“Opening Up”: How is Positive Change Made Possible for Gang-Involved Adolescents In Contact with a Mental Health Charity?

This research sought to explore if, and how, being involved with a mental health charity project is helpful to gang-associated young people. There are problematic gaps in access to adolescent mental health services in the UK, and the evidence base that supports them, particularly for young people labelled ‘hard to reach’. In addition, engaging adolescents is acknowledged as challenging for mental health professionals, and drop-out rates are high. Furthermore, recommended interventions do not address poverty and social disadvantage, the most salient risk factors for both adolescent mental health problems and for offending, and a blight on the lived experience of the most marginalised and vulnerable young people in UK society. Taking a critical realist stance, the current research aims to address these problems by using the qualitative methodology of grounded theory to develop a model of the positive change occurring at an innovative mental health project working with gang-involved young people. The project has developed an integrated approach that draws on different therapeutic orientations, particularly community psychology, mentalisation and attachment theory. Six young people and six professionals working at the project were interviewed. A grounded theory analysis, comprising the core category of “Opening Up” was constructed from the researcher’s understanding of participants’ accounts. Positive change was conceptualised as an opening up of: future possibilities; contexts for action and interaction; access to material and social resources and opportunities; the self in relationship; and ideas about the self and others. Central to the findings was the use of trust as a resource for change, and a service structure enabling professionals and young people to take “the time that it takes” to establish a therapeutic relationship facilitating positive change. In keeping with the community psychology influences at the project, a Youth Research Consultant advised throughout the research. Limitations of the findings and their implications for future research and practice at the individual, service and commissioning levels are considered.