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“Youth - Our Resource for the Future”
Proceedings of the Conference on Adolescent Health and Welfare held on Thursday 24th October 1996
At The Royal College of Physicians to mark The Tenth Anniversary of Youth Support
“Youth - Our Resource for the future”
First edition 1997 Published by "Youth Support” 13 Crescent Road Beckenham London BR3 2NF
Charity No 296080
All proceeds in aid of our work with families and young people
Introduction Dr Diana Birch
“Youth - Our Resource for the Future”
Our conference on 24th October 1996 marked the tenth anniversary of ‘Youth Support’. The charity began from a small idea - that of providing help and support for pregnant schoolgirls and young mums and grew to include services for young people with many differing needs. Forum meetings have formed a vital part of our work - Adolescent Health has been a neglected area in the UK and ‘spreading the word’, supporting and teaching colleagues is vastly important.
The first meeting of our ‘Forum on Adolescent Health and Welfare’ attracted approximately 50 people to the Royal Society of Medicine one evening - this last conference had us turning delegates away as numbers went over the 450 mark -the maximum possible at the Royal College of Physicians and resulted in us having to hold parallel plenary sessions using the just opened new lecture theatre with a video link between the two. Our prayers were answered when the builders finished on time!
This was a really proud moment for those of us who had struggled so hard to obtain some recognition for adolescent services and the need of young people to have a medical service in their own right. Colleagues travelled from across the world at their own expense to take part - Roger Tonkin from Vancouver opened the conference with a balanced view of ‘Youth Empowerment - Illusion or reality?’ - bringing some common sense to the latest ‘buzz word’ in adolescent health - empowerment.
Parallel plenary sessions on ‘Mental Health and Behavioural problems’ chaired by Eric Taylor with contributions on teenage suicide by Patrick Alvin from Paris, therapy by Ueli Buhlmann from Zurich and a moving personal story read by Laura, a young ‘Youth Supporter’; and a plenary on ‘Health and Physical Challenge’ chaired by Neville Butler raised complaints from delegates who found it hard to choose. Such is the dilemma of adolescence - learning to make choices!
The afternoon choices were no easier - ‘Teenage pregnancy and sexuality’ chaired by Pramilla Senenayake (IPPF) and including the youth support experience of fifteen year longitudinal survey of school girl pregnancy, exciting presentations by Fay Hutchinson and other colleagues from the Brook, Pamela Gilles from Nottingham to name but a few - vied with ‘Social and Behavioural challenges’ including Christine Ferron from Lausanne presenting a study of school drop outs, Dr Aggrey Burke on the challenge of race and Leon Polnay on the needs of young people in care.
The day ended with a keynote presentation ‘Looking to the future’. Dick MacKenzie (Los Angeles) had the audience visualising youth wandering through the ‘shopping malls of life’ picking and choosing experiences, risks and positive growth when they are ready - putting what you want in your own trolley.
We learned a great deal from the conference and perhaps the biggest lesson was that more people do have an interest in considering the needs of young people, there is a lot to learn , a lot to discuss and we need much more time! Hence our next conference will extend to two days and have alternative plenaries, workshops, posters and free paper sessions. Dates are 22nd and 23rd October 1998 at the Royal College of Physicians, London. I encourage your attendance.
Youth Support has flourished in the last ten years and the conference was a celebration of the energy, commitment and dedication of all our staff and friends - and particularly of our youth. Let us hope that we will continue to grow and serve young people for the next decade!
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Opening Address - Roger Tonkin
Youth Empowerment: Illusion or Reality?
The New Oxford Dictionary defines empower as ‘to give power to; to make able’. Since its inception ten years ago Youth Support has ‘walked the talk’ of what, in today’s parlance, we call youth empowerment. The organisation’s very name signalled the direction that its founder, Diana Birch, wished it to follow. It has not only been supportive to youth, but has actively involved them in its evolution. The imagery of liveliness, togetherness and interaction, and cheeriness dominate the Youth Support publications and are reflected in its day to day programmes.
But my question to you is, does that same ethos extend beyond individual programmes such as Youth Support to mainstream youth oriented services or even to society in general? Is what we celebrate today an illusion nurtured by a few outstanding programmes or a reality reflective of a shift in our social values concerning contemporary youth?
In our work with young people we find that they are quick to challenge us to show that we do care. They assume that we and the services that our programme staff provide are competent. Over the years Youth Support has successfully met that challenge thus justifying the confidence placed in it by it’s young clients.
However programmes such as Youth Support do not operate in a vacuum and their future will be shaped by what happens in the larger system and the newer models that fiscal realities and organisational restructuring are thrusting upon our major health care institutions. We must consider, in a studied way, what will such challenges do to support youth and to foster youth empowerment within the emerging system.
Surely, Youth Support has a leadership role to play in this regard. Surely, in the coming decade, Youth Support must not only continue to show that it cares and is competent to serve the needs of its clients, but also that it is on the forefront of responding, in a youth positive manner, to the challenges of change within the larger system.
Let me suggest that over the ten years of Youth Support’s existence there has been a paradigm shift within the field of Adolescent Health. We are shifting from a problem focused process to a resiliency based and coping process. The shift has been from an expert driven, medically oriented, disease club or fragmented model towards a consumer driven, peer support, family based, health oriented, comprehensive or holistic model. Programmes like Youth Support have contributed, in a positive way, to that shift.
Countries such as Argentina, Canada, Finland, and Israel have been among the early leaders in the field of Adolescent medicine. However, the modern model of adolescent Medicine, is credited as being developed in the USA and largely due to the leadership and inspiration of the late J Rosewell Gallagher. The American model has been exported to many other countries. More than fifty countries now have some form of Adolescent Medicine initiative.
