Youth Empowerment and Participation in Mental Health Care

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focal Summer 2009 research, policy, & practice point in children’s mental health

focal point Summer 2009, Vol. 23, No. 2

focal point is produced by the Research and Training Center (RTC) on Family Support and Children’s Mental Health in Portland, Oregon.

Summer 2009

Vol. 23, No. 2

Youth Empowerment and Participation in Mental Health Care L. Kris Gowen & Janet S. Walker...... 3 Sacramento’s LGBTQ Youth: Youth-Led Participatory Action Research for Mental Health Justice with Youth In Focus Jesus Sanchez, Cadelba Lomelí-Loibl, & Alyssa A. Nelson...... 6 The Met Students’ Action Research Project with Youth In Focus Chris Barrick...... 9 Digital Storytelling Andrea Spagat, Victor Damien, & Marquita Jones...... 11 Improving Outcomes Through Interventions that Increase Youth Empowerment and Self- Determination Janet S. Walker, Sarah Geenen, Elizabeth Thorne, & Laurie E. Powers...... 13 Developing a New Intervention: Reflections of a Youth Advisor Elizabeth Thorne & Nathan Tanner...... 17 New Measure of Youth Mental Health Empowerment...... 17 Youth ‘N Action: For Youth, By Youth! Tamara L. Johnson & Jean Kruzich...... 18 Youth Voice and Participation on the National Youth Summit Advisory Board… and Beyond Rebecca Strachan...... 22 Youth MOVE National: Youth as Change Agents Carl Yonder, Johanna Bergan, & Laura Rariden...... 25 Peer Mentoring: Real Recovery for Young Adults Michelle Butman...... 28 My Views on the Peer Model Summer 2009 focal point Staff: Justin Drakos...... 30 The Two-Way Benefit of Peer Mentoring Janet S. Walker, [email protected], Co-Editor Liz Pepin...... 31 L. Kris Gowen, [email protected], Co-Editor Nicole Aue, [email protected], Assistant Editor focal point is a publication of the Research and Training Center on Family Support and Children’s Mental Health. This publication was developed with funding from the National Institute on Disability and

Rehabilitation Research, United States Department of Education, and the Center for Mental Health Ser- vices, Substance Abuse and Mental Health Services Administration (NIDRR grant H133B040038). The content of this publication does not necessarily reflect the views of the funding agencies.

focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Youth Empowerment and Participation in Mental Health Care

hroughout the 25-year history of sitions; and, (5) Specific Settings/Sys- Tthe Research and Training Cen- tems. These items were then edited ter on Family Support and Children’s into more “youth-friendly” language. Mental Health (RTC), our work has Through RTC email lists and viral focused on supporting parent and forwarding of our survey announce- caregiver voice in creating family- ment, participants were invited to take driven services for families and their our survey. At the outset, respondents children who are or may be affected were asked to identify themselves as by mental, emotional or behavioral being 26 years old or younger (youth) disorders. Over the last ten years, our or over the age of 26 (adults). A total commitment to understanding servic- of 73 youth and 193 adults completed es and systems from the “user” per- the survey. spective has led us expand our focus. Much of the planning for this day As an expression of this commit- has been led by a Youth Advisory Board. (See Strachan article, p.22 ). ment, the RTC will be hosting the first “I think that having more National Youth Summit on Youth However, as we were working to se- Voice in Mental Health Systems on lect the topics to be addressed during peers work with young people June 22, 2009. Forty young leaders, the Summit, we decided that it was is important because when ages 15 to 25 will be attending this important to hear from a broader youth-led event. Participants will col- spectrum of young people. This led I was younger there were no laborate together through activities, us to create an online survey to see peer educators and so I had what sorts of changes in children’s mental health young people with no idea that people could get “I think that youth should be mental health conditions are most ea- better.” ger to see. better informed about what A list of potential topics was cre- –Youth survey respondent kinds of trainings there are ated, beginning with recommendations drawn from local- and state-level out there to get more involved youth summits (or equivalent events). in order to reshape our Additional items to be included in the Results survey were solicited from the Sum- system.” mit’s Youth Advisory Board. Then Youth Responses. When asked –Youth survey respondent two staff members narrowed down to rate how important each of the these recommendations to 28 items topics was to address at our Youth that were grouped into five catego- Summit, the most common topics conversations, and brainstorming ries: (1) Medication and Treatment; identified by youth as being “a top sessions to identify how to improve a (2) Therapy Relationships; (3) Youth priority” were the importance of life variety of youth services in their com- Advocacy, Peer Support, and Peer-to- skills training for youth (70%), the munities. Peer Services; (4) “Aging Out”/Tran- lack of support for young adults tran-

Regional Research Institute for Human Services, Portland State University. focal point This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

sitioning out of social service systems are forever closed to youth who combined with medication, (68%), mental health training for ju- have specific diagnoses.” but they need to be heard and venile justice workers (67%), the lack seen as options.” of training and education youth need “I don’t think staff should be to get meaningful employment (63%), calling us by our diagnosis or Adult Responses.The topics most and the need to fund youth advocacy symptoms. We are not those; commonly identified as top priorities organizations (62%). The majority of we are people.” by adults were the importance of life these topics identified as being top skills training for youth (69%), men- priorities pertain to youth opportuni- “Providing youth with healthy, tal health training for juvenile justice ties and supports (Table 1). researched alternatives to med- workers (65%), the lack of support Although not rated within the ication is so important. Tak- for young adults transitioning out of top priorities, medication- and treat- ing medication comes with too social service systems (64%), the im- ment-related issues were still a “top many labels and brings to the portance of strength-based counseling priority” for about half of the young forefront the issue of control. models (64%), and the involvement of people, and several of them made Who is controlling you? How youth in developing their own counsel- comments to clarify their ratings of are you being controlled? Often ing plans (62%). In other words, three these items: being affected by a mental ill- of the top five priorities identified ness makes control all the more were the same for youth and adults. “The overuse of labels and di- important in life. Alternative Although there is significant agnoses by counselors should be treatments such as therapy, overlap between the top priorities a priority. People don’t under- massage, herbal/alternative identified by the youth and adults, stand the long-term effects that medications, etc. bring that it is important to note that they are follow youth around after being control back into one’s life. not identical. Among the top pri- labeled. Some jobs and careers These options can always be orities that were not the same in the

table 1. top priorities to address at the national youth summit

life skills training

support for transitioning youth

mental health training for juvenile justice

training for meaningful employment

funding youth advocacy organizations

strength-based counseling models

youth development of counseling plans

0 10 20 30 40 50 60 70 80 90 100

PERCENT

youth responses adult responses

two samples, youth were more likely data show that these interventions to focus on “real world” experienc- increase youth empowerment and im- “It’s important for caregivers es—skills to get jobs and support- prove outcomes. A series of articles not to doubt the capabilities on peer mentoring (p. 27) highlights how youth can support other youth of the youth they are working “I think it is important to in achieving their goals as they transi- with.” teach youth the appropriate tion to adulthood. The article on digital storytelling (p. 11) demonstrates – Youth survey respondent ways to request a different how youth voice can be transformed therapist/therapy and into a powerful multi-media presentation to be used for education, advo- While these articles highlight a communicate their needs.” cacy, and empowerment. In articles number of successful and innovative by the Youth in Focus team (p. 6) and efforts to promote youth voice and – Adult survey respondent Youth n Action (p. 18), we hear how youth empowerment, these kinds of youth are involved in research, and approaches are still few and far be- as a direct result, have an impact on tween. New approaches, and wider ing youth advocacy organizations, how communities and organizations implementation of existing approach- whereas adults leaned towards priori- respond to the needs of young peo- es, will be needed if we are to trans- tizing issues related to treatment and ple. Finally, you can read about how form systems and services so that they counseling (strength-based counsel- will be truly youth guided. Investment ing models and youth involvement in in these approaches has the potential to pay large dividends. counseling). Differences such as these “Avenues for youth to give point to the importance of including youth perspectives when working to feedback to mental health Authors improve services for young people programs and systems are with mental health conditions. L. Kris Gowen is Co-editor of Fo- important.” cal Point and Research Associate at Youth Creating Change the Research and Training Center on – Adult survey respondent Family Support and Children’s Men- This issue of Focal Point includes tal Health at Portland State Univer- a series of articles that describe how sity. youth are active in shaping mental Youth MOVE National brings young health services and systems. One arti- people together to advocate for youth Janet S. Walker is Co-editor of cle (p. 13) describes two interventions, voice and rights in mental health (p. Focal Point and Director of Research Achieve My Plan! and My Life, that 25). Although most issues of Fo- and Dissemination at the Research are designed to support young people cal Point include articles written by and Training Center on Family Sup- in taking a lead role in creating and young people, this issue has a greater port and Children’s Mental Health at carrying out plans for their treatment, proportion of articles authored or co- Portland State University. education, and future. Preliminary authored by youth.

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Sacramento’s LGBTQ Youth: Youth-Led Participatory Action Research for Mental Health Justice with Youth In Focus

outh-led participatory es on issues such as food Yaction research (YPAR) and nutrition, physical provides a way for young activity, access to health people to advocate for them- care, mental health, envi- selves and their communi- ronmental justice, sexual ties, and for organizations health, and reproductive to engage youth in the effort justice. Previously called to bring about social and en- the “Adolescent Health vironmental justice.1 Youth Initiative,” YIF’s work in In Focus (YIF), a nonprofit the health field began in based in northern Califor- 2002 and focused on im- nia, fosters the development proving school wellness of youth, organizations, and centers while addressing communities by supporting issues such as stress, drug Youth-Led Research, Evalu- use and sexual health. In ation and Planning (Youth 2005, YIF redefined and REP). Our work is based on renamed the initiative the belief that youth can effec- observation, photography, and video “Health Justice” to especial- tively partner with adults to address to draw out and present community ly amplify the voices of those youth social and institutional challenges, knowledge. YIF’s youth-friendly cur- who are often the most marginalized and that these partnerships are cru- riculum structures research as a se- due to sexism, heterosexism, racism, cial to achieving just, democratic ries of eight “Stepping Stones” from poverty, violence, HIV/AIDS and and sustainable social change.8 Cur- team building and initial planning of STIs, drugs and alcohol, and other rently YIF emphasizes three main a research project through research such issues affecting young people’s themes through our Health Justice, design, data collection, analysis, find- well-being. Education Justice, and Community ings, recommendations, public pre- Because YIF sees all health justice Justice Initiatives. Nancy Erbstein2 sentation, and dissemination, leading work as interconnected, YIF’s Health has described how YIF contributes to direct action and advocacy. YIF has Justice Initiative continues to expand to the emerging frameworks of Com- experienced successes and challenges to include food justice, environmen- munity Youth Development4 and in using participatory action research tal justice, and mental health. For Social Justice Youth Development methods in fields (e.g., health) that, in example, when youth-led research (see box).3 This article describes our experience, are not traditionally reveals that homeless queer youth in YIF’s Health Justice Initiative and receptive to research not grounded in San Francisco report that a lack of illustrates our approach to youth- experimental methods. access to fresh fruits and vegetables led participatory action research For example, through our Health affects their mental health as much with an example of a needs assess- Justice Initiative, YIF projects have as a lack of affordable healthcare,10 ment by lesbian, gay, bisexual, trans- expanded definitions of health to we see that food justice is intimately gender, and questioning (LGBTQ) revolutionize advocacy for some of connected to prevention and early youth in Sacramento, California. the most marginalized populations intervention of mental health issues. of youth who are often overlooked Adapting the Health Justice Initiative Youth-Led Participatory Action or ignored by health systems. YIF’s to meet the needs of communities is Research for Health Justice Health Justice Initiative envisions a key part of our success, seeing both a world where the voices of under- systemic and personal change as in- With support from YIF, young represented youth, including queer tegral to our work. One project that people and adult allies investigate dis- youth, youth of color, foster youth, demonstrates the power and impact parities and advocate for greater jus- and homeless, immigrant and low-in- of YPAR on young people and on the tice in fields such as health, juvenile come youth are engaged in all aspects health field is a multi-phase project justice, education, and community of health policy that affect their lives. conducted with the Sacramento Gay planning. YIF supports young peo- Since 2005, YIF’s Health Justice Ini- and Lesbian Center. ple to utilize research methods such tiative has supported over 30 YPAR as interviews, focus groups, surveys, projects to make space for youth voic-

