Mental health treatment gets street smart
Charlie Alcock, psychologist and charity founder, says gangs should not be dismantled but adapted to do social good
guardian.co.uk, Tuesday 10 April 2012 14.30 BST
Gradually the peer group begins to do something more pro-social, collectively, says Charlie Alcock. Photograph: Martin Argles for the Guardian
Four years ago, Charlie Alcock was spat on, ignored, had pebbles thrown at her and was suspected of being an undercover police officer by the north London gang she was trying to strike up a conversation with by hanging around their fish and chip shop of choice.
The incongruity of a privately educated, academically high-achieving, white woman raised in rural Gloucestershire appearing from nowhere and saying she wanted their help was clearly not lost on the group of two dozen or so urban young men, who had struggled to stay in school and spent most of their days smoking cannabis and getting into trouble. It took six months before one member of the group even asked her, "in a not very polite way", what she was doing there.
Alcock, an NHS psychologist who wanted to start up a social enterprise tackling the causes of youth crime, gave him the short version: that although there were services aimed at his group, they weren't working. "And I think you know what works," she told him.
Over the next few months, the teenager became a go-between, conveying ideas between Alcock and his peers about what sort of a project they wanted to set up, eventually settling on music.
The music group was the genesis of Mac-UK, the charity Alcock subsequently founded in 2008 in collaboration with the young peopleinvolved in gangs. It was a way to engage with them and build relationships in order to start working with them on mental health issues.
Alcock wanted to find new ways to address the link between mental health and youth offending. "The group that was of great interest to me was young offenders, and the fact that one in three young people who offend have an unmet mental health need at the time of offence," she says.
Treatment or, as Alcock terms it, "street therapy" needed to be administered wherever young people would feel comfortable – whether in fish and chip shops or on park benches. It is a long haul. Alcock admits that "even now there are young people we've known for three years and they are only just beginning to work with us".
The Mac-UK programme works intensively for as long as two years with about 30 young "severely deprived" people aged between 16 and 25, often homeless. All have refused traditional offers of help. Street therapy is central to the project, with young people self-referring and deciding when, where and for how long they would like to meet.
Her insight into how she might better reach young offenders came while working on an "alternative to incarceration" project in New York during her clinical training. There, one young man told her that as a result of talking to psychologists like her, his cousin had been killed for "snitching".
"Until you can find a way to work with us that's safe, you might as well go home because you're actually putting us at more risk than if you weren't here," she recalls him saying.
For people on the margins of society there's a distrust of public services – either because of a bad experience with the authorities or from fear of imprisonment, says Alcock. The only way to reach them was to become part of the furniture of their lives.
Alcock views gangs as enterprises whose goals needs fixing rather than as ventures that need to be disbanded. Gangs might be criminal in outlook but, she argues, they can be transformed into community organisations, responding to people's needs.
"It's about what the group does. So the whole idea of Mac is that gradually the peer group begins to do something more pro-social, collectively. Rather than dealing drugs, carrying weapons, they're setting up a music project or whatever it might be," she says. The young people use their DJ skills to run the music sessions themselves, employed by Mac-UK.
From dealing with troubled teenagers Alcock can see that on the street there is an explosive mix of heavy skunk [cannabis] use, frightening levels of domestic violence growing up and clinical depression. Some youngsters speak of hearing voices, others admit self-harm.
"This group have often grown up with lack of adult role models, found school particularly challenging, and you mix some of those risk factors with environments of real threat – which is what gangs create, and you add skunk as self-treatment, then it's no wonder that a lot of these young people do have issues with mental health," she explains.
To engage such disaffected and chaotic young people, the 16-strong Mac-UK team, which includes psychologists, youth workers and volunteers, seeks to win their trust by taking part in whatever group activity is taking place. "So [if] there's a gym group, we have mental health workers on the treadmill – going quite slow," says Alcock.
Once a bond has been established, Mac-UK sessions with trained staff can occur anywhere. These "might take place on buses, benches, stairwells. We might go with a young person to court – waiting for four hours to be seen by the judge is an amazing opportunity to do work," she says. "The young people definitely trust me now [and] others in the team," she adds.
As well as providing mental health support to those who need it and improving their access to mainstream services, Mac-UK aims to reduce re-offending and get the young people into employment, education or training. Three-quarters of the first cohort moved into training, education or employment – albeit temporarily for some. Three of the young men on the music scheme have gone on to set up their own successful project – Mini Mac – which delivers music and mental health awareness into schools.
It is a persuasive pitch from an assertive 32-year-old social entrepreneur, bidding to solve some of society's most intractable problems. As Alcock says: "Five per cent of young people cause 95% of youth crimes, and it's that 5% that we work with."
Her approach, which has been funded by the Paul Hamlyn Foundationand Camden council, is now being evaluated by the Mental Health Foundation. It is also being piloted in another area of north London with a plan to set up a further three projects in the capital in the next 18 months. The projects will be in partnership with staff from council and NHS services, who Mac-UK will take under its wing and introduce to the young people.
"They're often young people who are homeless or have moved out of their family situation, so they're often in young persons' hostels or sleeping on friends' sofas, occasionally rough sleeping. In our experience, if one of this group was homeless it's going to be the local drug dealer that gives them a room. That is how it works," says Alcock.
Her Mac-UK model can be adapted at a local level, she says, because it is "grown from the ground up" by the young people that it seeks to help. She adds: "I want it to become the status quo for working with this demographic."
Lives North-west London.
Education Cheltenham ladies college; Warwick University, sociology degree; Oxford Brookes University, psychology conversion; Salomons campus – Canterbury Christ Church University, PhD in clinical psychology, specialising in community psychology.
Career 2008-present: chief executive, Mac-UK; 2007-08: clinical psychologist, Camden and Islington NHS foundation trust, assertive outreach team for adults with severe and enduring mental health issues.
Public life Member of the independent advisory network for the Home Office's ending gang violence team.
Interests Snow-boarding and crafts, including making cards, candles and bath bombs