Understanding and addressing the challenges of outcome measurement associated with differences in culture
As part of our commitment to Closing the Gap, the Anna Freud Centre’s strategy to close the gaps in mental health support for children and young people in the UK, we are forming a group of lead professionals and practitioners to work with us to explore the challenges of using common outcome measures with children and young people from diverse backgrounds and cultures. It is our aim that the group design and produce useful guidance for all staff who use mental health questionnaires as part of their support for CYP’s mental health and wellbeing.
This piece of work is focused on differences in culture and ethnicity, and how lead professionals and practitioners might consider these differences when choosing, introducing and using measures.
Our proposed plan for the working group involves 3 steps:
1. Highlight the issues
From conversations we have already been involved in, we are aware of various barriers and issues that different groups of children and young people experience in engaging with outcome measurement. While some of these are specific to particular contexts, there are also a lot of common or overlapping issues such as: different meanings and concepts relating to mental health; distrust about the motive for asking for the information, or how the information might be used; accessibility of the language generally. There are also some issues associated with the outcome measures themselves (how they were developed, in what contexts/ with whom) and how they are used in different settings.
2. Produce guidance on how it can be done better
Share experiences of practitioners and young people, together with relevant research literature to produce guidance that summarises common issues, that identifies good practice, including measure and context-specific practice, and that promotes good ways of using measures in all cultural contexts.
3. Promote other tools and resources that support better practice
To bring attention to already available resources, tools, guidance and learning that mental health professionals in all areas and contexts can access in order to enhance practice and improve impact.
This work reflects the CORC’s goal to address challenges to meaningful outcome measurement:
‘A key area for our own research has been whether the measurement tools that we use adequately reflect the diversity of lived experience in relation to mental health and wellbeing, and how we can develop tools and research that better reflect individual and cultural diversity, prioritising what is important to young people. ‘
It will also build upon previously published papers that draw out different experiences of support based on ethnicity. These include this free paper exploring the circumstances around case closure which found that compared to White British young people, Black or Black British young people, mixed-race young people, and those from ‘other White’ backgrounds were more likely to have case closure due to non-mutual agreement than case closure due to mutual agreement. Another recent study using CORC data found that Black children and young people, and those who did not provide information about their ethnicity, were more likely to attend services for a single session only (full paper). Our 2015 paper described data showing that, similar to adults, children from black and minority ethnic backgrounds may be more likely to access CAMHS through compulsory than voluntary care pathways.
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Lee Atkins, Regional Officer