LGBTQ Youth Mental Health The group felt that it was impera- bring this information to other tive to get a general sense of LGBTQ neighborhoods and communities. In Sacramento, the sprawling youth experiences in Sacramento and Trainings should be available for capitol city at the heart of Califor- that a needs assessment could provide teachers and youth service provid- nia’s Central Valley, LGBTQ youth insight on what strategies might sup- ers, particularly for those from ru- confront daily challenges to health port LGBTQ youth throughout the ral and conservative areas. and spirit. More so than their hetero- city. With help from Youth In Focus, • Increase awareness and under- sexual peers, LGBTQ youth are of- the youth researchers created a sur- standing of the transgender com- ten on their own in seeking support, vey concerning LGBTQ youth needs, munity, identity, and experience, resources, positive relationships and with an emphasis on mental health. by encouraging more trans vis- 5 safe spaces. Since 2007, Youth In Following YIF’s Stepping Stone ibility, and conducting workshops Focus has been promoting and sup- process through team building, re- and trainings such as Trans 101 porting youth-led participatory ac- search design and data collection, from the Transgender Law Center tion research with LGBTQ youth in youth were then ready to conduct of San Francisco. Sacramento, particularly regarding their data analysis, formulate find- mental health needs. Sacramento has ings, and make recommendations, • Increase LGBTQ-specific pro- a growing number of youth-serving opening up many windows on this grams, such as LGBT Big Broth- agencies, too many of which seem to oft-silenced community of young er/Big Sister, gay-straight allianc- lack the consciousness, skill and sen- people. Many of the youth research- es in high schools, parent support sitivity to work effectively and respect- ers expressed a sense of solidarity programs and organizations, fully with the LGBTQ youth com- in struggle with survey participants LGBTQ sex education, and 6 munity. YPAR projects are creating they had not even met. The survey, LGBTQ-specific youth activities. a stage for LGBTQ youth to discuss distributed directly to peer networks their needs and demands for mental and more broadly by counselors and With an overwhelming sense of health services, thereby gaining the gay-straight alliances at high schools, both need and optimism, the youth attention of gatekeepers and service elicited key issues and suggestions for research team developed its strategy providers from the city, county, and improved programs and activities. Of Central Valley region. the 100 LGBTQ youth surveyed, 70% Through a partnership among agreed that coming out in an unwel- Youth In Focus, the Sacramento Gay coming environment heightened their CYD and SJYD and Lesbian Center, and adult allies experience of depression and anxiety, in local Gay Straight Alliances, LG- 72% agreed that there is a lack of support for LGBTQ youth to come out, BTQ youth in Sacramento are ac- ommunity Youth Develop- quiring skills in self-advocacy, civic 48% said the pressure of identifying* participation, and research. Over the as LGBTQ is the biggest challenge in Cment (CYD) “focuses on how course of the project the research coming out, and 54% felt that men- we can harness the energy, creativ- team included 25 young people ages tal health is the biggest issue for their ity, and dedication of both youth 13 to 22 who had connections to the LGBTQ peers.6 and adults to create systems and Sacramento Gay and Lesbian Center, The data analysis phase gave the communities that fully engage and three adults. Participant numbers youth research team insight for form- young people in their own develop- from this transitory population fluctu- ing recommendations and strategies ment and in building sustainable to meet these great needs. Prioritizing ated as participants self-selected, but community.” (Hughes & Curnan, there was a core of five. This team of prevention and early intervention, the 4 LGBTQ youth had many questions as team recommended the following: 2002, p. 28) they initiated the research. The broad • Increase mental health services for ocial Justice Youth Develop- question, “What are the needs of LGBTQ youth and increase vis- LGBTQ youth in Sacramento?” stood ibility of providers who have skills Sment (SJYD) “is youth devel- out as the one the youth research to work with this population. Ser- opment to achieve a higher quality team wanted to tackle, having other- vices should be affordable and ac- of life through a more equitable wise lacked opportunities or spaces to cessible, consist of strong outreach world” (Ginwright & Cammarota, do so. To begin the research process, to community centers and schools, 2002, p. 93).3 SJYD “expand[s] youth vocalized ideas and concerns and provide transportation. the current terrain of youth devel- they believed to be pressing for their peers. They articulated the effects of • Train schools and institutions to opment to include practices that homophobic society: their narratives build their capacity to create sys- encourage youth to address the of abandonment, depression, anxiety, tems for working with LGBTQ larger oppressive forces affecting homelessness and suicide reiterated youth. Connections with such them and their communities … the strong need for action regarding institutions as the Sacramento [to] contest, challenge, respond, Gay and Lesbian Center can help the mental health of LGBTQ youth. and negotiate the use and misuse of power in their lives” (p. 87).3 * In the context of this research, “identifying” was defined to mean choosing to identify with a particular LGBTQ label or labels.

to be not only an informative process of quantitatively and qualitatively as- social justice approach. Social but also an exercise in advocacy for sessing youth health needs and outlin- Justice, 29, 82-95. ing effective, efficient, youth-friendly the many who are silenced by ho- 4. Hughes, D. M., & Curnan, S. B. strategies for action. For the youth mophobia. (2002). Toward shared prosper- involved in YPAR projects, research The project’s significance has been ity: Change-making in the CYD becomes a means for young people underlined by support and enthusiasm Movement. Community Youth to connect as agents with their com- from various organizations. In the Development Journal, 3, 25-33. spring of 2007, the Sacramento Gay munity and policy makers rather and Lesbian Center YPAR project than merely as clients, recipients of 5. Ryan, C. (2003). LGBT youth: attracted attention from the Univer- services, or subjects of study. YPAR Health concerns, services, and sity of California, Davis’ Center for can be a key tool for prevention and care. Clinical Research and Regu- Reducing Health Disparities and the early intervention in the health field latory Affairs, 20(2), 137-158. National Institute for Mental Health. 6. Sacramento Gay and Lesbian The Community Health Program Center Youth Research Team. Manager at the Center for Reducing (2008). [LGBTQ youth survey Health Disparities, Katherine Elliot, data]. Unpublished study. Ph.D., MPH, connected YIF and 7. UC Davis Center for Reducing the youth research team to a county- Health Disparities. (March 2009). wide research project investigating the needs of under-represented com- Building partnerships: Conversa- munities throughout the Sacramento tions with LGBTQ youth about region. The youth research team mental health needs and community strengths. Report. shared key information with the university for publication.7 YIF, in turn, 8. Youth In Focus (2002). Youth received an invitation to participate REP: Step by step: An introduction with the Sacramento County Mental to youth-led research and evalua- Health Services Act (MHSA) Steer- tion. Oakland CA: Youth In Fo- ing Committee. The youth research cus. team’s recommendations continue to 9. Youth In Focus (Producer), San- inform the collective efforts of LG- chez, J., & Young, M. (Directors) BTQ youth of Sacramento, Youth (2009). Rainbow 916: A Sacra- In Focus, the Sacramento Gay and mento LGBTQ youth narrative. Lesbian Center, the UC Davis Cen- and beyond. Service providers, public [Video]. Sacramento CA: Youth ter for Reducing Health Disparities, In Focus. the MHSA Steering Committee, and health officials, and others involved in the LGBT Mental Health Collabora- the health field can engage YPAR as 10. Youth In Focus & Tee. (2008). tive of Sacramento. In 2008-09, YIF a transformative process that allows Building bridges: LGBTQQI and the Sacramento Gay and Les- agencies to more effectively reach youth and health care services in bian Center youth culminated their youth and start to truly address the the bay area: The Bay Area LG- research by filming a documentary**9 critical mental health needs of mar- BTTQQI Youth Health Care to gather and share the narratives and ginalized young people. Scan (B.A.L.Y.H.S.) Project. Re- needs of LGBTQ youth throughout trieved May 12, 2009, from http:// Sacramento, with the goal of educat- References www.issuelab.org/research/ba- ing and attracting attention from local lyhs_project_an_assessment_ service providers and putting human 1. Cammarota, J., & Fine, M. (Eds.). of_the_health_care_needs_ of_lgbttqqi_youth_and_their_ faces on the research project data. (2008). Revolutionizing education: Youth participatory action research health_care_services_in_the_ Summary in motion. New York: Taylor & san_francisco_bay_area_. Francis. Authors Youth In Focus’ twenty years of 2. Erbstein, N. (2009). Moving to- experience has demonstrated that wards critical civic praxis. Pre- YPAR is a powerful tool for marginal- sentation delivered at UC Da- Jesús S. Sánchez is Project ized youth to transform not only their vis Department of Human and Manager of Youth in Focus. own lives and community, but also Community Development cours- the ways in which youth voices are es Adolescent Development Cadelba Lomelí-Loibl is Bay heard by adults and policy makers. (3/9/09) and Community Youth Area Project Manager of Youth in YPAR challenges the narrow defini- Development (4/29/09). Focus. tions of what is considered legitimate 3. Ginwright, S. & Cammarota, research in the public health field. Alyssa A. Nelson is Central Val- J. (2002). New terrain in youth ley Co-Director of Youth in Focus. These methods have proven capable development: The promise of a

**Funding for the documentary project was provided to Youth In Focus through a REACH grant from Sierra Health Foundation.

The Met Students’ Action Research Project with Youth In Focus

outh in Focus staff members students were taking the survey, our YJesús Sánchez and Alyssa Nelson research team was there to make sure interviewed Chris B. about the experi- that students understood the survey and could ask any questions about it. ences and challenges of being involved After we looked at the data, I became in an action research project. part of the core group that carried out the planning for creating the re- What was your youth-led participa- source center. tory action research project? What were some of The Met Sacramento charter the project’s challenges? school recently wrapped up a youth- led action research project with Youth We first started this project as In Focus. Our research question was: a class but quickly realized that the dents on the project, but since I had What types of information do stu- majority of the students were not as obtained an internship with Jesús at dents at the Met need to help meet engaged as was needed. Many of the Youth In Focus, I was still able to join their various needs? The goal of the students in our class didn’t take the the process at its beginning stages. project was to create a resource cen- project seriously, so Jesús decided to The student research team met bi- ter at our school where students could lead a smaller group of students who weekly with Jesús and started figuring get information about internship pro- were really inspired and motivated out the proper steps to get the project grams, community service projects, to finish what we started. The group rolling. Jesús helped us develop our higher education, and health. The consisted of Seetha Ream-Rao, Jolene thoughts and ideas about the process. process took about 10 months to com- Duren, Maria Farinias, and me. We created our research question and plete and was coordinated by Jesús At one point we had a summer questions for a student survey so that Salas Sánchez, Project Manager at break in the middle of the data col- we could learn which resources stu- Youth In Focus. lection phase. It was kind of chaotic. dents at the Met wanted. I was also The original surveys we administered part of the group of students that How were you involved before summer break had to be ad- collected student surveys from differ- in the process? ministered to our school’s incoming ent classes at our school. We worked students so that we could get their closely with the teachers so that we The process started when Jesús point of view, too. could administer the surveys during came to the Met to work with my Another challenge came when class time. Out of 140 students in the class to devise our research project. we started to analyze the data. When I was not one of the original stu- school, 96 took our survey. While

we looked over the survey results, education. Based on those findings was challenging at times but overall we worried that about half of the we provided flyers and pamphlets on very beneficial to be a part of the cre- students were not taking the survey those three subjects, and established ation of the center. seriously. We knew this because a lot community connections in those of the students told us that they did three areas. Currently, a new group What were some other not care about the survey and that of students is continuing the resource youth accomplishments? they didn’t fill them out properly. center work by creating more rela- We felt this was a major roadblock tionships with community organiza- A fellow project member, Seetha in our project because the resources tions and getting more information Ream-Rao, wrote and received a that were going to be brought into from students about how the resource grant of $5,000 from the Grants Ad- the resource center were going to be center should function. visory Board for Youth* to make the based on the survey results. Despite resource center both attractive and this concern, we used all the surveys How well do you feel the functional. Recently, faculty members when we analyzed our results and we project achieved the goal of have benefited from the resource cen- believe our research gave us an accu- developing the resource center? ter, using information and resources rate sense of what students wanted to to link students to various service see in the resource center. The resource center has been pro- providers. Lastly, my fellow project moted well and runs successfully. In member, Jolene Duren, took the lead How did the research February 2009 the resource center on developing a short documentary** help you understand was also turned into the Student Store. about our process of creating the re- what your peers wanted? The Student Store has been very prof- search project and the resource cen- itable for our school. Students feel so ter. It was a great way to wrap up our Even though some students didn’t much more comfortable getting in- work and create a fun final product. take the survey seriously, there was formation from a space on campus, still the data analysis piece to carry especially when looking up informa- Author out. Based on our analysis of the tion on higher education, internships, surveys, we concluded that students and health services. Overall, the Met Chris Barrick is a high school ju- mostly wanted information on in- Sacramento is a better school due to nior at The Met Sacramento High ternships, health services, and higher the Resource Center/Student Store. It School.

