SERVICES

Service Mapping

The diagram below maps services that are explicitly focused on the Early Action System Change priorities. It plots them against whether they are provided by the voluntary sector or public sector, and whether they adopt a prevention approach, or treatment. 

A SYSTEM THAT DOESN’T KNOW ITSELF, CANNOT CHANGE ITSELF.

SYSTEM THINKING

Why do we need a different way of thinking to address complex social problems?

Linear thinking only tell part of the story (‘X leads to Y’).

To truly understand how systems operate, and to help us identify opportunities to address complex social problems, we need to think through the interconnected systems and feedback mechanisms or ‘loops’ that exist around the problem.

Think differently. Think systems.

 
 

Applying Systems Thinking

Method 1. Insight workshops with managers, commissioners and practitioners across Renfrewshire.

Method 2. Rapid review of existing data evidence on drivers contributing to priority outcomes to sense check and enhance workshop participants drivers and loops.

75+ hypothesised causes and consequences of poor emotional wellbeing

45+ hypothesised causes and consequences of coercive control

A briefing report mapping the relationships between these causes and consequences will be made available once finalised.

Complex social problems, need multiple intervention points.

EXPENDITURE

Financial Mapping

In the context of significant financial cuts coupled with rising levels of need, there have been calls for public services to prioritise spend on prevention and early intervention.* 

We undertook a financial mapping to understand expenditure within children’s services in Renfrewshire. 

The fund map report can be accessed here. 

* Christie Commission on the future delivery of public services (2011).

The most reliable indicator of system reform is change in the flow of public money

Source: Twenty-One Lessons and Five Investment Opportunities (2015) Dartington.

 

EVIDENCE

Selected Evidence Map Insights

ANXIETY AND DEPRESSION 

  • Research shows that self-stigma is a significant factor in preventing help-seeking. Barriers include individuals lacking the knowledge about the drivers of mental wellbeing; lack knowledge about available services; believe they should cope alone or; are not hopeful treatment will have an impact.

  • Self-critical perfectionism and socially prescribed unrealistic expectations are likely contributors of anxiety and depression, particularly amongst adolescent girls.

  • Accessibility of specialist mental health services remains a significant challenge. While individual attitudes toward mental health and help-seeking can be a barrier, those trying to navigate the system are dissatisfied with the process, even when national targets are met. There is a perception amongst some service users that you need to be extremely unwell to be seen, and a feeling among GPs that they have nowhere to refer patients to beyond CAMHS. Audits suggest CAMHS is being overburdened, highlighting a need to consider and revise the nature of support before young people reach crisis point.

  • School-based programmes have been evaluated most favourably, but implementation is key, particularly around delivering a whole-school approach. Best evidence suggests that programmes should extend beyond the classroom. This aligns with calls from young people for more mental health practitioners in school, and feedback from GPs who suggest school settings are better suited to referring children because they have more knowledge. Recent independent, and UK evaluations of programme also highlight the need to investigate ‘common element’ type approaches, which point to effective kernels of practice to improve emotional health.

COERCIVE CONTROL 

  • Research into violence, coercion and abuse suggests that violence is experienced from a young age and is perpetrated in equal rates by boys and girls, though there is evidence that boys use more severe forms of violence. 

  • Differences between genders emerge in responses to violence, with girls more likely to be emotionally affected by violence, and more likely to report it to authority figures. 

  • Research also shows that incidents of violence start as early as at 12 years old and that early victims are more likely to be repeatedly victimised. 

  • On an individual-level, there is an association with belief in strict gender norms and violence however, it is unclear that interventions targeting attitudes – particularly those aimed at young children – have a long-term effect, let alone will impact on behaviour.

  • Most young people report abuse or violence in relationships to peers. Boys to men (2014) research project revealed that almost half (45%) of those who had been in a relationship reported being victimised, 25% being perpetrators, with a large overlap (92%). 

  • Interventions to combat abusive behaviour need a two-pronged approach  with projects teaching how to identify abuse, promoting bystander intervention and teaching around healthy relationships being kept separate from those exploring and engaging critically with stereotypical attitudes gender roles.

  • Research suggests that there is a strong co-incidence of perpetration and victimisation, and that those victimised at a young age correlated with victimisation at a later stage. This suggests that interventions should take into account effective approaches for those who may both experience, as well as perpetrate violence (i.e. girls who perpetrate violence – such as those using violence in self-defence - are less likely to seek help for victimisation).