labelling consequences.  It implies deficiencies and lack of ability, which is disempowering.  Looking at abilities and what one can do, as a means for finding ways to do things they currently cannot do (strength based approach) is more doable in team and group settings as they can see how others do what they cannot and learn from them not as deficiency, but in enabling better group functions.

Author Response

Thank you for your thoughtful review  - in particular, the very useful observation of the importance of John Dewey to theorizing the youth work approach - the following paragraph has been added:

Youth work aligns with the student-centered educational philosophy of Dewey’s progressive experiential education (1900, 1916, 1938). Learning is therefore grounded in the twin processes of continuity and interaction, and dynamic learning situations are established that are student-directed and enable the development of a social experience, involving working with others in groups. This allows young people to see and utilize each other's abilities and strengths and encourages collaboration.