* The GABY program is made possible through a partnership of Sacramento Region Community Foundation and Sierra Health Foundation: http://gaby.sacregcf. org/ (last accessed 4/29/09).

** Funding for the documentary project was provided to Youth In Focus through a REACH grant from the Sierra Health Foundation.

celebrating 25 years

www.rtc.pdx.edu

10 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Digital Story Telling

veryone has a story to tell, and words in the way they want them and Esharing those stories is a powerful have also learned new technology. form of connection. Personal stories We have a film screening festival on can be a key tool for education and ad- the last day of the workshop so everyone can see each other’s stories. vocacy; the authenticity of the first-per- DST for me was an empowering son perspective can inform and move and healing process and I believe that others in a unique, unfiltered way. it could be beneficial in some way to Shaping one’s personal narrative can everyone. When I watched my story also be therapeutic; reframing struggles for the first time I felt proud of myself with personal challenges—disability, for overcoming the obstacles I talked illness, failure—as overcoming ob- about in my story and being able to stacles can make a person feel stronger share them with everyone. I’ve also and even be central to the therapeutic been able to use my story to help educate providers at conferences about process.1 Digital Storytelling (DST) some of the issues youth are dealing is a process and a product that serves with. I enjoyed the whole process so therapeutic, educational, and advo- much I trained to be a facilitator and cacy purposes. We present three linked now I help facilitate DST groups. pieces that share experiences with of the workshop, ground rules are DST is truly a therapeutic and heal- DST; a youth participant, her men- set, everyone introduces themselves, ing process and I hope that all youth tor, and a DST producer each share and the story circle begins. The story have the chance to participate in this circle is an important part of making stories that highlight how this mecha- process. everyone feel comfortable with telling nism helps people better understand their stories to others and often bonds Victor Damien themselves and reach out to others. the group together when it’s over. The circle is led by a facilitator whose Marquita Jones There is nothing more powerful main job is to make sure that every- than hearing the stories of youth in one is respected while telling their their own words, in their own light, I found out about DST while I was stories and has the support needed to and in their own expression. Now a member of the Youth Task Force at do it. Even though the ideal time for imagine not only hearing these sto- our weekly meeting. When it was first each person is no more than fifteen ries, but seeing them too. DST allows introduced I knew I would want to minutes, no one is rushed to finish youth to capture their stories using be a part of it because of my love for because of how personal and emo- visuals, photos, videos, and music, so hearing and telling stories, plus the tional the stories can be. After people that they and other people can watch $150 stipend didn’t sound too bad. I tell their stories, they have the option and experience parts of the lives of understood that I would use pictures to hear feedback from the other par- our youth. Not only does DST help and video to tell about an important ticipants about some visuals or strong youth heal, express themselves, and time in my life, but I had no idea how points in their stories. When the story build community; it also enables the whole process of DST could help circle is over, the process of making them to find the internal strength heal and educate me. the stories digital kicks off. People needed to move forward in life and Digital Storytelling workshops write their stories in about 250 words, transform themselves into something are normally three to four days long look for pictures, record their voices, better. I have heard one therapist say and are set up in a way to make ev- and go through tutorials to learn how that he learned more about his client erybody feel safe and comfortable to use Photoshop, Final Cut Pro or in a three-minute digital story than he enough to share their personal life Sony Vegas so they can complete did in three years as his therapist. As stories with complete strangers who their story. After this, the youth have a provider, I personally feel that the are also brave enough to face their created their own stories in their own 24-hour workshop experience of cre- stories themselves. On the first day

Regional Research Institute for Human Services, Portland State University. focal point 11 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

ating a digital story has more impact ceived funding for training in DST. the viewers. Sometimes digital stories than 24 sessions with a therapist and More than anything, I really saw are created for educational purposes, is more cost effective. how effective creating a space for or to spur community action. One The young person actually gets a young people to tell their stories using group, No More Funerals, is using stipend for his or her time creating this multi-media tech could be. The its stories as part of a curriculum for the story. What’s more, the youth workshop process is a great way for a peer-led youth violence prevention have the opportunity to be linked to youth to find their own voices. The program. I believe DST is one of the other youth activities, jobs, or groups goal of these workshops is to help most effective educational techniques so that he or she can continue to be youth find the resources within them- because it connects people to people. involved in creative and constructive selves to find their own voices. It’s an DST shows how people respond to ex- outlets. opportunity young people don’t have periences in a deeper way than what We use digital stories to help edu- very often; it’s very empowering and is possible through documentaries, cate providers about youth issues, and gives them perspective. It reminds reporting, research—it combines a lot to conduct workshops to get more them how they got through those dif- of elements to make it work on many youth to tell their stories. Some youth ficult moments in their lives and lets different levels. It connects the story- have used DST to help advocate for them know that they are going to get tellers to those who may not have a themselves in Juvenile Hall; the op- through future difficult moments. full appreciation of their experiences portunities for this are endless. I be- The process is truly transformational or even know about them. lieve in digital stories and the power for the storytellers. DST also can be used for profes- they have to produce sustainable DST is a healing experience be- sional trainings. In one case, Youth change. If you get a chance to see cause it allows people to talk about Connection (a group of foster youth) them you will realize this, too. their experiences and to project their documented their experiences using voices. Their stories come from psy- DST and shared them with social Andrea Spagat chological and spiritual spaces. What workers for trainings on transition- makes these stories so unique is that aged youth. They vividly illustrated DST is a way of communicating they use the participants’ own words. what their experiences were like, and that is particularly effective because There is no one in between to inter- how they could be better supported. it allows us to talk to the hearts and pret them like a journalist or a film- DST also can be used to change minds of people. It is particularly maker. There is no outsider perspec- policy. Youth Connection also powerful for those whose voices are tive. These stories come from the showed their stories to key decision often marginalized or ignored. These people who have actually lived the ex- makers in Sacramento [California’s people can come into our workshops periences, sharing what they are like. state capitol]. There is a lot of legisla- and create thoughtful pieces that can The Center for Digital Storytell- tion coming out of our state capitol be heard by others with whom they ing works with advocacy organiza- to support these young people, and normally don’t communicate. Their tions and constituencies who want it’s getting bipartisan support. I think voices reach out beyond the dominant to get their voices heard—domestic the digital stories helped expedite this culture narrative. I was introduced to violence survivors, foster youth—as process. DST at a conference I attended when well as general community health I was working with a violence preven- workers. I’ve done a lot of work with Authors tion initiative. I saw the Center for young people, but about 80-90% of Digital Storytelling’s presentation, my work is with adults. Some people Andrea Spagat is San Francisco/ and immediately DST made sense to want their stories simply to reflect Pacific Northwest Region Director for me from so many angles. As soon as their personal experiences; others the Center for Digital Storytelling. I could, I applied for a grant and re- want them to be transformational for Victor Damien is Youth Coor- dinator for the Children’s System of the principles of digital storytelling Care in San Francisco.

Marquita Jones works with San Sharing stories can lead to positive change. The process of supporting Francisco System of Care, sits on the groups of people in making media is just the first step. Personal narratives California Child Welfare Council, in digital media format can touch viewers deeply, moving them to reflect and is a Digital Story Telling facilitator and trainer. on their own experiences, modify their behavior, treat others with greater compassion, speak out about injustice, and become involved in civic and Reference political life. Whether online, in local communities, or at the institutional/ policy level, the sharing of stories has the power to make a real difference. 1. Pennebaker, J. W. (1997). Writ- ing about emotional experiences From the Center for Digital Story Telling as a therapeutic process. Psycho- www.storycenter.org/principles.html logical Science, 8, 162-166.

12 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Improving Outcomes Through Interventions that Increase Youth Empowerment and Self-Determination

oung people with serious men- collaboration with an advisory board Ytal health conditions are at high that includes youth, caregivers and risk for experiencing poor outcomes service providers. (See Thorne article, as they grow into adulthood. Com- p. 17.) pared to peers without such condi- AMP is designed to be used in any tions, these young people are more context where a young person with a likely to drop out of school, experimental health condition is involved ence chronic unemployment and in a team planning process. Human underemployment, have contact service and educational agencies and with the judicial system, and be dis- systems often convene teams to work connected from their communities.8 collaboratively on plans for serving Schools and agencies that serve young people as they approach the these youth often create treatment, transition into adulthood. This is service or transition plans that are in- particularly true for youth who are intended to help the young people make volved with multiple systems or who a successful transition into adult- are felt to be in need of intensive in- hood. Unfortunately, these plans are tervention. These kinds of planning typically created for youth, with little teams include IEP (Individualized input or buy-in from the young peo- Education Plan) teams, wraparound ple themselves. For example, federal teams, foster care Independent Living legislation requires that schools pro- and cope better with stressful circum- Program teams, transition planning vide transition planning—via an indi- stances. Existing research strongly teams, youth/family decision teams, vidualized education planning (IEP) supports the idea that young people and other teams that create service, process—for high-school age youth with serious mental health conditions transition or treatment plans. AMP who receive special education ser- who have higher levels of self-deter- is designed to have an effect both at vices. Despite this mandate, it seems mination, empowerment, and self-ef- the level of individual youth and at that most students do not participate ficacy are more likely to have success- the level of the agencies that serve the meaningfully in the IEP/transition ful transition outcomes.9 youth. planning process. Many do not even This article describes two research Youth-level intervention. The have a transition plan, and many stu- studies that are underway at Portland intervention with youth begins with dents who attend their IEP meetings a series of individual sessions with a 9 State University. Both studies are test- do not participate at all. ing interventions designed to increase designated “AMP coach.” The coach The failure of schools and agen- young people’s self-determination, helps the young person work through cies to engage young people in plan- empowerment and/or self-efficacy a series of structured exercises and ning for their futures represents a lost by supporting them to take an active, activities that lead up to the first opportunity. Properly implemented, leading role in their own treatment, “AMP meeting.” During the AMP an individualized planning process care, or transition planning. While meeting, the youth takes an active can provide young people with the both of these studies are still under- role in leading portions of the meet- kinds of experiences that directly way, initial data is showing positive ing and shaping the content of the contribute to increases in self-deter- results. team plan. The AMP meeting is not mination, empowerment and self-ef- a separate meeting from the regular ficacy. People who have higher levels Achieve My Plan! (AMP) planning meetings, and it does not of self-determination, empowerment, result in a separate plan. Instead, it is and self-efficacy have confidence Achieve My Plan! (AMP) is an in- the same meeting and the same plan; that, through their own decisions tervention that is being developed at however, there are differences from and actions, they can reach goals that the Research and Training Center on typical planning meetings in that both are personally meaningful. What is Family Support and Children’s Men- the plan and the planning process more, these people actually are more tal Health at Portland State Univer- are somewhat adapted to reflect the successful in reaching their goals. sity. One of the most unique aspects youth’s participation and goals. Overall, they also tend to have better of AMP is that the intervention and The youth’s initial preparation general mental health and well-being, related materials were developed in before the first AMP meeting takes

