Trust Me

23/05/2016 16:37 | Updated 26 May 2016

Trust me, I'm a doctor. Well I'm not but trust me anyway.

Would you?

Would you trust someone with your physical health who had no medical training but who cared deeply?

What if you were really ill and needed real medical intervention? Would you want a skilled, experienced and well supervised doctor? Would you be happy with someone who had also been unwell, wanted you to get better but who had never successfully treated anyone before?

This seems like an unlikely scenario and an unlikely decision to have to make, but sadly it's the reality young people affected by crime and violence are regularly faced with in relation to their often complex needs and emotional wellbeing.

The depletion of resources within the voluntary and community sector to address community violence is of growing concern and is contributing to this reality. This lack of resource has also seen the boom of 'ex-offenders' and 'ex-gang members' taking up the role of mentor, coach, youth worker, outreach worker, mediator and youth practitioner but without the necessary support, development or supervision to practice safely or effectively. I personally don't like those labels and would rather think of individuals having lived experience of the issues they are trying to address.

Having lived experience and being an experienced and well trained practitioner are in no way mutually exclusive. In fact, it is my firm belief that a combination of both is essential to providing the highest quality and most impactful services for young people.

However, creating services that have lived experience at the core, combined with the highest levels of professionalism and best practice are challenging and require real investment, time, effort and energy. They also require an underlying recognition that youth work is a career that should be respected and invested in, one that involves specialist skills, training and experience. It is also a career that isn't for everyone, despite their passion.

Don't get me wrong, I have yet to meet a highly effective youth practitioner who isn't passionate but this has to be the starting point and not the full offer. There must be a solid understanding of what makes good practice including boundaries, safe relationship building, quality assessments, risk planning, impactful interventions, successful advocacy, partnership, collaboration, information sharing, safeguarding, evaluation and self-care.

There is scope to cause real harm with a lack of knowledge or understanding of mechanisms for support, how to empower young people to make positive changes and how to help young people keep themselves safe.

One young man sticks in my mind, he was someone who had a history of violent offending and who had served a significant prison sentence. Months after his release he expressed real frustration at his own lack of progress which he attributed to his ongoing cannabis use which he relied on to sleep, eat and feel confident enough to engage with others. He had been identified as a young person who was 'hard to engage' due to his offending history and previous disengagement with statutory services. He was referred to a local provider of gang interventions as they were thought to be best placed to work with him as a 'gang member'. He explained to me that initially he rated the practitioner allocated to him and found him easy to relate to as he had a similar background. He was also motivated by the fact that the worker had made real changes in his own life and showed him that this was possible. However, the young person powerfully concluded that he had got into the position he was in by becoming an expert on the roads (experience of street and group offending), he didn't need to hear any more about that life but needed someone with expertise in a different life. He reflected that at no point was his cannabis use discussed despite openly buying and using it whilst with his worker and then mentioning the debts he was in. The young man had never flagged it as a problem but was secretly waiting and hoping to be challenged. He didn't understand how the worker could say he cared but then let him keep making the same mistakes with his money. He realised that what he wanted was someone that understood him but that looked at things differently, could teach him things he didn't know, introduce him to people he'd never meet; take him to places he'd never been. Ultimately someone who could put him on a different path and not reinforce the bubble he was used to existing in.

I don't underestimate the importance of lived experience as an engagement tool. I suspect we can all relate to the desire to be understood without explanation and to know you aren't being judged as someone has been in the same boat as you are, but again this must be the starting point not the full offer. I also don't underestimate the skills I previously listed and the example highlights the need for these skills in practice. However, with time, good training and high quality management these skills and experiences can be developed. Whilst the offering is less and less each year there is still availability of training through Local Safeguarding Children Boards that can offer access to credible yet free development for staff and volunteers and effective partnership development with specialist providers can often open up access to learning and development opportunities. In my experience it is the self-care element that is the most challenging.

Inevitably, with lived experience comes lived experience. This is stating the obvious but it seems so regularly overlooked. Personal, and often recent, experiences of physical, emotional or sexual violence or abuse, imprisonment or the loss and bereavement that come with violence all have a traumatic impact. This trauma must be addressed before it is appropriate to expect individuals to go on to safely engage others experiencing similar trauma.

Trauma is yet to be properly understood by many agencies working with young people and I am not going to write an in-depth analysis here. However, it must be understood that trauma presents in a variety of ways many of which are attributed to 'lifestyle' choices and not recognised to be the symptoms of underlying emotional turmoil. These include self-medication with drugs or alcohol, unhealthy or dysfunctional relationships, self-destructive behaviours, depression, mistrust of others, numbing of emotions and detachment and a normalisation of the violence that resulted in trauma.

When those experiencing trauma enter professional environments it is not uncommon for these symptoms to be repressed and hidden. However, with most repressed emotions and behaviours they have a tendency to leak and in this scenario that often means with the young people being supported. Where this exists with an absence or lack of clinical supervision and regular management supervision and support the harm caused to individuals and young people can be extreme.

The prevalence of practitioners with these presentations tells me we are getting something really wrong. Not the commitment to bring those with lived experience into the youth support workforce, as I've said I think this is essential and must be encouraged within the statutory as well as voluntary and community sector.

Our persistent failures lie in the lack of resources, support and investment in the individuals and communities affected by crime and violence and in the services that exist in these communities. There is power in showing young people different pathways, in having trusted and credible messengers from within communities showcasing the opportunities to do things differently, in having tangible evidence that the cycle can be broken. To do this means we have to see communities as part of the solution and not just the problem, we need to empower and develop individuals and communities to create lasting legacies of support and to recognise the mutual benefit for those giving and receiving support.

This investment must be more than one off cash injections and must involve building capacity and capability of grass roots organisations. This has to include the embedding of best practice, access to high quality, evidence based training and development, access to clinical supervision and group support networks, offers of specialist input from other sectors and agencies and the promotion of a spirit of collaboration.

This may seem like an unrealistic expectation in times of austerity but show me a community that has not seen a youth murder - each murder costs in excess of £1.5 million when all costs to the public purse are included. Just imagine what that investment of £1.5 million would look like if allocated to developing community resources and resilience and putting those with lived experience at the heart of solutions.

Just imagine!