The model, while exemplary in many ways, is not totally transferable to other countries. You have but to look to the examples of it being developed here in the UK to see that the model is being adapted to fit different cultures, different health care systems, and different youth health needs. Indeed, some exciting work on adolescent or youth health is going on at centres in London, Nottingham, Oxford, Glasgow to name but a few.
As the numbers of countries and centres within countries with adolescent health programmes expands and the involvement of international bodies such as WHO, UNICEF, IPPF and UNFPA grows it can be predicted that the traditional medical model that we have long accepted will have to shift its emphasis. Indeed, we have much to learn from the approaches being employed in other countries.
I believe that the model will move towards a more supportive but competency based network of programmes that not only treat disease and injury and promote adolescent health. It is my impression that that is what more holistic programmes such as Youth Support have tried to do. It has tried to practice what others sometimes only preach.
As we move from an expert driven to a consumer driven model we will need to know what the consumer thinks about health and health care. What does health mean to youth? Is it an issue for them? Research on adolescents that actually asks adolescents what they think about their health and their health care needs and concerns is beginning to emerge. For example, a recent study in the UK revealed that adolescents, especially the younger ones, see family and peers as the principle sources of help and guidance while health professionals are much further down the list.
Indeed, UK youth differentiate between the listening style of approach used by family and friends and the lecturing or preaching style employed by most professionals.
This is what individual adolescents or youth tell us. Each of us can listen to their messages and adapt our individual professional practices accordingly. However, that does not necessarily shift the larger system.
There is also a need for broader population based information about the determinants of youth health. the Health Education Authority here in London is to be commended for its recent initiatives on behalf of understanding the health perceptive of the broad population of youth in the UK. In my own province, we too have studies adolescent health status and risk behaviours. The data, generated from the replies of some 16,000 grade 7 to 12 students, has been released to the public and to youth in each region.
We have been able to identify important regional, age, and gender based differences. There are differences in health and behaviour based on ethnicity, presence or absence of chronic conditions, and sexual orientation. the data is very powerful, especially when presented publicly in a positive, non-judgmental way. In our province it has heightened awareness of the needs of youth and is promoting an important shift in how we respond to those needs.
The results of our own survey are revealing but not necessarily international news. The topics covered in today’s conference are the very same health topics or problem areas that youth in BC identified. They reflect the new morbidities and are primarily issues of lifestyle. They can also be addressed by promoting behaviour change and introducing preventive strategies such as universal Hepatitis B immunisation, safety helmet legislation, or tough drinking-driving enforcement.
To be effective, these measures must be accepted by youth and be regularly practised by them. For this to occur, we must help to make them ‘able’. For this enablement to happen youth, as a group, must be involved in identifying priorities, proposing solutions, designing implementation strategies, and evaluating the results. They need to feel part of the response process, not just the object of it.
With new information about the perspectives and needs of youth at our fingertips we are still faced with the challenge of what to do about it. The expert driven system would respond by designing a system, lobbying for money to implement it, and then put a multidisciplinary team together to work on how to use the less than adequate funding that government then provides. There would be no money to evaluate and little time to ask youth or families if it was working. This is part of the dis-empowered reality facing today’s youth.
A consumer driven model, on the other hand, would respond by getting together to solve the problem with the resources available and decide how much of it they could do for themselves. Self-help, peer counselling, indigenous worker, consumer advocacy groups are but a few examples of the multitude of important initiatives that have emerged within recent years. They too are rarely evaluated. They certainly are more humanising but do they really influence outcome or merely contribute to the illusion of offering a more empowering service model?
While we have learned a bit more about what youth think about their health. We have much to learn about how to convert that knowledge into a more empowering model. In my country there is a trend towards increasing youth participation in national conferences and consultations about health care reform.
At provincial level a new system of regionalisation of health services is being introduced and youth are being invited to participate in a variety of advisory councils. Our Premier has established a youth office within his own office and is focusing on ways to create educational, recreational, and employment opportunities for our young people. In each instance the same questions arise. Who speaks for youth? How do we get a youth to sit on our committee? How do we engage youth in a meaningful way? What powers or authority should they be given? What is a Youth?
We have been trying to address these questions? It is not an easy process and we are finding that there are a lot of pitfalls. However, we are convinced that the process of answering them will help us down to the path towards a less illusory youth empowerment process and the ultimate goal of helping them to realise their maximum potential and health. What have we learned so far?
Firstly, that it takes longer than you might think or wish (years not months). Secondly, to be wary of political pressures for quick fixes and instant solutions. Thirdly, to trust in the good sense and positive motivation of today’s young people. Fourthly, to learn how to see the world through the same positive lens as do most youth and see the challenge or opportunity in each situation. Fifthly, to find ways to provide youth with the skills and supports they need to participate, in a meaningful and enriching way, in the shaping of a youth positive society. those ways include focus groups, training workshops, information packages, theatre, music, and art programmes, and, of course, the creative use of the electronic highway. Sixth, we must always remember to laugh together and maintain a sense of humour.
I believe that a Youth Positive Society is one that values youth, ensures that they are empowered, and respects their rights. to create such as Society we need to work together to shift the youth health paradigm even further towards a new form that fosters intergenerational collaboration and problem solving, promotes more effective networks between youth and youth serving organisations, and creates a caring, competent system of youth friendly human services.
It seems to me that as it celebrates the decade past and looks to its future Youth Support is well placed to play an important role by contributing its energy and experience to the task of helping individual youth but also by involving youth in guiding the process of redefining the model.
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