Regional Research Institute for Human Services, Portland State University. focal point 13 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

approximately three hours, and is tion planning. A basic level of train- come from data gathered by coding typically divided into three sessions ing and consultation is provided to all videotapes of team meetings. This at one-week intervals, though this agency staff. This training focuses on data reveals that, while youth did not schedule is flexible and can be tai- the importance of encouraging youth necessarily speak more frequently on lored to meet individual needs. In the to take an active role in developing average during AMP meetings, the first two sessions, the coach facilitates and carrying out the plans. The train- quality of their verbal contributions a process that begins with the youth ing also provides information dem- increased significantly. Thus, dur- exploring his/her long-term goals onstrating that including youth with ing team meetings, youth who had and dreams. Gradually, the focus is serious mental health conditions in received AMP were more likely to brought into the shorter and shorter planning is both feasible and benefi- make high quality contributions, such term, until the young person is able to cial. as suggesting strategies, goals, or ac- identify a small number of concrete, tion items for the plan. (This contrasts short-term activities that he/she sees to lower-quality contributions such as as important first steps in moving to- single-word responses to questions ward a long-term goal. At least one asked by others.) The AMP interven- of the activities must be connected to tion appears to have an impact on the academic or vocational goals, and an- adults in the meeting as well. Adults other connected to behavioral/mental in AMP meetings were significantly health. The coach and the youth also more likely to respond to youth con- develop and implement a plan for tributions in ways that supported the sharing the activities with the youth’s youth and/or encouraged the youth parent or other caregiver prior to the to provide further ideas, information AMP meeting, and gaining the care- or explanation. (This contrasts to giver’s support for the activities. responses such as ignoring or inter- The third coaching session fo- rupting the youth.) Finally, the data cuses on preparing the youth 1) to also indicate that teams were working present the activities to the team dur- more effectively during AMP meeting the AMP meeting, and 2) to par- ings. Overall, the teams in AMP meet- ticipate effectively in other aspects of ings spent significantly more time “on the meeting. The youth learns about task,” and team members were more how the meeting will be structured likely to encourage one another to and who will be there, how to com- focus on moving through the agenda municate positively and how to man- and adhering to the ground rules. age his/her stress, anxiety or other AMP’s impact was also evaluated emotional reactions. The youth also using data gathered from youth prior has the opportunity to review items More intensive training is provid- to AMP and afterwards. These data placed on the agenda by other team ed to agency staff who have key roles show significant increases in youths’ members, and to prepare his/her in- on planning teams and/or who par- perceptions that they were involved in put for those items. ticipate on multiple planning teams. preparation for their planning meet- The coach attends the AMP meet- This intensive training teaches the ings and that their teams were more ing to support the youth’s participa- adults how to create planning meet- accountable to the plan. The data also tion. After the first AMP meeting, the ings that will support youth participa- show significant increases in youth youth and coach meet to debrief and tion. The training provides examples empowerment as assessed with the develop strategies to ensure that team of common things that go wrong in Youth Empowerment Scale-Mental members follow through on their meetings and that discourage youth Health (YES-MH, see page 17). Af- commitments for the plan. Youth participation. The examples are ter AMP, youth described themselves preparation and follow up for subse- drawn from video recordings of real as more confident both in managing quent team meetings is less intensive, team meetings. Participants learn how their own mental health and in work- but coaches continue to work with the to recognize these common problems, ing with service providers to optimize youth as needed. and learn strategies for avoiding and their services and supports. Their AMP coaching can be done by remedying them. Follow up consulta- overall empowerment scores also in- people who have a variety of other tion is provided to these staff mem- creased. roles with the agency. The coach can bers during the early months of AMP On the basis of these positive ini- be a therapist or care coordinator, but implementation. tial results, the researchers and advi- the coach may also be a young per- Evaluation. To date, AMP has sors working on AMP are currently son who is a peer or near-peer of the been tested with youth in a wrap- seeking funding for a larger-scale youth who receive services. around program and with youth in a study that also examines outcomes in Agency-level intervention. In high school/day treatment program. areas such as mental health, educa- addition to focusing on individual Despite the relatively small sample tion/employment and service conti- youth, AMP focuses on the agencies size, the data show positive results. nuity. that provide treatment, care or transi- Several of these positive findings

14 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

My Life My Life is the first study investi- 1. Identify dreams and set transition gating the benefits of a self-determi- goals: Youth identify their dreams Among youth in foster care, seri- nation enhancement intervention for for the future (graduate from high ous mental health conditions are ex- youth in foster care and special edu- school, apply to college, get a driv- tremely common. In the Casey Na- cation. Sixty youth, age 17, were ran- er’s license). domly assigned to either a comparison tional Alumni Study, more than half 2. Share dreams and goals with oth- group that received typical services of young people who had exited fos- ers: Youth learn how to share their and supports, or to an intervention ter care had mental health challenges, dreams and transition goals during group that participated in the My Life with 25% experiencing post-traumatic individual discussions with foster intervention. The intervention lasts stress disorder and 20% experiencing and biological families, important 6 for approximately 12 months and the major depression. Foster youth in peers, and professionals. general tend to experience relatively youth’s self-determination and transi- poor outcomes as they age out of tion outcomes are measured before 3. Identify steps and supports to care. In comparison to their same- they begin, at the end of the interven- reach goals: After youth identify age peers in the general population, tion, and 12 months after the interven- their broad transition goals, they youth emancipated from foster care are less likely to have stable housing, to be connected to a caring adult, to graduate from high school, to go to Transition planning within the foster care and college, or to be employed.1, 6, 5 Youth in foster care who also have mental special education systems is intended to ensure health conditions appear to face even higher levels of risk as they reach the that services and supports are in place as the young age of emancipation and leave the fos- person moves towards his/her goals for the future. ter care system. For example, research by Smithgall and colleagues showed that only 16% of foster youth in special education with a primary disabil- tion ends. Intervention youth receive identify specific steps they can car- ity classification of emotional distur- about 50 hours of coaching in the ap- ry out and supports needed from bance graduated from high school; plication of self-determination skills others to achieve them. to achieve their personal transition even more worrisome, they found that 4. Formalize planning objectives: goals. They participate in 3-4 mentor- 18% left school because they were in- Youth present their goals and pro- 7 ing workshops with young adults who carcerated. posed steps and supports needed Transition planning within the have foster care experience and who are working or in college. Addition- in a formal transition planning foster care and special education meeting. systems is intended to serve as the ally, each youth develops an individu- youth’s roadmap from school to adult alized transition plan that he or she 5. Agree on responsibilities and time- life, ensuring that services and sup- presents in an inter-agency transition frames for carrying out plans: The ports are in place as the young person planning meeting (e.g., with school youth and other team members moves towards his/her goals for the and child welfare representatives). formulate specific plans for goal future and self-sufficiency. However, a My Life’s approach for promoting achievement, clarify responsibili- study by Geenen and Powers (2006)3 the involvement of foster care youth ties, and define monitoring proce- found that the transition plans of fos- in transition planning is based on dures to ensure progress. the belief that youth need to acquire ter youth with disabilities were poor 6. Problem-solve strategies to achieve skills and beliefs necessary to design, in quality, both in absolute terms and goals: Youth learn to apply prob- implement and oversee their transi- in comparison to the plans of youth lem-solving and planning strate- tion process, and foster parents and in special education only. Many of the gies to overcome barriers to goal professionals must be mobilized to foster youths’ plans were developed achievement. without a parent advocate or educa- support youths’ efforts. Thus, youth tional surrogate, documented limited and their coaches regularly commu- 7. Carry out plans: The youth carry expectations for the foster youth, did nicate with, and solicit support from, out the strategies to achieve their not specify accountability for plan foster parents, special education staff selected goals, regularly evaluate implementation, and reflected little and child welfare case workers; and their success, and use problem- to no collaboration between the child the youth nurture connections with solving to address new barriers. welfare and special education pro- other supportive adults in their lives 8. Monitor and manage support for grams. The findings from this study with whom they develop agreements achieving goals: Youth learn and for specific forms of support (e.g., stay highlight the need for student-direct- apply steps for building partner- at the adult’s home during a college ed, individualized and collaborative ships and managing help from holiday break, help the youth fill out transition planning for youth in foster others. care and special education, and serve job applications). The My Life tran- 9. Celebrate success and resilience: as an impetus for a pilot study entitled sition planning process includes nine Youth learn how to self-monitor My Life.4 key steps.

Regional Research Institute for Human Services, Portland State University. focal point 15 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

and celebrate their goal achieve- sions and carrying out plans for their 7. Smithgall, C., Gladden, R. M., ment and resilience to barriers futures. The findings also indicate Yang, D. H., & Goerge, R. (2005). (e.g., frustration and discourage- that youth who take this active role Behavior problems and educational ment by others). experience gains in empowerment or disruptions among children in out- self-determination. Ultimately, both of-home care in Chicago. Chicago: Outcomes being measured in- of these interventions aim to have an Chapin Hall. clude youth self-determination; in- impact on other outcomes, such as 8. Wagner, M., Newman, L., Ca- volvement in transition planning; em- education, employment, and mental meto, R., & Levine, P. (2005). ployment; educational participation health. The current AMP study is Changes over time in the early and achievement; and quality of life. preliminary and so has not examined postschool outcomes of youth with Data are still being collected at one- these types of outcomes; however, the year follow-up so findings are only My Life study appears to be having disabilities. A report of findings preliminary at this point. However, just these sorts of effects. More gen- from the National Longitudinal initial findings suggest the interven- erally, these findings support the idea Transition Study (NLTS) and the tion is having a positive impact in sev- that youth-driven planning is a feasi- National Longitudinal Transition Menlo Park, eral areas: ble and effective strategy for promot- Study-2 (NLTS2). ing better outcomes for young people CA: SRI International. Retrieved • Self-determination: Youth in as they move into early adulthood. May 29, 2009, from www.nlts2. the intervention group reported org/reports/2005_06/nlts2_re- significantly higher levels of self- References port_2005_06_complete.pdf. determination following interven- 9. Walker, J. S., & Child, B. (2008). tion and one year after interven- 1. Avery, J. (2001). Education and Involving youth in planning for their tion, in comparison to youth in children in foster care: Future suc- education, treatment, and services: the control group. Differences cess or failure? Retrieved May 29, Research tells us we should be doing between the groups appear to be 2009, from www.newhorzons. better. Portland, OR: Research widening over time. org/spneeds_avery.htm. and Training Center on Family • Transition planning: Youth un- 2. Geenen, S. J. & Powers, L. E. Support and Children’s Mental derstanding and involvement in (2007). Tomorrow is another Health, Portland State Univer- transition planning meetings and problem: The experiences of sity. related activities are higher for youth in foster care during their youth in the My Life intervention transition to adulthood. Children Authors than youth in the control group; and Youth Services Review, 29, the difference between the groups 1085-1101. Janet S. Walker is Co-editor of widens further at one-year follow- Focal Point and Director of Research 3. Geenen, S. & Powers, L. (2006) up. and Dissemination at the Research Transition planning for foster and Training Center on Family Sup- • Quality of life: Youth completed youth with disabilities: Are we port and Children’s Mental Health at a quality of life measure with four falling short? Journal for Voca- Portland State University. domains. Overall, youth in the in- tional Special Needs Education, tervention group reported signifi- 28, pp 4-15. Sarah Geenen is Assistant Profes- cantly higher quality of life than 4. Geenen, S. J., Powers, L. E., Ho- sor at Portland State University and youth in the control group, both gansen, J. & Pittman, J. (2007). the director of two projects focused following intervention and one Youth with disabilities in foster on enhancing the self determination year later. Intervention youths’ care: Developing self-determina- and outcomes of youth in foster care scores on three of the four domains tion within a context of struggle and special education. are significantly higher (Scores on and disempowerment. Exception- the fourth domain are higher but ality, 15, 17-30. Elizabeth Thorne is Project Man- not statistically significant). 5. Goerge, R. M., Bilaver, L., Lee, ager of the Achieve My Plan! (AMP) Youth who participated in the My B. J., Needell, B., Brookhart, A., Project at the Research and Training Life intervention also appear to have & Jackman, W. (2002). Employ- Center on Family Support and Chil- better outcomes in terms of employment outcomes for youth aging out dren’s Mental Health. ment (particularly at one-year follow of foster care. Retrieved May 29, up) and placement stability. 2009, from http://aspe.hhs.gov/ Laurie E. Powers is a researcher hsp/fostercare-agingout02/ at the Research and Training Center on Family Support and Children’s Conclusion 6. Pecora, P. J., Williams, J., Kessler, Mental Health at Portland State Uni- R. C., Downs, A. C., O’Brien, K., versity and Director of the Regional The initial findings from the AMP Hiripi. E. & Morello, S. (2003). and My Life interventions suggests Research Institute for Human Ser- Assessing the effects of foster care: vices. that it is quite possible to increase the Early results from the Casey Na- extent to which young people are in- tional Alumni Study. Casey Fam- volved and engaged in making deci- ily Programs.

