Written by Kate Astbury
As an organisation comprised of young people, it will come as no surprise that we believe young people should be afforded opportunities to be involved in the development of policy, which controls provisions affecting their lives. The meaningful involvement of young people is essential to create services which cater to their needs and understand their concerns. Developing policy in this way would improve service provision and efficiency.
There are a variety of participatory models, engaging young people to greater degrees and at different stages of policy development. This includes providing feedback, taking part in strategic planning, policy consultations, and shared decision-making. The value of including young people in some capacity is clear, however, the means of this inclusion and whether the process results in meaningful involvement rather than tokenistic participation is less obvious.
When CERT was invited to take part in a project trying to address this issue we eagerly accepted. The conundrum action and working group was born out of earlier research conducted by academics at the university of Glasgow, which looked at the factors which affected the use or non-use of condoms and contraceptives amongst young people in Scotland. The first recommendation from this research advocated for the meaningful inclusion of young people into service provision and decision-making. The conundrum action and working group brought together academics, policy makers from the Scottish government, service providers, and young people to address how this recommendation could be achieved. We collectively attended meetings to discuss the digital sexual health priorities of young people, and created a ‘systems map’ to understand where sexual health policy decisions were being made, and where improving and increasing the involvement of young people would be the most beneficial. As a working group we were not only learning what young people wanted from their sexual health services, but also the best method for involving young people in the decision-making in a meaningful capacity.
Our involvement in the project provided us with an abundance of learning about our own role as a policy group comprised of young people, and how we can make the most impact in improving contraceptive policy in Scotland. I’ve summarised below a few of the key lessons we have taken away from our involvement.
1. Understanding young people's needs and concerns is essential to delivering effective policy
Involving young people in decision making allows a greater understanding of what young people want from their services and also what might make a young person more hesitant to engage with those services. For example in evaluating the digital outputs, some young people raised concerns about data privacy involved in self-monitoring tools for sexual health, and misinformation that could be spread from peer support groups, and therefore indicated that they were less likely to use these kinds of outputs. On the other hand, live chats with healthcare professionals and postal STI test kit ordering systems proved popular. Consequently the inclusion of young people’s views can focus investment in policies with a higher chance of success with service users.
2. Permanent structures are required to create channels for involvement
Whilst co-leading interviews with stakeholders in the sexual health field, it became evident that there was an appetite for working with young people and an acknowledgement of its value, but difficulties were encountered in creating structures which enabled these relationships. Stakeholders noted that they found it difficult to find networks of young people willing to be involved, and young people felt they lacked information on how to become involved. As a result, participation where it happens can tend to feel ad hoc, temporary, inconsistent, and lacking a continuous process. The project demonstrated the need for more permanent structures and follow ups to keep an engaged relationship between young people, stakeholders, and policy makers.
3. Understanding where decisions are made in the system is important in order to improve the level of youth participation
Beginning the project, we collectively decided that one of our priorities was to create a systems map which outlined where the sexual health decisions were being made. This allowed us to assess the current level of youth involvement, and understand where improving youth participation would have the biggest impact.
Making this map also allowed us to understand where youth involvement was lacking and factors that might be contributing to this low levels of participation that could be tackled. We noted factors that could deter young people from participating in sexual health decision making, amongst which were religious factors, social stigmas of appearing too interested in sexual health, young people fearing they are too inexperienced or having nothing valuable to contribute, and a perception that sexual health is only relevant to those who have already had sex.
4. Involvement shouldn’t be performative or seen as an additional hurdle to policy development
The research recommendation advocated for the ‘meaningful’ involvement of young people, suggesting the quality of their involvement makes a difference to the result. Where involvement is just seen as another box to tick, adding additional burdens to already overstretched stakeholders, the inclusion of young people becomes tokenistic rather than beneficial. We found that building a mutual relationship of trust with young people, in which they felt their contributions were valued and would make a difference to the output, created a conducive space for improved decision-making.
Although these takeaways come from experience working in sexual health policy, as a working group our hope was that the findings of the project could be extrapolated to other policy areas, and can act as a model of how to build meaningful and sustained collaboration with young people, and in doing so improve policy outputs.
Further information on the Conundrum project and working group: