Supporting young people to stay healthy and well: Nola

An interview with Nola Smith, NEET* Re-engagement Manager, Student Services and Safeguarding Team

 *(Not in Education, Employment or Training)

In November 2023, we spoke to Nola about her work helping vulnerable young people to re-engage with education. She explained that alongside their college work, they need support with a range of serious mental health issues including crippling anxiety, Tourette’s Syndrome and eating disorders, but it can be difficult to access the wider services and support they need.

What does your working role at Weymouth College involve?

My main role is working with some really vulnerable young people who have struggled in education and may well have been out of education for a number of years. They may find the classroom too overwhelming and really struggle with their mental health, so they tend to come with me for a year as part of a Re-engagement Programme to develop their soft skills, work on their confidence and reduce their anxiety. We also do some progression work with a qualification to hopefully prepare them to integrate into mainstream education next year.

What type of support do you provide to the students?

We offer one-to-one mentoring support for all of our NEET students, and we have a cohort of 25 this year. Our main group start college after half term. They attend college on a Monday, Tuesday, Wednesday afternoon and Thursday morning, so it’s a much more reduced timetable to the ordinary mainstream timetable.

We work around the resilience framework, which forms the core of my project, and we do things like social action projects, national campaigns and international campaigns. We try to educate our young people on what’s going on in the world and what some of the issues are in the world.

We actually start with the ‘World Toilet Day’ as it makes them laugh, but also because a third of our world still does not have access to clean, sanitised functioning toilets, so we do a little bit of campaign awareness raising and then try to create posters or something to highlight these issues.

We then focus on campaigns around mental health issues and things locally that have become an issue. We also run an arts and crafts programme; it includes art therapy which enables them to explore their emotions and how they can communicate using words.

On Wednesdays we do social action projects, as we like to give back to the community. Each half term we choose an area of the community to help. We’re hoping to help the Street Pastors and Dorset Youth Association. In the past we have done work with the Horse Course and Bus Shelter. Last year we made 30 Christmas gift bags to give to young people in supported living. So, by doing this we are giving the students a sense of belonging and we are giving them coping strategies, peer support and a shared journey.

It’s quite an intimate little programme, which is very nurtured and helps me to get to know the students and identify where their battles are.

What are the key issues that students raise concerns about?

Mental health is the consistent issue, and all of the young people I work with have anxiety to a level that’s crippling. This isn’t your usual level of anxiety; this is a level that actually debilitates them.

In the last year though, the issues that have been highlighted the most are eating disorders and Tourette’s Syndrome. Both of these issues are relatively new to me and I’ve seen an increase within the last year.

What are the biggest barriers that inhibit your support to the students?

I know Tourette’s Syndrome has been around for a long time, but I’ve not worked or had much experience supporting young people with Tourette’s. A friend of mine, who is also a colleague at the college, has been diagnosed with Tourette’s and she has helped to educate me quite a lot. I now run a summer programme to help bridge that gap between young people finishing school and starting college and this year, out of 61 young people that engaged in the programme, we had eight that had a diagnosis of Tourette’s. This is something that I’ve not known to be so prominent and prevalent until this year.

I think certainly in education and probably in the college, there’s ignorance around Tourette’s and how it presents, how you support people with the condition, and what support is being provided locally – I don’t really know that there is a lot of support available locally. To get a referral to a neuropsychologist and to get a diagnosis is really hard, when actually it seems quite evident if you’ve got really severe ticks and you’re spewing verbal profanities! So that’s definitely been an issue for me.

The process of young people with Tourette’s getting support I find quite frustrating, and I don’t really know where to access help. I feel that locally one of the barriers is that we need to educate ourselves more and staff working in education need to understand better ways to manage that. You can’t just kick someone out of the classroom if they’ve sworn and they’ve got Tourette’s, but then if they haven’t got Tourette’s and they swear then you need to manage that and be seen to be treating people fairly.

I also have barriers around how best to support young people with Tourette’s because some of them find having the condition embarrassing, depending on what ticks they present; it has to be handled very sensitively.