16 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Developing a New Intervention: Reflections of a Youth Advisor

athan, age 20, along with marketing videos. Nhis mom, Sonja, have Nathan believes strongly that been dedicated members of the work he is doing on AMP is the Achieve My Plan! (AMP) important. He thinks that AMP advisory board for the past can “give youth a sense of self three years. Nathan has dealt confidence, and help them to with mental health issues all of feel more independent.” Being his life, and has been involved an advisor to the AMP project with various treatment, educa- has also affected Nathan in a tion and counseling services positive way. Nathan admits that for nearly as long. During his while his motivation to become treatment and education plan- an AMP advisor in the beginning ning meetings, Nathan remem- was “mostly about the money,” bers “never feeling like my he says that it has become about opinion mattered or was impor- much more than that. “Before all has attended as an opportunity to be tant to anyone…. People just spoke of this [AMP],” Nathan reports, “I heard by a group of researchers, care- for me. I never realized it should didn’t know what I wanted to do…. givers, professionals and other youth. have been the other way around.” I wanted to be an archaeologist, but “People in the meeting actually cared Nathan recalls that several years there isn’t much demand for that.” about what I thought and what I had ago his mom received an email in- Now, Nathan sees himself walking to say. Now I know that my opinion viting her and Nathan to become a new path. “I want to become a matters,” Nathan remarks, regarding advisors for a project that was work- spokesperson for people with mental his experience in helping to shape the ing to increase youth participation health issues, and help them get the AMP intervention and related ma- and engagement in their treatment, most out of life. Before being on the terials. Over the years as an advisor, education and transition planning. board, I never talked. Now, I want to Nathan has not only shaped AMP (The project was later named AMP.) make a career out of it!” materials, but has also presented with Although his mom was unsure, members of the research team at a Nathan talked her into going, mainly number of conferences. However, -by Elizabeth Thorne, AMP Project because it paid more than he could Nathan’s favorite activity has been Manager, based on an interview with make working. Nathan describes the acting in role plays that were taped Nathan Tanner AMP advisory board meetings he for various AMP trainings and social

New Measure of Youth Mental Health Empowerment

he Youth Empowerment Scale-Mental Health (YES- formation about themselves and their experiences with TMH) is a new measure designed to assess young peo- mental health services and systems. Results from the ple’s feelings of confidence and efficacy with respect to study provide evidence of the measure’s reliability and managing their own mental health condition, managing validity. their own services and supports, and using their experience and knowledge to help peers and improve service sys- More information about the YES-MH can be found online tems. The YES-MH has 20 items and takes less than five at: minutes to complete. It provides an overall empowerment score as well as scores for empowerment in each of the http://www.rtc.pdx.edu/PDF/pbComplete three areas noted above: self, services and system. SurveyPacket.pdf 1. Walker, J. S., Thorne, E., Powers, L. E., & Gaonkar, The properties of the YES-MH were investigated in a R. (in press). Development of a scale to measure the em- study that is about to be published.1 In the study, young powerment of youth consumers of mental health servic- people from around the country completed the YES-MH es. Journal of Emotional and Behavioral Disorders. as well as a series of other measures, and provided in-

Regional Research Institute for Human Services, Portland State University. focal point 17 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Youth ‘N Action: For Youth, By Youth!

Youth Involvement in his neighborhood or gang. He checked people who will not judge him for his Washington State the program out and found it focused challenges. She speaks out about it in on his strengths and talents and not a parent support program and they elaney, 16, is living with her the poor choices he’d made by joining connect her to a youth organization Dgrandparents due to parental a gang. That was important because that combats stigma. Gio joins the abuse and neglect. She’s angry from he had not thought anyone would un- program and realizes for the first time the trauma she experienced and does derstand him. The program gave him that, not only is he not alone, but also not look to her classmates for sup- a chance to remove himself from the he has nothing to be ashamed of. He port, as she fears they will view her lifestyle of his neighborhood and get can now help people who go through situation negatively. She tries to iso- involved in positive and productive ac- what he went through and do some- late herself and falls under the radar tivities with his peers. It also provided thing positive with peers like him- because she feels no one cares. Her him resources to help deal with his self. What is this program that helps teachers and peers perceive her as dis- depression, which he was self-medi- young people turn their “problems” connected and uninterested. Where cating with drugs and alcohol. He got into strengths? can she go for support? Where can she help with his addiction and became Policy makers and service provid- go to be heard? Where she can meet involved in a supported employment ers can’t figure out why their multi- people who understand her situation? program. He now works full time and million dollar pilots are not working Sean, 20, struggles with depres- serves as a leader in the organization. and why youth continue to spiral sion. When he moved into a neighbor- He shares his experiences with other down in their lives and “fail” pro- hood filled with drugs and violence youth who are undergoing challenges grams. They’ve brought in consul- about five years ago, he joined a gang in their life, so that they may create tants from all over the nation; they’ve to protect and support his family. He resiliency in their lives like he did. reviewed all their data and notes and didn’t want to join a gang but felt there Where did he go? What organization finally, they realize they have never were no other options. He knew gang would accept a “gang” member? heard from the youth themselves… life wasn’t for him after seeing friends Gio, 17, has a mental health di- Where can they go to get youth voice? and family die, fall into addiction and agnosis. School becomes increas- Who will support these youth? go to jail. Two years ago, a friend told ingly stressful as he fears the stigma Answer: Youth ‘N Action. The him about a local youth organization of mental illness will fall upon him young people in Youth ‘N Action that wanted to hear his voice and give if people find out his diagnosis. His have had different experiences, but him opportunities he couldn’t find in mother knows he needs to have a pos- their goals are the same: to make life itive social connection and be around better for youth in Washington, and

18 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

to the youth to help them create the Table 1. Self-Report of Educational Status, positive outcomes they desire. YNA provides youth with a vari- Educational & Criminal Justice Experiences (n= 33) ety of opportunities to make a positive difference. For example, in East- Educational Status Percentages ern and Western Washington, YNA holds regional monthly meetings Currently in high school 63% where youth get together and talk about the positive differences they’d Graduated high school 10% like to see in their lives, communities and the systems that serve them. Dropped out 17% Additionally, youth receive education about programs and services available Other 7% to them to help them reach their life goals. Currently in community college 3% YNA also provides youth with opportunities to advocate and edu- Regarding education: Have you ever... cate. Youth bring their voices to important state-level venues such as the ...been suspended? 67% Washington State Community Trans- formation Partnership, a coalition of ...been expelled? 15% consumer advocacy organizations, and the Prevention Policy Summit, ...attended an alternative school? 33% held in May of 2008, where over 260 mental health stakeholders identified ...had an IEP (Individualized Education Plan)? 58% Washington State’s priorities in the Regarding criminal justice: area of mental illness prevention. At Have you ever... the national level, YNA members trained psychiatrists on youth-direct- ...had criminal justice involvement? 45% ed care at a psychiatric conference in New Orleans, presented study results ...been arrested? 39% on the needs of transition-age youth at the Research and Training Center’s ...been charged with a felony? 18% Building on Family Strengths Con- ference at Portland State University, ...been charged with a misdemeanor? 18% and participated in other conferences sponsored by Georgetown University ...served time in prison? 12% Institutes and the Federation of Fami- lies for Children’s Mental Health. ...served time in jail? 3% Youth ‘N Action also provides many avenues to encourage leadership and positive youth development, to add positive experiences and peers Action—that was designed to partner such as Spokane’s YNA Student 2 to their lives. Youth ‘N Action is a with family support and advocacy Student program (a peer support pro- unique program that supports youth groups and professionals. Eventu- gram in a local high school) and the voice. Youth are the experts in their ally, Health ‘N Action partnered with Youth Stigma Reduction Speakers lives and their recoveries. SAFE WA (Statewide Action for Bureau. A developing pathway is in Family Empowerment of Washing- the area of artistic expression. YNA About Youth ‘N Action ton), and became the statewide youth leaders are currently producing a play advocacy program now known as titled. ‘Life is Not a Game,’ designed As work on systems of care was Youth ‘N Action (YNA). to give a real-life view of the issues undertaken in King County, Wash- YNA brings youth voice to public youth in transition face in regard to ington, there was a growing recog- policy and empowers at-risk youth mental health, family, peers, social nition that as important as parent ages 14-24 to make positive differenc- lives, education, and employment. empowerment is, it does not guaran- es in their lives, their communities, As the collaboration between tee that consumer youth will receive and systems that serve youth. YNA Youth ‘N Action and SAFE WA con- services relevant to them. This led is a youth-driven organization sur- tinued to develop, members realized to the formation of a separate youth rounded by youth-friendly adults and they held widely different perspectives program—originally called Health ‘N professionals who provide support regarding youth involvement within

Regional Research Institute for Human Services, Portland State University. focal point 19 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

YNA. They came to believe that an ty to participate in one-on-one phone • Educational: evaluation process would assist them interviews or attend focus groups. to more clearly identify a philosophy Youth were met in their local areas, My first impression was good. I main- for the benefit of the youth, their fam- provided with transportation through ly did the educational things about it, ilies and the state of Washington. volunteers and project staff, paid $40 so I think it is a good program. for their participation, and provided A Youth-Driven with a meal. Youth were happy with • Fun, cool and FOOD: Evaluation Process how the focus groups were conducted and thankful for the opportunity. The first time I went to a Youth ‘N In the spirit of being youth-driven, Focus groups were audio taped, Action meeting, you know, it was cool. youth made the key decisions in ev- professionally transcribed and edited. It had food there, but that wasn’t it. ery step of the evaluation. Adult part- After this, a group of key youth and You all trying to do some real stuff ners were available as a resource, not adult stakeholders met to review fo- trying to set up a little fund raiser and a force, and offered their partnership cus group transcripts and highlight stuff, a little concert and stuff… You and support throughout the project. trends. Once again, youth took lead- all had former NBA star Joe Pace. It To start out, YNA leaders developed ership, since their familiarity with was crazy when I seen that, Joe Pace, the Youth ‘N Action program logic youth culture and typical peer situa- hey a basketball player. I was like, model. The logic model helped them tions would allow them to make more “OOOHHH!!!” to form their draft focus group ques- subtle and accurate interpretations of tions. Subsequently, they finalized the the focus group data. • Community service: focus group questions, created ground rules for the focus groups, and edited Highlights from the Results My first impression was that it looked a pre-focus group questionnaire for like a lot of fun and it looked kind of participants to complete. When this What were your first interesting to get involved in. A lot of hard work was done, they celebrated impressions of Youth ‘N Action? things like how to help our community with other YNA members at a bil- in different ways. So our community liards and arcade restaurant. • Empowerment: can be a better place. Youth co-facilitators from East- I liked it because everybody spoke their ern and Western Washington were • Meeting new people: trained in focus group facilitation mind but also listened at the same through discussion and role playing. time. When I first came I thought it was Thirty-three youth ranging in age • Acceptance and felt no stigma: pretty cool. I would like to be doing from 14 to 24 participated in the focus this on a regular basis. It taught me groups. The sample was 58% male a lot about tolerance and I guess not and the mean age was 17.1. The ma- My first impression of the group was jority of participants were European that it was a good, fun place to come judging, just accepting people regard- American (46%), with 24% African hang out and not have to hide who less of their faults. American, 6% Native American and you are. You can hang out with dif- 24% multiracial. Five of the 33 par- ferent races of people and not worry How has Youth ‘N Action ticipants had children. Other back- about anything, not worry about be- affected you personally? ground information is provided in ing judged or anything like that. Table 1. • Life, professional and leadership skills: On the questionnaire, youth were • Opportunity: provided a list of diagnoses and asked It has helped me with a lot, I think to check if they self-identified with For opportunity, I thought this could you call it intrapersonal skills, like and/or had ever been diagnosed with take me places, places to where I can any of them. ADHD and other dis- get what I think and how I feel off of ruptive behavior disorders, learning my mind and off my chest. disabilities and anxiety were the three most frequently identified diagnoses. • Good environment and non-reli- Frequencies of self-reported diagno- gious: ses are shown in Table 2. The range of diagnoses was from 0-7, with a My first impression of Youth ‘N Ac- mean of one. It is noteworthy that tion was, I came to one of the meet- 49% of the youth did not check any ings and I really enjoyed the fact that diagnoses. it was a youth group that wasn’t based Interviews were conducted in a on any particular religion, because youth-friendly manner and environ- usually that is what youth groups fo- ment. Youth were given the opportuni- cus on.

20 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

never thought I would be sitting right Table 2. Youth Self-Report of having been here right now, about to be a “facilita- diagnosed or self-identified* (n= 33) tor.” [laughter] • New friends and new experiences: Diagnosis Percentages I have more friends now that I never Anxiety disorders** 18% thought would like me because I was different. Depression 12% Final Thoughts Bipolar disorder 6% I [Tamara] started this evaluation ADHD and other disruptive behavior disor- 34% as a youth leader in Youth ‘N Action ders*** who was motivated and thankful for all the opportunities, encouragement Learning disabilities 24% and support Youth ‘N Action had provided me. I felt that if we did this Substance abuse 12% evaluation it would show people how Serious Emotional Disorder 9% valuable this program is to youth and how it can touch so many lives and Eating disorder 6% create change in the community. All it took to turn my life around was Did not check any diagnosis 49% someone who cared and someone who listened and now I’m able to Checked “unknown” 12% help so many other young people than myself. Other 9% Authors *Percentages add to more than 100% because of multiple diagnoses **Includes obsessive compulsive disorder (OCD), post-traumatic stress disorder Tamara L. Johnson is Co-Pro- (PTSD) gram Director and Youth Advocate ***Includes conduct disorder and oppositional defiant disorder for Youth ‘N Action and a certified peer counselor. time management and responsibility • Trust, respect, confidence, under- Jean Kruzich is Associate Profes- sor at the University of Washington, and stuff like that. standing, belonging and stigma reduction: School of Social Work, Seattle and • Leadership, advocacy, youth voice Co-Principal Investigator of Voices and empowerment: There are people out there like me that of Youth, a project of the Research deal with mental health, and it is like and Training Center on Family and I think that Youth ‘N Action taught I am not the only one out there, you Children’s Mental Health. me a lot more about myself, trying to know. I feel better now that I’m not For more information see the fol- help other people. Guidance, growth, the only person out there. support and motivation. lowing websites: • Resources, opportunities and fun: Once I got involved in the program Youth ‘N Action: I quit stealing, because when I went I have been to Olympia meeting leg- www.YouthNAction.org to the meetings and we talked about islators and stuff. That is something our problems that helped me out… If that I thought I would never do either. Statewide Action for Family Youth ‘N Action were to disappear my They got to get to know me – well, Empowerment: life would probably change. I’d prob- not really get to know me, but see my www.SAFEwashington.org ably go back to stealing. Well, prob- face and shake hands with a couple of ably not, because they taught me a lot people that I never thought I would of things. Also, I probably wouldn’t be see. Those are like big type of people having that much fun, as I was saying. —well, not big type, but legislators, I’d probably go back to my shyness a people that write laws and bills and little bit, maybe. That’s about it. stuff. I am coming from Seattle and I

Regional Research Institute for Human Services, Portland State University. focal point 21 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Youth Voice and Participation on the National Youth Summit Advisory Board… and Beyond

t is Saturday morning. Nine members were also expected to be Iyoung people from Oregon, leaders during the event, and to Massachusetts, California, Texas, take part in presenting outcomes and New York have gotten out of from the Youth Summit during bed, picked up their phones and the following Building on Family dialed the 1-800 conference call Strengths Conference. In return number. What motivates them to for their involvement, individuals spend two hours of their Saturday would receive compensation for this way? They are all members of time spent on conference calls, the 2009 Portland National Youth funds to travel and stay in Port- Summit Advisory Board. These land and attend the Youth Summit youth, who have never met face and Building on Family Strengths to face, are working together with Conference, and a stipend upon adult allies and the Portland State completion of the event. University Research and Training The Summit Coordinator was Center on Family Support and committed to creating an atmo- Children’s Mental Health (RTC) sphere where young Board mem- to build a youth-driven event from bers felt heard and valued, and the ground up. All their monthly where decision-making was trans- Saturday planning meetings and parent. Board members received email communications will come meeting agendas and relevant together this June in Portland, Or- young people to join the Youth Sum- documents before each conference egon for the 2009 Portland National mit Advisory Board and plan the call, and were invited to send any Youth Summit. There they will meet Youth Summit event. This Advisory comments or request changes. Mem- with 30 peer leaders from around the Board was appointed to identify spe- bers were encouraged to lead team- country to share unique stories about cific goals and intended outcomes for building exercises at the beginning their own experiences with mental the Summit, initiate recruitment for of each call to facilitate relationships. health challenges, foster care place- youth and young adult participants, During the first conference call, mem- ments, homelessness, the juvenile oversee the creation of a participant bers voted on which day of the week justice system, and residential treat- application process, and plan the and time of day future calls should ment placements; and to identify Summit agenda. take place. Because members of the common themes and areas for im- Recruitment of Youth Summit Board had many existing commit- provement within services for youth. Board members began with a request ments, such as school, work and vol- circulated nationally to youth leaders, unteering, they also received remind- The Youth Summit youth coordinators and adults con- ers about conference calls through Advisory Board nected to systems of care. Identified emails, individual phone calls and and interested young people submit- text messages one or two days before The Youth Summit was intended ted resumes and cover letters stating each call. For those youth who could to be a youth-driven event, and so the why they wanted to become a part not attend certain calls but could first step in the planning process was of the Youth Summit planning team. communicate electronically, a group to hire a young adult who had per- Young people were then selected website was created through Google sonal experience with mental health based on their experiences as youth Sites to facilitate comments on plan- services to act as the Youth Summit leaders, their passion for making im- ning and application materials, as Coordinator. The Coordinator, with provements within youth services, and well as to provide access to previous support from RTC staff, led a pro- their ability to commit time. Board meeting agendas and minutes. Most cess to recruit “systems-experienced” importantly, youth were encouraged

22 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

to speak up if the language being used decision-making, initiation and ac- ing on documents electronically was through any communication avenue tion. In the process of planning the a challenge. When initiating phone was not youth-friendly or clear. Youth Summit, the Advisory Board correspondence, time zones had to be hovered in between the fifth and sixth considered as well as school and work Challenges rung: The Board was consulted on schedules. At times, individual Board and included in many decisions, but members understandably needed to Despite the above efforts and more often than not, youth were in- focus on managing their own men- dedication, it was at times a challenge formed and asked to give input on de- tal health in addition to dealing with for the Coordinator to encourage par- cisions and actions initiated by adult life difficulties such as homelessness, ticipation and completely let go of the allies. providing child care, and obtaining steering wheel. In his 1997 book Chil- Many of the Youth Advisory social service support. As participa- dren’s Participation: The Theory and Board members, though well in- tion from some members began to Practice of Involving Young Citizens tended, did not follow through with wane, Board members collaborated in Community Development and En- planned attendance on conference with the Coordinator to create partic- vironmental Care, sociologist Roger calls, or respond to requests to review ipation expectations and outcomes. Hart identified eight levels of youth documents with edits and ideas. As a The Coordinator, youth allies, and involvement, outlined into a “Lad- result, the RTC Coordinator became other board members strived to be der of “Youth Participation.”1 Each less comfortable assigning tasks to supportive of and flexible with each sequential rung of Hart’s participa- board members, given the time con- member’s level of involvement when tion ladder (Figure 1) facilitates more straints of planning the Youth Sum- creating membership expectations. youth participation and therefore, mit. Some youth did not have easy or However, a handful of youth were more youth empowerment. The goal consistent access to the Internet; there- not able to complete their obligations, of meaningful youth involvement is fore, communication was often done and Board membership dropped from facilitation of mutual adult and youth primarily by phone, and collaborat- nine active members to six.

figure 1. Hart’s Ladder of Youth Participation

8. Youth/Adult Step 8 Youth/Adult Partnerships: Partnerships Youth initiate projects and decision-making is shared with adults 7. Youth-Led Step 7 Youth-Led Activism: Activism Youth initiate and direct projects while adults are in the supportive role 6. Participatory Step 6 Participatory Action Research: Action Research Adults initiate projects, but decision-making is shared with youth 5. Youth Advisory Step 5 Youth Advisory Councils: Youth provide feedback on projects that Councils are initiated and run by adults 4. Community Step 4 Community Youth Boards: Youth Boards Youth are assigned project roles by adults and are informed how and why they are being included Step 3 Tokenism: 3. Tokenism Youth appear to be included, but really they have little or no choice in how they participate in adult-initiated projects 2. Decoration Step 2 Decoration: Youth are used to help with adult- initiated projects in an indirect way 1. Manipulation Step 1 Manipulation: Youth are included to create the appearance of youth-inspired projects that are in fact run by adults

(Adapted from “Ladder of Participation” from “The FreeChild Project Youth Voice Toolbox” www.freechild.org)

Regional Research Institute for Human Services, Portland State University. focal point 23 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Meaningful Youth Advisory Board, he is a part of the Something else to consider when Participation Oregon Family Supports Network, inviting a young person to be involved the Leadership Education Adven- with an organizational board is to As mentioned, Youth Summit ture Direction program in Oregon, make sure that young person feels Board members were selected partly and the Resources, Education, and like part of the group. Taking the based on their involvement with many Assistance for Community Housing time to build relationships facilitates other youth service organizations. program in Kentucky. When asked youth investment and leadership. “It Seventeen-year-old Chelsea Garcia, what he believes is most valuable in is really nice when each person in the from Houston, Texas is a youth board encouraging youth voice as a part of room goes around the table to intro- member with three additional organi- board membership Rafferty replied, duce themselves and say what they zations. As a part of the statewide ini- “Having at least two young people do,” Garcia explains. “It takes a lot tiative Youth On Board, Garcia and present makes a difference. It is much of the intimidation away when you other young people work with non- more comfortable for that young realize ‘Hey these are people just like profits and government organizations person to say ‘Hey can you repeat me.’ It also makes you feel more a to create more youth-friendly spaces that?’ if another young person is pres- part of the process when you can say on planning committees and other ent.” Rafferty and Garcia agree that what you do and see that they respect decision-making bodies. To Garcia, board members must be ready to slow your experience.” Garcia and Raf- the thing that really drives her to be down for youth. “Not because youth ferty both believe it would have been a part of these groups is the fact that can’t grasp the concepts,” Rafferty helpful if the Youth Summit Board she feels her ideas and words are re- elaborates, “but because youth aren’t could have met as a group in person ally valued. “It makes such a differ- spending 40 hours a week around for their planning conference calls. “It ence when the people in suits ask you those concepts and ideas like most of just makes such a difference to be able your ideas, listen, and then put them the other members are.” Also, Raf- to see body language.” Rafferty says, into action. Once you see you are put- ferty believes it is helpful to have an “You also eliminate so much talking ting yourself out there and they are advocate there who can speak up if over each other that you get when you going to listen, it makes you feel like an adult-dominated board is veering are only hearing voices on the phone. more than just the ‘token youth.’ You away from “youth-friendly language” That is why I am a big fan of web are an important part of making the or is using unclear acronyms. “You cams if they are possible. Having that changes happen.” would be surprised how many times eye contact makes all the difference.” Martin Rafferty, age 22, of Eu- a young person or ally speaks up be- Including a youth in service as- gene, Oregon, is also very active in his cause they need something explained, sessment and planning through or- community as a youth board mem- and other adults are relieved ‘cause ganizational board membership not ber. In addition to serving on the 2009 they don’t get it either,” laughs Raf- only benefits that young person, but Portland National Youth Summit ferty. it greatly benefits the organization’s ability to hear from the population they serve. By making a few small ad- justments, organizations can ensure Tips to meaningful Youth Board Involvement that their programs are taking steps “up the ladder” towards youth participation and empowerment. • Take time to have team-building exercises. Whether it is an all-day activity or a quick icebreaker, it creates healthy working relationships and Reference gets energy up. • Use acronyms sparingly, or include a key that lists acronym meanings. 1. Hart, R. (1997). Children’s participation: The theory and practice • Have a “youth ally” available to meet with youth in between meetings, of involving young citizens in com- review concepts, and speak up for youth if non-youth-friendly language munity development and environ- is being used. mental care. London: UNICEF • Include at least two youth seats on the board for a more comfortable set- and Earthscan. ting. • Consider the school or work schedule of the young people involved. Author • Include youth in voting and other decision-making processes. Rebecca Strachan is a graduate • Wear name tags the first several meetings so everyone can be identified student of social work at Portland by their first name. State University and the Youth Sum- mit Coordinator with the Research • When you ask a young person their thoughts, take them into serious and Training Center on Family Sup- consideration and follow up with youth on the progress of their ideas. port and Children’s Mental Health at • And in the words of Chelsea, “When all else fails, bring brownies!” Portland State University.

