Youth Support in the Emergency Department: A hospital intervention to reduce youth violence

Yaél Ilan-Clarke, Jeffrey De Marco, Amanda Bunn & Professor Antonia Bifulco

Re-Imagining Youth Justice: Howard League

2nd April, 2014

Centre for Abuse and Trauma StudiesApplied research in the digital age

Oasis Youth Support

@ Guys & St Thomas’ Hospital

Session Plan

• The OYS intervention • Evaluation methods• Findings

• Evidence for change: Quant• Qual findings: Trust and support

• Summing up

Slide 2

Why the Emergency Department (ED?)

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The intervention Oasis Youth Support (OYS) service

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The Evaluation - Mixed methods:

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Young people – Questionnaires:

Questionnaires: Strengths and Difficulties Questionnaire (SDQ)

(Goodman, 1997) – Psychopathology, Emotional, conduct, hyperactivity, peer, and prosocial

ASSETT Self-Report – ‘What Do You Think’▫Family and where you live▫School/college/work▫Lifestyle and area▫Substance use▫Health▫Thinking and behaviour▫What you think about your injury and how it affects you (Adapted

from original WDYT!)

Exit survey – satisfaction with the serviceSlide 6

Service-access and referral (20 March 2014)

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Evaluation Results:Characteristics of 103 YP in service

• Gender: – 79% Male, 21% Female

• Age: – Mean = 14.8 (Boys), 14.2

(Girls)

– Range: 11-18• Ethnicity:

– 39% Black/Ethnic minority

• Family:– 41% Live with Single

Parents/ 2% Care

Slide 8

Nature of violence (n=101)

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FINDINGS: ASSETT WDYT1) Change in lifestyle risk (n=31)

P<.001 P<.01 P<.002

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SDQ symptoms questionnairei) Change in disorder levels (n=31)

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P<.001

P<.003

Change in SDQ disorder*: Baseline to follow up

* Case or Borderline case level

Exit Surveyi) Perceived benefits (n=51)

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Perceived best aspects of OYS:-Support-Mentoring-Activities-Friendship

Summary of quantitative findings

• A significant change in YP seen at follow up, particularly in:– Family relationships– Thinking and behaviour / Conduct disorder

• The intervention was endorsed by young people, who reported that the best thing was the 1-2-1 relationship with mentor

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Qualitative findings 1) YPs views of the service and youth workers

• YP appreciated the positive relationships and felt these to be a vehicle for change

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‘After I finished working with T it seemed pretty much the same, but then you know when occasions came up when I had to pick if to go into a fight or not, T’s interviews and chats would pop up so it did change my attitude to these things...’ (A25)

‘After I finished working with T it seemed pretty much the same, but then you know when occasions came up when I had to pick if to go into a fight or not, T’s interviews and chats would pop up so it did change my attitude to these things...’ (A25)

Qualitative findings 2) Imagining a better future

The discussions YP had with the YWs provided them with an avenue to explore more positive futures that they hadn’t previously considered.

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‘...it doesn’t only help you with frustration and anger wise, it helps you to learn about how hard it is to work in the outside life and how important it is to do college or school work…[its] not only helping YP sort their life out, [its] helping them understand where they could be in the future and what they have planned, instead of getting involved with all the violent gangs, they can come out of that and do something positive’.

‘...it doesn’t only help you with frustration and anger wise, it helps you to learn about how hard it is to work in the outside life and how important it is to do college or school work…[its] not only helping YP sort their life out, [its] helping them understand where they could be in the future and what they have planned, instead of getting involved with all the violent gangs, they can come out of that and do something positive’.

Limitations

Evaluation Intervention

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Clinical and Social implications

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Click to edit Master title style

Yael Ilan-ClarkeCentre for Abuse and Trauma studies (CATS)Middlesex Universityy.ilan-clarke@mdx.ac.uk0208 4116606

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THANK YOU.