The Hills Youth and Family Services
What has been most instrumental to your progress?
The focus groups with youth were most impactful to our project. Much work and research is occurring among professionals in the field of mental health, however often those impacted by the service provision—in our case children—are not involved in developing that service or program. In order to make the connection with youth in our project, we relied heavily on our strong partner relationships with other youth programs, who offered support, space, relationship bridges, and on-going feedback loops throughout the project. If we truly expect to see a change in children’s mental health through the delivery of a range of mental health services and programs, we must ensure those services and programs are influenced by children so that there is buy-in, comfort, and accessibility. Youth participating in these focus groups offered a range of experiences and emotions they were struggling to deal with, and many mentioned that the staff at their youth centers were part of their circle of support because they had meaningful, trusting relationship with them. In many ways, the youth confirmed that our youth centers would be a meaningful location to integrate access to mental health services.
Another important factor was the selection of a community facilitator who was able to relate to the focus group participants and have a strong understanding of mental health as a range of services as well as the cultural and social influences on accessing mental health services. The community facilitator brought a balanced skill set of facilitating discussions, reviewing and categorizing responses, and then helping the project coordinator and therapist to draw conclusions and identify collective themes, trends, and opportunities.
Key lessons learned
The project was inherently designed to incorporate feedback from multiple sites across our community. The intent was to ensure a broad range of voices and geography within the city. With that, we recognize the importance of flexibility and openness to making adjustments when original plans don’t ultimately fit into what each site was able to offer. For example, our project design was to hold formal focus groups at each youth center. However, multiple centers expressed difficulty in helping to encourage caregivers to attend these sessions. Thus, the facilitator and project coordinator adjusted the discussion questions into a paper questionnaire and delivered it during other family-friendly events that were already scheduled at the centers and drawing caregivers onsite. While all three groups—youth, caregivers, and staff—agreed that mental health is important, not all caregivers were able to make space in their schedules to attend an extra activity outside of their regular day-to-day routines. The questionnaires filled that gap and still ensured we connected with the target number of caregivers.
Our grant project involved learning, planning, implementing, and evaluating. However, we could have improved the overall project by expanding the timeline and request amount so that there were more resources budgeted for the implementation and evaluation phase. We had a strong plan for gathering input, but because implementation would be based on whatever was gathered, we didn't have a formal plan for resources needed for implementation. We were proud of the outcomes that are now in place, but recognize that they also came at a cost to our organizations that perhaps could have been budgeted for to help with their start-up.
Reflections on the community innovation process
The most important aspect of the community innovation process diagram for this project was collaboration. Working with multiple youth programs’ staff, youth, and caregivers required high levels of accountability, communication, and mutual buy-in to keep us on track. From the start, our project had clear buy-in and strong collaboration from all partners, which ultimately made the project a success. And, collaboration between the project coordinator and group facilitator was important to ensure we provided a consistent and supportive environment for our participants. Between the project coordinator and group facilitator, each brought to the project personal and professional experience with children’s mental health needs in various cultural contexts.
Progress toward an innovation
Our progress includes two different models of mental health service delivery with youth programs in Duluth. One offers training to advocates and mentors in a youth mentoring program to help them be more prepared to handle difficult conversations and situations that may relate to a need for mental health services. The other provides a range of outpatient mental health services co-located with a drop-in youth center. This site provides both billable and non-billable services responsive to youth and family needs that were designed based on input gathered in feedback sessions throughout the grant period. Overall, the innovation is the integration of mental health services into traditionally non-clinical, non-treatment-based youth programs. And, more specifically, the evolution of how youth and families have perceived those services as welcoming and beneficial rather than judgmental, unnecessary, or out-of-touch with those they are intended to support.
Our organization continues its involvement in community mental health conversations at all levels of service delivery. We are involved in a community effort with our large health systems titled Northland Healthy Minds to spread the word on community resources and plan events for May 2019’s mental health awareness month, we are involved in the development of a new community-school model that will bring more resources to one of our local high schools including a day treatment program across the street, and we offer training and presentations to other youth programs and conferences to share what we’ve learned through our feedback sessions, implementation, and on-going development of our service delivery as youth and family needs and demands evolve. We will continue to seek ways to expand and integrate services into youth-centric programs that are cost-effective and intentionally designed for the youth.
One last thought
This project connected with 163 participants (youth, caregivers, and staff) ranging from 5-60 years old through 19 feedback sessions. Youth centers continue this conversation still as they seek to leverage shared resources through staff training and staff sharing. Caregivers also have increased their communication with staff at some youth centers to seek socio-emotional support for themselves and/or their children. While mapping resources within our community, we learned that many others are doing the same thing, but our service providers are also disjointed and needing support to learn how to work together rather than compete against one another for clients. Sustainable funding to provide non-billable services continues to be a need and gap in our community because some organizations have billing departments and are expected to provide billable services to meet budget needs, yet required paperwork and insurance enrollment is not always available and can cause a delay in accessing services. Thus, a balance of some philanthropic funding to fill that gap period and/or provide a short-term stabilization-type service has been the most effective at one youth center.