24 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Youth MOVE National: Youth as Change Agents

outh Motivating Others through of experience in empowering families Today, Youth MOVE National’s YVoices of Experience (Youth and creating positive system change. main goals are: MOVE) National is a youth-led na- Board members thought that it would tional organization devoted to improv- be of great benefit for Youth MOVE • To assist in developing the Youth ing services and systems that support National to learn from this experi- Leadership program at meetings positive growth and development by ence. This relationship would also • To create youth movement prin- uniting the voices of individuals who allow for professional mentoring of ciples and policies have lived experience in various sys- Board and staff, and would have the tems including mental health, juvenile added advantage of providing office • To develop training tools, guides justice, education, and child welfare. space in the National Federation’s and other documents The youth movement began years home office, which is close to both • To unite the voices and causes of ago when youth coordinators and SAMHSA (the Substance Abuse and youth youth across the country were ad- Mental Health Services Administra- • To act as consultants to youth, pro- vocating for national involvement. tion) and our nation’s capitol. The viders, families, and other adults Their passion and determination con- conversations led to Youth MOVE be- tinued on until 2003 when the Na- coming a subsidiary of the National • To create youth movement prin- tional Youth Development Board was Federation of Families. ciples and policies formed with the support of a diverse In October 2007, with start-up • To provide national youth leader- group of youth coordinators from funding from SAMHSA, the Nation- ship representing youth served by communities across the county. al Youth Development Board transi- mental health and other youth- The National Youth Development tioned into a national youth-led ad- serving systems Board existed in an advisory capacity vocacy organization known as Youth in the early years. In 2007, the Board MOVE National. With this start-up • To coach others in the area of au- took the first step toward becoming funding, Youth MOVE National was thentic youth involvement an independent organization. Mem- able to hire a full-time Director, Carl bers of the Board asked the National Yonder, and part-time administra- Youth MOVE National is work- Federation of Families for Children’s tive assistant, Brian Campbell. Mov- ing to become a model of successful Mental Health to consider acting as ing forward in January 2008, Youth youth involvement in consultation Youth MOVE’s fiscal agent. The fam- MOVE National was officially incor- and policy work at the national level. ily movement—and the National Fed- porated to become Youth MOVE Na- With members from around the eration itself—has had over 20 years tional, Inc. country—from Montana to Florida,

Regional Research Institute for Human Services, Portland State University. focal point 25 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

funding to youth (23 years of age and increasing authentic youth involve- Youth MOVE under) to facilitate awareness-raising ment in this process of change. Mission Statement and stigma-reduction projects in local communities. Between 2008 and You can become an individual 2009, Dare to Dream America, with member of Youth MOVE National! e the members of Youth startup funding from SAMHSA, has WMOVE National will awarded 20 grants to youth across the Your support of Youth Move Na- work as a diverse collective to country who demonstrated high in- tional is valued and appreciated as unite the voices and causes of terest and energy around unique and your membership dues enable Youth youth while raising awareness creative projects. The ideas of youth MOVE to broaden its ongoing efforts around youth issues. We will astounded Youth MOVE National, to build programs and policies for advocate for youth rights and with concepts ranging from ad cam- positive youth involvement across the voice in mental health and the paigns to creative theatre productions country. The Youth MOVE National other systems that serve them, to a Battle of the Bands. This program board is eager to support and work with its members in order to bring for the purpose of empowering has offered many youth the opportunity to improve the knowledge and about positive systems change. Please youth to be equal partners in the understanding of each local commu- check our website, www.youthmove. process of change. nity around mental health. us as we will post updates on activi- Beyond Dare to Dream America, Youth MOVE National provides sev- New York to Hawaii—the board of eral services such as serving as con- Youth MOVE Youth MOVE National is a diverse sultants on panels at the national, vision Statement group. One board member is a for- state and local levels; assisting in de- mer gang member, while others were veloping youth-guided programs and involved in foster care for their entire projects for improving services and e the members of Youth lives. Board members bring their own systems; and providing youth speak- W‘Motivating Others personal beliefs and values, yet all are ers for conferences and workshops through Voices of Experience’ committed to using their personal across the country. Board members (MOVE) National envision sys- success on behalf of Youth MOVE have participated in high-profile op- tems in which every young per- National. portunities such as the Georgetown son that enters a youth-serving This diverse coalition has already Transition Policy Academy and the system is being prepared for life achieved positive work within the International Initiative for Mental through genuine opportunities mental health system. For example, Health Leadership, for which board and authentic youth involve- one of Youth MOVE National’s early members traveled to New Zealand ment throughout all systems lev- projects was to develop a definition of and Australia! Other board members els. We help guide the redevelop- what it means to have a youth-guided have presented to the American Asso- system of care. Youth-guided means ment of the systems so that no ciation of Child and Adolescent Psy- that young people have the right to youth falls through the cracks. chiatrists and served on the Council be empowered, educated, and given a We advocate for youth to utilize for Coordination and Collaboration. role in making decisions, both about their power and expertise to fos- Youth MOVE National was fortu- their own lives and about the policies ter change in their communities nate to be able to participate in the and procedures governing care for and in their own lives. first-ever Youth Coordinator Con- youth in the community, state and na- ference in Washington DC, where tion. Youth MOVE National works close to 80 youth coordinators met Creating this definition was im- toward the day when all people to discuss their work and the need for portant to the work of building sys- will recognize and accept the future collaboration to continue the tems of care, and board members culture of youth, their families, youth movement. There is a lot of charged forward with passion to and the communities that serve important work being done by youth create more tools to inspire change them in order to be truly cultur- coordinators across the country and through youth involvement. Youth ally competent. Youth MOVE Youth MOVE National is there to MOVE National board members had National looks forward to the help support the positive change for the unique opportunity to travel and day when youth are no longer youth-serving systems every step of learn of the youth movement occur- the way. treated as numbers, problems ring in our neighboring nation, Cana- or caseloads, but as individuals da. From this relationship, the project How Can You Help? and humans. We will all stand Dare to Dream was brought to the as partners: youth, youth advo- United States by Youth MOVE Na- There are several ways to help cates, supporters, parents, and tional. Based on the successful Dare Youth MOVE National continue its professionals to see our youth to Dream Program from Ontario, work as an organization devoted to become successful. Canada, the U.S. program promotes improving youth-serving systems and positive mental health by providing

26 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

ties pushing forward the national together and be formally recognized youth movement. We are also in the as Youth MOVE Oregon. The young 2009 STAFF of the RESEARCH AND TRAINING CENTER ON FAMILY process of creating an email listserv people are organizing within the SUPPORT AND CHILDREN’S for all Youth MOVE National mem- Oregon Family Support Network MENTAL HEALTH bers. (OFSN, a chapter of the National Regional Research Institute for Federation of Families for Children’s Human Services You can create a Mental Health) until they are ready School of Social Work Portland State University Youth MOVE chapter! to leap out on their own. Martin Raf- PO Box 751 ferty, a youth leader in Oregon, has Portland, OR 97207-0751 Voice: 503.725.4040 Youth MOVE National is excit- been assigned the role of Director for Fax: 503.725.4180 ed to offer the opportunity to youth this newly forming organization. He www.rtc.pdx.edu groups around the country to be- says that “This work is about uniting come chapters of Youth MOVE and systems. This work is about youth Barbara J. Friesen, Director; Janet S. Walker, Director of Research and Dis- become part of a network of youth leadership.” semination; Donna Fleming, Center Co- actively involved in creating positive The group’s first statewide stig- ordinator; Nicole Aue, Publications and Multimedia Manager; Sarah Peterson systems change. Our chapters will be ma-reducing activity is helping to and Cintia Mason, Project Support. free to run in their own individual- plan Children’s Mental Health Day at Voices of Youth: Pauline Jivanjee and ized way while carrying out the mis- the capitol in May 2009. Members of Jean Kruzich, Co-Principal Investiga- sion and vision of the national board. the group will also be participating in tors. The Youth MOVE National board the national anti-stigma “BUST IT” Transition to Independence: Pauline Jivanjee, Principal Investigator; Nancy will serve as the connection to keep campaign. Our youngest youth mem- Koroloff, Project Consultant; Mandy Da- a tight relationship between national ber stated, “We’re going to have free vis, Senior Research Assistant; Christo- and local levels. The voice of youth at t-shirts, singing, dancing, food… oh, pher Burkett, Research Assistant. a community level will be proclaimed and legislators and stuff—it will be a Achieve My Plan: Janet S. Walker and Laurie Powers, Co-Principal Investiga- and addressed by our national orga- blast!” tors; Elizabeth Thorne, Project Manag- nization while the chapters will serve Serving youth with profession- er; Jonathan Melvin and Celeste Siebel, as the eyes and ears of Youth MOVE alism, respect, and commitment is Student Research Assistants. Work-Life Integration: Julie Rosenzweig National at the state and local level. YMO’s top priority. YMO members and Eileen Brennan, Co-Principal In- believe young people are a great as- vestigators; Anna Malsch, Project Man- Collaborate with set to their communities and should ager; Lisa Stewart, Graduate Research Assistant; Kayti Mills, Student Mentee. Youth MOVE National be encouraged, supported and recog- Transforming Transitions: Beth Green, nized for their contributions. They Principal Investigator; Anna Malsch, Youth MOVE National realizes wish to support youth advocating for Project Manager; Eileen Brennan, Proj- ect Collaborator; Brianne Hood, Gradu- that we cannot do it alone. We need positive change. If you would like to ate Research Assistant. help and welcome the opportunity to get in touch with YMO please email Practice-Based Evidence: Barbara J. collaborate with other organizations Martin Rafferty at martinrafferty@ Friesen and Terry Cross, Co-Principal to further the mission and vision of gmail.com or call OFSN at (541) Investigators; Pauline Jivanjee, Project Collaborator; L. Kris Gowen, Research Youth MOVE National and to work 342-2876. We look forward to Youth Associate; Abby Bandurraga, Student towards the day where positive sys- MOVE-ing into your area of the state Mentee. tem changes are a reality. and nation! Underrepresented Researchers Mentor- ing Program: Anna Malsch, Project Co- ordinator; Abby Bandurraga and Kayti A Local Example: Authors Mills, Student Mentees. Youth MOVE Oregon Learning Community: Barbara Friesen Carl Yonder is the first director and Harold Briggs, Co-Principal Inves- tigators; L. Kris Gowen, Research As- Youth from across Oregon are for Youth MOVE National. Though sociate. beginning to organize themselves to he doesn’t always like speaking about Building on Family Strengths Confer- bring a strong and united youth voice himself, he feels his work in whatever ence: Donna Fleming, Conference in the design, implementation and form will. Coordinator; L. Kris Gowen, Project Manager; Lisa Stewart, Anna Malsh, evaluation of youth mental health Liz Thorne, Sarah Peterson, and Nicole services, organizations and systems. Johanna Bergan, Youth MOVE Aue, Conference Planners. This work has gone on across the state National Board Member, is pas- Publications: Nicole Aue, Publications with many different organizations sionately dedicated to removing the Manager; Sarah Peterson, Publications Coordinator; Cintia Mason, Publications and programs. The newly formed stigma around mental illness and Assistant. Youth MOVE Oregon (YMO) is aim- improving mental health awareness, We invite our audience to submit letters ing to unite these groups and bring a especially in rural areas. and comments: strong youth voice for improving all youth-serving systems. Laura Rariden strives to serve Janet S. Walker and L. Kris Gowen, Editors: Recently, at the Governor’s Wrap- youth with professionalism, respect, [email protected]; [email protected] around Initiative Youth Work Group and commitment. meeting, youth from across Oregon Publications Coordinator: [email protected] met and decided it was time to join

Regional Research Institute for Human Services, Portland State University. focal point 27 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

Peer Mentoring: Real Recovery for Young Adults

oung adults struggling with Young adult peer mentors are individ- However, only about 10 participate Ymental health issues can often uals that offer their firsthand experi- in 1:1 mentoring in a given 6-month feel different, isolated, and power- ences of living with and overcoming period. In 1:1 mentoring, a peer men- less. Unfortunately, this isolation mental health issues to support and tor is paired with another young adult can lead to negative outcomes such assist young adults who come to the to work together in the community as withdrawal from the community, program. The peer mentors demon- for approximately six months, for 1-2 dropping out of school, and sever- strate by their simple presence that hours a week. Young adults coming ing ties with friends and family.2 Ad- recovery is real and possible. for mentoring are provided a hand- ditionally, a mental health diagnosis To promote recovery, TRACS of- out at the beginning to clarify the can leave young adults with the fear fers an array of services from which mentoring relationship. (See box.) At that the future is no longer bright and young adults may choose, allowing the start of the mentoring relation- that hopes and dreams are no lon- them to select what will be most help- ship, the young adult sets goals that ger possible. Fortunately, the truth is ful and skip what might not be as good will be addressed in weekly meetings. that recovery is a real possibility and a fit. Current services include peer TRACS has found it very important something that every young adult can support groups, monthly social/recre- to maintain a focus on goals rather achieve despite the challenges that ational events (laser tag, trivia nights, than general, open-ended support. come with a mental health condition. casino nights, sports games, etc.) with The risk with just offering support TRACS (Transition Resources young adults from other programs, is that when the young adult moves and Community Supports) is a pro- Photovoice projects (using photog- on from the program, he/she is back gram of South Shore Mental Health raphy for social action), and open to the same place he/she started. So in Massachusetts that serves young studio nights for artistic expression. TRACS prefers to focus on bridging adults ages 16-25 with mental health TRACS also offers resource work- that young adult with other, more or co-occurring mental health and shops, book discussions, and support natural and sustainable resources that substance use disorders. Founded on groups for parents and caregivers. will help him/her long-term. Men- principles of psychiatric rehabilita- Lastly, TRACS offers 1:1 peer mentors are encouraged to approach each tion, stages of change theory, and the toring where mentors provide more mentoring relationship as an oppor- transition to independence process, intensive, community-based outreach tunity to effectively work themselves TRACS strives to facilitate the recon- and support to a young adult. out of their jobs; that is, to facilitate struction of hope, purpose and mean- the young adult moving forward in ing in the lives of the young adults The 1:1 Mentoring such a way that at the end of mentor- served.2,1,5 One strategy used to meet Relationship ing, the young adult no longer needs a this goal is hiring young adult peer mentor. Mentors are encouraged to be mentors onto our staff and incorpo- TRACS serves about 50 young open about their illness and recovery rating them into the team at TRACS. adults in any given 6-month period. experiences, to the point that they are

