Using the crisis that brought them to hospital as a turning point
Supporting young people through our Hospital Youth Worker provision.
Your dedication and generosity has enabled our Hospital Youth Worker (HYW) Provision to support hundreds of Sussex young people. Thank you for allowing us to be there for young people when wellbeing bridges into crisis.
An independent evaluation of year two of the HYW provision based in the Children’s Emergency Department (CED) at the Alex, has now been published and we are delighted to share some of the highlights with you.
The evaluation was conducted by the National Children’s Bureau, who gathered information from 11 in depth interviews with programme staff, professionals and parents/ carers, four qualitative case studies based on young people’s experiences
of the HYW programme and data gathered from 87 survey responders from three stakeholder groups: 25 parents/carers, 40 RACH hospital staff and 22 referral partners.
Overall the evaluation report highlights how the provision has:
• improved the mental health and wellbeing of young people attending the hospital.
• improved health outcomes of young people by supporting them to engage with medical professionals.
• improved longer term life outcomes by plugging in young people to care and support programmes to meet their needs within the community.
Year two of our Hospital Youth Worker provision
The Youth Workers, employed by our delivery partner the Trust for Developing Communities (TDC), have met over 500 young people through the service over the last two years.
Capacity continues to be a huge challenge. To help, TDC have bought in Social work students from Brighton University to support the service, which has been key to increasing capacity.
The Youth Worker provision makes young people “more ready to engage with health care staff and ongoing services”.
Over year two, there have been two Youth Workers in place working Monday-Friday 12-6. They prefer to meet young people face to face, but where this isn’t possible young people are contacted by phone following their hospital visit.
The Youth Workers make a holistic assessment of a young person’s
needs, aiming to understand their situation and why they came into hospital. They offer support, tools and resources to help young people in the short term, helping to safeguard them from immediate harm and regulate their behaviour.
They build trust with young people, establishing a relationship and work with them to ‘co-author’ referrals or signposting into support that will meet their needs.
After initial contact, most young people receive one follow up contact. The HYW team have worked with some young people in the community to “plug them in” to other sources of support.
Year two in numbers
158
Young people supported by the HYW team
74%
Young people going on to engage with follow up support
186
Referrals made into the provision over year two
88%
Young people referred or signposted to other services or sources of support
The qualitative data gathered highlighted numerous examples of young people accessing support they wouldn’t have without the HYWs.
Many respondents to the survey felt that the HYWs helped to strengthen young people’s existing networks of support.
Reporting on outcomesimproving health and wellbeing
Most parent/carers taking part in the survey reported seeing improvements in their child’s mental health and wellbeing following contact with the HYWs, with young people being more optimistic about their future.
“As soon as the ball was rolling, we saw a lighter....almost like a relief. The fact that something was happening, and it was all driven and centered on her. It was like a weight was being lifted is the only way I can describe it.” Parent/carer.
Whilst HYWs were not able to provide long-term support for all young people, a key aspect of the role was to refer young people to new sources of support. This was recognised as a key factor for improvements in the mental health and wellbeing of young people.
A professional working with a young person who experienced anxiety, low mood, agoraphobia and suicidal
ideation, which contributed to pronounced isolation, disengagement from hobbies, friends and education, highlighted that after being referred to a mentoring programme by the HYWs, her mental health significantly improved.
“It felt like she was more stable, she had more self-worth. Her self-esteem improved; she started seeing friends.”
Some parent/carers reflected that, following a positive experience with HYWs, young people were more trusting of mental health professionals and willing to engage with support, leading to improvements in their mental health and wellbeing over the longer term.
“Subsequent support has helped her mental health and anxieties and willingness to seek and accept support where necessary.”
Reporting on outcomesshort term outcomes
• Parents reported that ‘in hospital’ support improved their child’s wellbeing and engagement with medical treatment. Qualitative stories highlighted how the HYWs were able to keep young people’s behaviour regulated by being a source of reassurance in a difficult environment.
• Respondents to the survey highlighted how HYWs were able to spend time with young people in hospital, building a trusted relationship. They were able to take a more holistic social and emotional approach than clinicians, enabling young people to feel listened to, relieving their concerns and anxieties.
• The survey also highlighted how the HYWs improved the hospital staff’s understanding of young people’s needs, for example, by sharing urgent safeguarding information.
• It was consistently reported that the holistic approach provided through HYWs relieved anxieties. The positive relationship with and trust built by the Youth Workers made a big difference to how young people engaged with their medical treatments. For some young people, HYWs were able to keep young people in the hospital for treatment, when they would have otherwise left.
• Being caught and signposted on while in hospital made a big difference to what happened next for many young people.
Reporting on outcomeslong term outcomes
• According to the survey data, around three-quarters of parent/ carers agreed that the HYW programme had a positive longterm impact on their child’s mental health and wellbeing and feelings of safety.
• 80% of parent/carers agreed it had improved their child’s engagement with mental health support.
• Around two thirds of parent/carers agreed that engagement with the HYWs had a long-term impact on reduced exposure to/ involvement in violence, victimhood and exploitation.
• 64% of parents and 100% of referral partners agreed that the Hospital Youth Workers reduced the immediate risk of their child reattending.
• There were also positive perceived changes to young people’s longterm engagement with care and support, support networks and managing their physical health.
• There have been many examples of disclosures of information from young people about their situation that would not have happened if the Youth Workers were not in place at the Hospital (examples of abuse disclosures and disclosures of suicidal ideation).
Demographics of people supported through the provision
For those where primary referral reason is known*
Dysregulation
Mental health
Suicide ideation
*The remaining 29% had no clear referral route.
Primary reason for referral
Self-harm, injury, overdose concerns
Victim of peer to peer incident
Substance misuse
Other support services involved
No additional services
Police, youth justice and youth work
11%
33% 20%
Other services involved
36%
Social services/ social work
Mental health and wellbeing services
Additional demographics
The average age of young people accessing the service was 14.8yrs.
A majority of 60% identified as male, 38% as female and 2% as transgender.
Their ethnicity was 78% white, 8% mixed/ multiple ethnic groups and 5% from black backgrounds.
Ninety-six people were from the Brighton area. The remaining 62 were from Lewes, Adur, Hastings,
Eastbourne, Horsham, Rother and Wealden.
The majority of the young people had Autism, a mental health condition or a specific learning disability.
Twenty-four of the young people supported had one or more disabilities. The majority of these 24 had either Autism, a mental health condition or a specific learning disability.
Case study 1
Background: YP2, 16, was struggling with mental health and had been out of education for two years following an incident of assault.
YP2 was first referred into the HYW Programme by safeguarding nurses following an incident of self-harm.
Six months later, she was re-referred for substance misuse identified while attending for a separate health issue.
Engagement: The HYW worked with YP2 over the phone. YP2 disclosed she was struggling with isolation and mental wellbeing.
This lead to the HYW making a referral into a local Health and Wellbeing Youth Worker Programme.
She was also signposted to a local women’s group and family mediation. service, referred to young carers and provided with resources around drug harm reduction. After two of these referral partners not getting in touch, the HYW was able to chase, and they were actioned soon after.
Impact: Contact with the HYW team meant YP2 felt in control of her future. The referral partner explained to her school why she was unable to attend, stopping fines for nonattendance and arranging remote schooling.
This led to improved mental health. Her dad explained that it felt like “she had more motivation, self-belief and optimism for life,” as well as her sense of safety in the community.
Case study 2
Background: YP4, aged 16, was living with carers at the time of her referrals into the programme.
She had a history of familial abuses, substance misuse, and has previously attempted suicide. At the time of her first referral, her existing support, included a social worker and contact with CAMHS.
After an initial referral in Summer 2023 following an overdose, YP4 was admitted to the RACH ED in Autumn 2023, when she recontacted the HYW team herself to ask for support.
Engagement: After her first referral into the programme, YP4 was admitted to a long-stay ward to recover from an overdose.
She met with the HYWs repeatedly during this period, with the HYWs working to understand the reason for her overdose and “what she would like to do about it”.
They set her homework tasks to help alleviate boredom, referred her to a local substance misuse service, a youth project and a victim support service, and shared information about her history of substance misuse with existing support.
When she got in contact with the HYWs following an admission to the ED, YP4 disclosed that she was planning a suicide attempt (this was not known to other sources of support), and her carers informed the HYW that she had ordered a large quantity of drugs to their home.
The HYW team immediately passed this to the RACH safeguarding lead, nurses and YP4s social worker, who arranged immediate support. In the longer term, the HYW team attended joint strategy calls with various sources of support.
Impact: YP4’s carer described how the HYW referrals made YP4 feel that someone was looking out for her. Information shared by HYW’s was also crucial to other agencies having ‘clear information about what they’re working with’.
The HYW team supported the family to understand what was happening with YP4’s treatment, and played a crucial role in discovering and communicating that YP4 was considering suicide. HYW were seen as an ongoing advocate for YP4.
