Increasing engagement with young people's services in Essex through co-produced social media content

The Emotional Wellbeing and Mental Health Service (EWMHS) covers Southend, Essex and Thurrock and is open to young people up to the age of 18 (or up to 25 for those with special educational needs). The service provides advice and support to children, young people and families who are in need of support with their emotional wellbeing or mental health difficulties.

Any child or young person experiencing mental health difficulties, as well as any parent, guardian or professional, can access the service for help and guidance.

Situation

It has been established that social and psychological barriers negatively impact young people’s access to the team’s service. This acknowledgment stems from feedback from service-user groups around the impression of its service pre-engagement.

Participation groups often reported negative feedback regarding initial impressions of its service pre-referral, in part resulting from a lack of effective communication.

Despite the existence of useful information on its website, this platform does not sit in line with the favoured tool for content consumption by young people - social media.

The service also struggled with young person engagement in participation groups, which is a key resource in directing service improvements.

There is a need to improve ‘preparation for treatment’ for young people on waiting lists, as well as decrease the stigma surrounding Children and Young People Mental Health Services (CYPMHS) treatment.

Aspiration

This project demonstrates an opportunity to provide quick, universal access to information about a service, as well as access to reliable NHS psycho-education material.

The service wanted to use ‘expertise by experience’ of existing service users to facilitate peer-to-peer information sharing and ensure any content produced was relevant to young people.

Finally, they wanted a safe and secure platform for the sharing of mixed content developed through collaboration between clinicians and young people, as well as sharing of clinically supported resources.

Solution and impact

Through collaboration with young people, Instagram was selected as the digital platform for content-sharing to enable the service to reach as broad an audience of young people as possible.

A dedicated Instagram account has been set up by Essex EMWHS: ‘ewmhs_nhs’. It is described as an NHS service supporting children and young people's mental health and wellbeing in Essex with further information that the account is staffed Mon to Fri, 9 to 5 and is for information sharing only. The account also links to the EMWHS website (linktr.ee/ewmhs_nhs) as well as other relevant sources of information.

Preparing for treatment

The views of existing service users were gathered to shape content, including posts around preparing for a first appointment, realistic testimonials of young people’s journey through its service, and summaries of different types of therapeutic practice. They also supported the sharing of NHS-approved and Organisation for the Review of Care and Health Apps (ORCHA)-supported products.

Accessibility

EWMHS has provided universal access to its platform, which includes psycho-educational materials, resources of the week (such as WYSA, Kooth and Togetherall), out of hours and crisis information, and campaigns to increase young person engagement. A promotional campaign is planned through secondary schools, GPs and local authorities. Links are provided to the website, which contains clinical and referral information (EWMHS has a self-referral policy), as well as links to appropriate external platforms for further information.

Instagram was also selected as participation groups revealed an issue with ‘storage’ of apps on many young people’s phones, meaning they would prefer to access any content on an app they already have downloaded.

Stigma

Content was generated in collaboration with young people to provide positive examples of mental health care within the service.

Furthermore, using Instagram as a platform to share content enables young people to not need a ‘mental health app’ visible on their mobile phone or internet search history, allowing them to feel more confident in maintaining privacy.

Participation

Content for the Instagram account is generated from young people’s service user groups - for example, young people asking for more information on the difference between different therapies and wanting to distinguish between different key mental health presentations.

The service recognises the importance of participation in communicating effectively with young people, and so has funded both ‘participation worker’ and ‘digital participation worker’ positions to help grow this area. A new ‘participation strategy’ is currently being developed, which aims to expand participation and increase the impact it has on service developments. As participation is integral to the content produced for Instagram, this strategy will also help inform and improve the content generated.

Functionality

Instagram is a social media platform which enables sharing of information in a creative and engaging way. It is easily accessible and usable and was highlighted by young people as the most suitable platform for content sharing and engagement.

Capabilities

• Offers a platform to share a variety of information that can be easily accessed by large numbers of young people
• Offers a familiar user experience which helps support engagement
• Cannot offer treatment

Scope

The EWMHS Instagram account is aimed at supporting young people on waiting lists, in treatment, or indeed those who have not yet made contact with the service but may be in need of support. It is not restricted in its area of use, but is targeted for use at home rather than within a clinical setting.

Key learning points

Collaboration

Make sure content is generated from young people, while also ensuring any content of a clinical nature has oversight from clinicians. This process is necessary to ensure neither young people nor clinicians are alienated from the content that is produced.

Effective collaboration is required to help social media posts stay up to date with key mental health issues affecting young people while also maintaining clinical accuracy and reflecting current safeguarding procedures.

Consistency

Ensure a selection of content is generated before a promotional campaign. Producing regular content without gaps of time between posts is important for building a following of regular users. A conscious decision was made to post every day, enabling followers to develop confidence in the consistency of content delivery.

Reach

Develop a clear promotional campaign focusing on increasing ‘following’ by young people. This is key, as the effectiveness/wider impact of your content is limited by the number of people it reaches.

The promotional campaigns have focused on 3 key areas so far:

• young people already in the service - the team developed posters to be put up in all hubs, and delivered a presentation about the Instagram to all managers and clinical leads of the hubs in their service. This information was then disseminated to clinical staff of each team to ensure confidence with sharing the Instagram to young people under their caseload
• young people contacting the Single Point of Access Team (SPA) - the team made contact with the SPA manager and agreed, when age appropriate, all young people will be signposted to Instagram as a resource for emergency contact numbers as well as additional information
• young people in schools - the team made contact with the pastoral leads of several schools to ask for advice on the best channels to share their Instagram in this environment. From these conversations, the team attended a Behavioural Attendance Partnership meeting to introduce their account to schools and produced a poster to be sent to schools, with plans to create an ‘advert’ moving forward. The poster was shared to schools, along with a short presentation introducing Instagram, through their Special Educational Needs and Difficulties (SEND) team

Governance

Develop a clear governance process and standard operating procedure (SOP), taking into account key issues such as direct messaging and comments.

The project team developed their SOP for the Instagram project and made a decision to not allow comments on their posts initially. As the account is only managed Mon to Fri, 9 to 5, the team would not have had the capacity to review any harmful comments that were posted outside of these hours. In addition, a decision was made to post emergency contact numbers, including the out of hours number, every Friday, to ensure young people have easy access to support outside of normal working hours. Furthermore, a digital governance group made up of key service leads has been established to meet quarterly to review key digital projects. The Instagram account has been included as a recurring item on the agenda so that the team can review and discuss ideas around how to continue to improve its content and reach.

Key figures/quotes

“Thank you so much for sharing my photos, it’s made me feel very proud and definitely made my day.”
Young person talking in reference to a winter blues campaign launched through Instagram

“The reason I think it is good is because we are taking easily accessible self-help tools and resources to a platform that so many young people are already using. Having the information in this format in a place that is familiar to young people might make it easier for them to either help themselves or take a step to ask a service for help.”
Erin Raine, participation worker

“This Instagram account is not only informative and educational, but it helps break down the stigma of talking about mental health. It helps the service feel more accessible, and less scary, and normalises conversations about wellbeing.”
Eloise Wright, digital participation worker

Find out more

Account name - 'ewmhs_nhs'

https://www.instagram.com/ewmhs_nhs/

Key contact

Chris Scalzo, UKCP registered child psychotherapist, Emotional Well-being and Mental Health Service, North East London NHS Foundation Trust

chris.scalzo@nelft.nhs.uk

Lucien Withers, digital participation worker, Emotional Well-being and Mental Health Service, North East London NHS Foundation Trust

lucien.withers@nelft.nhs.uk