28 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

achieved,” “not achieved at this time,” What is a Peer Mentor? or “no longer applicable.” Discussion centers on what happened concerning each goal. Regarding goals not met, A Peer Mentor is … A Peer Mentor is Not… the young adult can choose whether to continue working on them or not. • Someone you can go to for ad- • A therapist. New goals may also be added during vice on things like how to get • A case manager. the meetings. A written summary ac- housing, get a job, enroll in col- companies the goal review sheet to lege, etc. • A bank! Please do not ask your explain each rating. A similar review mentor to loan you money. • Someone you can go to for sup- process is used at the wrap-up meeting port around things like making • A crisis line… if you need emer- at the end of mentoring to assess further progress on goals. By doing this, friends, dealing with problems gency or 24-hr support, please contact your local crisis team, both the young adult and the program at school, navigating job inter- are able to track where there has been views, etc. whose number is on the welcome sheet. success and where there is still room • Someone who can support you for more work. and understand you from the • A doctor, which means that your Here are some examples of the perspective of having had simi- mentor can not give you advice goals that have been reached through lar experiences. about what medication to take 1:1 mentoring: or whether or not to take it. • Someone who can tell you about • Obtained learner’s permit and/or his/her experiences with matters driver’s license such as medication and help you with things like how to remem- • Enrolled in classes for and/or obtained G.E.D. ber to take your medication, how to talk to your doctor about • Started attending part-time college what you are experiencing, etc. classes • Obtained part-time employment comfortable. Disclosure about their mentor, the program coordinator and • Learned to use public transporta- personal stories, however, is generally anyone else the young adult would tion limited to when the young adult is in- like (family, case manager, friend, • Increased connectedness with oth- terested in the information and when therapist, etc.). At this review meet- ers in the community it will benefit the young adult, rather ing, the young adult rates each goal • Learned relaxation techniques to than for the mentors to get their own and objective as “achieved,” “partially use when anxious support.

Goal-Setting TABLE 1. GOALS ACHIEVED BY YOUTH During the goal-setting process, INVOLVED IN PEER MENTOR PROGRAM young adults are encouraged to keep in mind areas of their lives that are PERCENTAGE OF PERCENTAGE OF often overlooked in more traditional GOALS ACHIEVED GOALS ACHIEVED services, such as spirituality, health, GOAL DOMAIN OR PARTIALLY OR PARTIALLY recreation and relationships. TRACS ACHIEVED AT 3 ACHIEVED AT 6 generally sorts goals into five catego- MONTHS MONTHS ries: employment, education, inde- EDUCATION 100% 80% pendent living, wellness, and social network/community connections. EMPLOYMENT 67% 100% Young adults can set as few or as INDEPENDENT many goals as they want, but each goal 73% 75% should be something feasible to work LIVING on together with a mentor. To track SOCIAL NETWORK/ progress on goals, a goal sheet is de- COMMUNITY 50% 100% veloped after the initial meeting with CONNECTIONS the young adult and this is referenced often during mentoring outings. After WELLNESS 100% 50% about three months, a review meeting is held with the young adult, the peer TOTAL 69% 82%

Regional Research Institute for Human Services, Portland State University. focal point 29 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

developed with input from mental My Views on the Peer Model health consumers, is designed to look at recovery in a broad context rather than just evaluating presence and absence of symptoms. Young adults believe that the peer model in treatment is important because of the sup- rate their agreement with statements Iport that it provides. The peer model helps young adults connect with on a 5-point scale (strongly disagree their peer mentor on a more personal level. This level is a deep understand- – strongly agree). The RAS includes ing of what young adults are going through. Since I have already gone subscales3 measuring the domains of: through a similar situation, as a peer mentor I can show other young adults that mental illness does not have to control their lives. More importantly I • Personal confidence and hope show that an individual can recover from a mental illness and be a produc- (e.g., I am hopeful about my fu- tive part of society. The other helpful part is that, as a peer mentor, I have ture) had the chance to interact with these young adults in their community. This • Willingness to ask for help (e.g., I way the young adults have a chance to start their recovery within their com- know when to ask for help) munity and not outside of it. I believe this helps promote a higher chance of recovery and stability for them. Overall, I believe the peer model helps • Goal and success orientation (e.g., show young adults that recovery is possible; however, it takes time and a I believe that I can meet my current personal goals) helping hand. • Reliance on others (e.g., Even Being a peer mentor has benefited me in many ways. I feel the most impor- when I don’t care about myself, tant change I have seen in myself since starting this position is that I am other people do) more outgoing and open. Before starting this job, I was a shy and intro- • No domination by symptoms verted person. This job challenged me to be more extroverted. This change, (e.g., Coping with my mental ill- however, has not only been seen in my work as a peer mentor but also in ness is no longer the main focus of my school, personal, and family settings. This job has also challenged me to my life) travel out of my comfort zone. For example, some of our young adults do not know how to use public transportation. This job has challenged me to While the RAS is a helpful indi- learn different forms of public transportation and to not only use it but also cator of overall recovery, it still does to show and teach other young adults how to use it as well. Overall, this job not capture all the nuances that are has changed how I look at my own treatment going forward and how I can part of the mentoring relationship, so TRACS developed an additional benefit both myself and other young adults. short survey that is given at the end of mentoring to further evaluate impact. – Justin Drakos Survey questions are rated on a 7- TRACS Peer Mentor at South Shore Mental Health point scale from “got much worse” to “got much better,” and young adults are provided space to comment on • Increased comfort being around the impact and learn where there is each question. Questions on the sur- other people room for improvement. vey were developed based on feedback staff received about ways mentoring • Increased confidence in ability to To directly assess progress on was helping young adults that were form social relationships goals, TRACS monitors the goal review process described above. Table often not captured on a goal sheet. • Increased comfort opening up to 1 shows the percentage of goals by They include how mentoring influ- other people domain that were obtained over a enced participants’ comfort around • Used a planner effectively to man- nine-month period by eight young other people, levels of independence, age time and keep track of ap- adults who were involved in our peer sense of hope, and interest in achiev- pointments and schoolwork inde- mentoring program over a six-month ing goals. pendently period. Please note that some goals Evaluation using the RAS and are only worked on between the the internal survey is still in process, Program Evaluation three- and six-month reviews, while but preliminary data has been very others are worked on for the entire positive. An effort has been made to TRACS receives positive feedback six-month mentoring period. administer as few surveys and ask as from young adults, their family mem- To assess the more global impact few questions as possible to maintain bers and other members of their treat- that mentoring is having on a young the integrity of responses and not ment team about the impact of men- adult’s recovery, young adults are frustrate young adults who come for toring in their lives. Staff are also able now asked to fill out the Recovery services, not forms. Nonetheless, the to see the progress, but more attempts Assessment Scale (RAS) at the start feedback is extremely helpful and is have been made recently to quantify and end of mentoring.4 This scale, incorporated into ongoing quality im-

30 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

provement efforts. It is hoped that in- 4. Giffort, D., Schmook, A., Woody, program that explains the six stages corporating input from young adults C., Vollendorf, C., & Gervain, M. of change and teaches you how to free who participate in mentoring as well (1995). Construction of a scale to yourself from bad habits. New York: as input from the peer mentors will measure consumer recovery. Spring- W. Morrow. help TRACS maintain its integrity as field, IL: Illinois Office of Mental a young-adult-driven program with a Health. Author focus on what is truly most important 5. Prochaska, J. O., Norcross, J. to the individuals served. C., & DiClemente, C. C. (1994). Michelle Butman is Coordinator of TRACS at South Shore Mental Changing for good: The revolutionary Final Remarks Health.

Young adults challenged by mental health issues face an array of po- tentially overwhelming experiences. The Two-Way Benefit of Peer Mentoring By partnering with them to infuse a sense of hope, build resiliency and promote recovery, TRACS hopes have been diagnosed with bipolar, anxiety, and PTSD. I have been in to steer young adults away from po- I recovery from these mental health conditions for about four years. I at- tentially detrimental outcomes and tribute much of my recovery to being a young adult peer mentor since early onto the path of positive, purposeful 2006. I find this position to be very rewarding and empowering. It is great futures. The use of young adult peer to have a job that has meaning and allows me to help others using my past mentors facilitates this process by experience. I went through something that may have been negative but I ensuring that recovery is real, visible was able to get through it and come out a stronger person in the end. My ex- and tangible for young adults still in perience can help other young adults going through similar situations now the throes of illness. Peer mentors not who want support from people who have experienced it themselves. only provide a model of what is possible but also coach young adults on For most of my life I felt that I was unheard and had to struggle with my how to make that possibility a real- illnesses alone, making it much more difficult to recover. Since working ity. By supporting young adults in the with young adults through mentoring, I now see that many feel the same process of reaching even small goals, way that I did while going through this period in my life. I feel that because TRACS hopes to teach young adults I share similar experiences with my peers we are able to connect on a much skills that they will be able to use on deeper, more personal level than, say, a psychiatrist or therapist who has not an ongoing basis after mentoring is had the lived experience of a mental illness. over. As with any program, ongoing evaluation and improvement is cru- I remember feeling like people did not understand what I was going through. cial to ensure that the program is ac- I felt judged—people made assumptions about me because of what I was tually accomplishing what it intends. dealing with. The young adults that I have worked with tell me they feel As such, we look forward to continu- this way too and that they feel more comfortable talking to someone who is ous developments and improvements in the program. on the same level as them, rather than an adult who is much older because this can be intimidating. They know that when they go out with me one- References on-one that I am not judging them, trying to prescribe them medication, or evaluating their behavior. 1. Anthony, W., Cohen, M., Farkas, M. & Gagne, C. (2004). Psychiat- I have worked with a couple of young adults who, after a few weeks of ric Rehabilitation (2nd ed.). Boston, meeting with me, seem much happier than when we were first introduced. MA: Center for Psychiatric Reha- This position allows me to take young adults out into the community and bilitation. accomplish a set of goals that they created during the intake process. In some cases the young adults do not have someone they feel comfortable talk- 2. Clark, H. B. & Davis, M. (2000). ing to or they just do not get out much, but the mentoring program gets Transition to adulthood: A resource for them out and allows them to talk with someone around their age about assisting young people with emotional or behavioral difficulties. Baltimore: common experiences. Mentoring connects them with another young adult Paul H. Brookes Publishing Co. who is in recovery from a mental health condition and this is proof to them that recovery is possible. They have the opportunity to learn that they do 3. Corrigan, P. W., Salzer, M., not have to go through this alone and that they can be a stronger, happier Ralph, R.O., Sangster, Y. & Keck, person. L. (2004). Examining the factor structure of the Recovery Assess- – Liz Pepin ment Scale. Schizophrenia Bulletin, TRACS Peer Mentor at South Shore Mental Health 30, 1035-1041.

Regional Research Institute for Human Services, Portland State University. focal point 31 This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health Summer 2009, Vol. 23, No. 2

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Child Care and Employed Parents of Chil- Our most recent and popular issues: dren With Emotional or Behavioral Disor- (up to five copies are free upon request) ders. 2008. Journal of Emotional and Behavioral Disorders, 16, 78-89. ti Stigmazation . 2009, 23(1), Winter. Children’s stigmatization of childhood Caregiver—child: mutual depression and ADHD: Magnitude and de- influences on mental health. 2008, mographic variation in a national sample. 22(2), Summer. 2008. Journal of the American Academy of Child and WORKFORCE. 2008, 22(1), Winter. Adolescent Psychiatry, 47, 912-920. EFFECTIVE INTERVENTIONS FOR IMPLEMENTING AND SUSTAINING EVIDENCE- UNDERSERVED POPULATIONS. 2007, BASED PRACTICE IN SOCIAL WORK. 2007. Journal 21(2), Summer. of Social Work Education, 43, 361-375.

32 focal point Regional Research Institute for Human Services, Portland State University. This article and others can be found at www.rtc.pdx.edu. For reprints or permission to reproduce articles at no charge, please contact the publications coordinator at 503.725.4175; fax 503.725.4180 or email [email protected] FOCAL POiNT Research, Policy, and Practice in Children’s Mental Health