There are also issues around eating disorders. I’ve worked with young people for 20 plus years, so eating disorders aren’t new to the world of vulnerable people that I work with, but it is becoming increasingly frustrating for me. My automatic response has been to refer to CAMHS, but I’ve had CAMHS workers tell me that I’m being dramatic, and they’ve actually told the young person that they don’t have an eating disorder, despite the fact they don’t eat more than 200 calories a day and they weigh 34 kg. They won’t let themselves go to 35kg, so to me, if they’re controlling food that much, that’s an eating disorder, but they’re still not getting help!

I had a young person in this last year that I fought and fought and fought for and the door was shut at every opportunity. CAMHS shut the door, CAMHS Gateway shut the door, CMHT shut the door. Even at the eating disorder clinic, they didn’t expedite any referral until I said to them, I think this young person is going to die. In the end they were rushed to hospital and they’re still in hospital now, nine months later. The eating disorder clinic did say had it been a week later, it would have been a different story.

I get that every service is stretched but I feel as a college and, in our team, we’ve got a high level of expertise. We’re not mental health specialists, in terms of qualifications, but we work with young people that are really vulnerable. We’ve got a wealth of knowledge between us, and I feel when we are raising concerns, they need to be considered. I think that’s my biggest barrier.

What changes would make a big difference to your role and the support you would like to provide?

I would really like a clearer pathway for someone with Tourette’s who is struggling. I can support them with the college, but who else can support them?! Externally, what agencies and support services can we refer to and? It’s the same with eating disorders. We need a defined pathway of support and some assurance of knowing that you are going to get that support.

Response is really important for the young people, more so than for me. I can say to them that I’m going to keep fighting their battle, but I have to keep going back every time, so I can’t. I’m not getting anywhere, and I think having a clear direction within those areas would be really helpful.

Although we have a good working relationship with the Mental Health Schools Team, we don’t work directly with them which is frustrating; we would like to have a professional relationship with them. The young people could really benefit from that earlier intervention and lower-level mental health support before it escalates to the point of crisis. I think as a college, there’s a real gap for our 16 to 18 year olds that they don’t meet any criteria.

Are there any services that you are currently working with that assist you well in your role?

Although I’ve said that CAMHS haven’t particularly helped me, I know individuals who work with CAMHS that I have a really good working relationship with, so I can contact friends within CAMHS. CAMHS have also been present at a lot of the events that we run. They’re a good service and there are individuals in that service who are amazing, but I think on the whole something needs to change.

We don’t work directly with the Mental Health Schools’ Team, but my best friend has just qualified as a Mental Health School Team Practitioner, so I take a lot of their resources as they are willing to share it.

Sadly, because of suicides that we’ve had locally, over the past year I’ve built positive working relationships with the educational psychologists, with Mosaic and with Open Door, so I feel like there’s really positive links there with the college. The mental health event that I ran last January, called the ‘January Blues’ event, raised awareness of men’s mental health, and it really brought together a community of support services.

We have also got a really good relationship with REACH, so we can refer any of our young people who struggle with drug and alcohol addiction.

With all services, it’s about who you find. There’s always someone that’s really, really good and if you can get that person, then you’ll get the result that you need. However, if you’re having to go generically through the referral process and you don’t know who you’re going to end up with, then it’s like flipping a coin!

We work with so many different agencies. We’ve worked with Healthwatch Dorset for years and I think Healthwatch Dorset has always represented the voice of young people, so it’s great to have this opportunity to share our views and experience.

Student, aged 17:

“Waiting lists for all mental health services are ridiculous; it seems like I can’t be ill enough to get support or I’m too ill to be helped. I sometimes feel like a number to them. There’s not enough help to go around for everyone unfortunately.

“CAMHS is just too understaffed and it means many people like me cannot be facilitated with the right support at the right time. Luckily, for CAMHS I have a good case coordinator and I had an emergency referral, meaning I didn’t have to wait two years like everyone else. But for the eating disorder service, for example, by the time I got an assessment after a year they wouldn’t take me on and I was left with nothing because things were a lot different than to when I got referred. Kooth is a really good service to use but things like Shout and Connections are too automated and don’t help me at all.”