National Conversation

Includem Report
Introduction
Includem is a Scottish based charity that works with young people who live in some of Scotlands
most marginalised communities with high levels of multiple deprivation. This often leads to young
people being excluded and experiencing a high level of difficulty engaging with services and their
communities.
We envisage that the voices of young people will be listened to and acted upon with coordinated
feedback into the National Conversation in partnership with Our Voice.
The national Our Voice team approached and agreed with Includem in December 2015 to design a
framework for effectively hearing the voices of young people regarding the future of health and
social care services in Scotland. Includem resources were deployed to interview young people using
a combination of individual and group interviews to gather feedback in relation to the national Our
Voice questions:
1.
2.
3.

What support do we need in Scotland, to make healthier choices?

What areas of health and social care matter the most to you?
Thinking about the future of health and social care services, where should our future focus
be.

Building on our co production and service design experiences involving young people, Includem has
ensured that young peoples voices are heard through this important project.
During the project Includem consulted with 19 young people across the broad range of our services
within Glasgow, Fife, Dundee and West Dunbartonshire; using our relationship based model of
practice; which is built on trust, transparency and respect. We worked collaboratively with young
people during the project to ensure we systematically captured their views for the ongoing
contribution to improvement of Health and Social Care for the future.
Numbers of young people involved

A total of 19 young people were involved in the consultation

Age range of participants

The age range of those young people who took part in the interviews was between 10 years
old to 19 years old

Gender Split

A total number of 10 young females were interviewed

includem.org

Page 1 of 13

A total number of 9 young males were interviewed

Geographical Spread

Young people taking part in the interviews lived within those areas highlighted within the
multi deprivation index. The areas involved were Glasgow, Dundee, Fife and West
Dumbarton

Number of Interviews

In total there were three group interviews involving 14 young people

Five young people took part in individual face to face interviews

Range of referrals and reasons for working with Includem

Those young people who took part in the interviews come from a diverse range of backgrounds and
social circumstances; with a common denominator being a wide range of physical and complex
emotional health concerns. Many of those interviewed for the project are supervised and supported
through local authority compulsory supervision measures.
The 19 young people who took part currently work with either Includems intensive support Core
Teams or the Transitional Support Team, (which works with 16 24 year old young people who have
continuing vulnerabilities and require some additional preparation for life).

Facilitation approach
To help facilitate the conversations with young people we explored a wide range of engagement
techniques with the young people prior to the interviews. These discussions took account of the
preferred individual and group learning and communication styles of all those involved and were
designed to assist young people to express their views in their own language
The techniques deployed were:

Podcasts
Mind Mapping
Cartooning
Group Interviews
Individual Interviews
Flip Charts

Staff involved in the individual interviews received coaching to build on their experiences of
facilitation and interview techniques to ensure this was carried out with skill and sensitivity.

includem.org

Page 2 of 13

includem.org

Page 3 of 13

The findings
Health and Wellbeing
Health and Social Care Provision
All young people were in agreement that NHS is hugely important to everyone in society and not
just young people.
All young people interviewed agreed that having easy access to all primary health care services was
important to them and their families.
There was a clear view expressed it was important that health and social care services were free to
all. One young person said If services arent free the people who need help wont get equal
treatment if they have to pay.
Specifically, young people spoke of their own access to specialist services like CAMHS, speech and
language therapists, specialist education support. Those young people in receipt of these services all
recognised how valuable and necessary they are to getting ongoing support from these services.
Community Nurses
One young person spoke of the benefit of having community based nurses to help with her dads
epilepsy. She commented that having a community alarm fitted in our house was reassuring if my
dad was having a seizure. The nurse was also reassuring and told me what to do in an emergency
Speech and Language Therapists
One young person commented that the speech and Language Therapy services should be open
later and at weekends. I dont like being taken out of school to see my therapist. It would be much
better if I could visit my therapist after school finishes.
She advised that young people should not be nervous to go early and see their therapist. There are
real benefits. I got good support and so did my parents throughout.
Physical Health and Healthy Eating
Young people identified the following areas as important to maintaining good physical health:

Sleep is important for maintaining a healthy lifestyle

More encouragement for young people to be healthy is needed. Obesity is too high its ok
to indulge some of the time but you dont want four chins.

There should be free lunches for all young people at school.

Breakfast is the most important meal of the day It gives you energy and sets you up for
the day.

Having access to healthy food that is cheap and affordable We should put up price of
unhealthy food and bring down the price of healthy food.

includem.org

Page 4 of 13

Home economics is a good subject to learn about food you learn whats in food, how to
cook and prepare it and what is healthy for your body.

Schools should avoid the danger of information overload about healthy eating. Education
should strike a good balance on how they promote healthy eating.

School Meals
More information about the dietary content of school meals in order to make healthier
choices would be helpful for young people.

Young people eat unhealthy options like burgers and kebabs as they are cheaper than
healthy options. Meal Deals are fattier for you but they are much cheaper.

Too many energy drinks are taken by young people and more education is required about
any harmful effects these drinks can have.

Advertising and Promoting Healthy Eating

Young people were able to easily name and identify what they considered to be unhealthy
food promotion adverts. They were able to sing the songs and recite popular catch phrases.
Conversely they struggled to do same for healthy food promotion adverts. Only one young
person could name a healthy food promotion advert.

Personal and social education classes should be mandatory for young people with a focus on
combining eating healthy with safer sexual health and good mental health.

Vaccinations
There was a healthy discussion and debate around the issue of multiple vaccines for young people.
Two camps with different views emerged. One group were clear that they thought early vaccinations
were a good thing for children and the other group were against multiple vaccinations as they felt
unsure about their safety for children.
This discussion concluded with agreement that more education around the balance between risks
and benefits of vaccines was necessary to clear up the confusion that still existed for many people.
Relationships with Professionals
All of the young people stressed the importance of having a good connection with those
professionals delivering services. The young people spoke generally about positive experiences of
services when they had met nice personable doctors, nurses, dentists and teachers.
One young person stated You are more likely to keep your appointments if you know that your
Doctor smiles and is friendly towards you.
A young woman shared an experience of her mum being in hospital with pneumonia. The nurse in
hospital was friendly and kind to us and she made good eye contact with us. The nurse played with
us and made it fun and we werent scared.

includem.org

Page 5 of 13

A young boy talked about his dentist being patient and always offering him reassurance when he
was nervous.
Emotional Health and Well-being
All of the young people identified good health as being more than physical health. They clearly
expressed views that centred on the need for more information and increased support for young
people in the following areas
Self-Harm and Suicide
Young people commented on the need for more specific support to be available in schools
to young people who self-harm and have thoughts of suicide. Understanding how a person
feels increases your confidence to support your friends. I know a friend that is hurting and it
would be better if more people had the confidence and knowledge to offer her more
support.

Teachers should learn more about giving emotional support to young people that self-harm,
think about suicide sometimes and have anger management issues.

Teachers should be more versed and trained in offering emotional support to pupils with
LGBT issues

Depression, anxiety and stress

Increasing the understanding of teachers, doctors and nurses about what depression is and how
young people feel when they are depressed was raised as an important issue. One young person
commented that Depression is like Gin and Tonic it makes you cry I heard it on Loose Women.
(TV Show)
A wide range of suggestions were made for achieving this:

Teachers and Doctors need to be better informed with more information about how to help
young people with emotional health problems.

Need more posters in schools and community venues about how to get help if you are sad
and depressed. Theres plenty of posters in the school about anti-bullying but none about
mental health and how to go and get help if you need it.

Doctors should focus in the future on mental health and not just physical health issues.

Organise more talks to young people in schools about mental health. We have to encourage
people to speak about how they are feeling and then make sure they have people in school
they can talk to about it.

Older people need to listen to young people. Sometimes older people think they are
listening but they are not listening. They need to take action to give us the support when we
need it.

Personal and social education classes should be mandatory for young people with a focus on
combining eating healthily, safe sexual health and good mental health.

Gender and sexuality

includem.org

Page 6 of 13

The older cohort of young people identified their gender and sexuality as an important aspect of
healthy emotional well-being. One young woman said it mattered to her because I witnessed
homophobia from other pupils at school. She stated that she had felt unsupported by teachers at
her school and felt the education system could do more generally to challenge homophobic
bullying.
Another young woman said her experience at school was that there was not enough action by
teachers to challenge homophobic bullying when it happened.
Others expressed the view that there was some heterosexual bias in education towards relationships.
One young person said the books we get at school, from primary onwards should be encouraging
people as they grow up to know that it is ok to be gay. I was the only person supporting my mate
when she was being bullied at school for being gay.
This was reiterated by another young person who suggested that books within schools should
represent different types of family relationships; single parents, same sex parents and heterosexual
parents.
Some young people observed that there was no sex education or awareness of it in Catholic schools
and that this should be added to the curriculum in the future.
Transgender
A clear view was expressed that more information is required in schools and communities around
transgender issues. Some of those interviewed stated that they wanted more information and
support for young people who are in this position.
One young person who identified as a transgender person said there was a need in schools and
other public buildings for easy access to toilets that were signed as gender neutral for those in
gender transition to be treated fairly and equally.
Foster Care Services
Young people in Foster Care or who had experienced foster care in the past highlighted a number of
areas they perceived as important to their emotional well-being:

Social Workers are an important source of support to young people in foster care. One
young person commented If you are a bairn in trouble social work can really help you.

Foster Care was seen as a place of safety and the foster carers were viewed positively. Ive
been in foster care for 8 years. It has been better for me. I can talk to them and they are
like my family.

Another young person spoke of the need to have additional support from organisations
like Includem to be there for me when I need help and when I just want someone else to
listen to my point of view, who doesnt assume any knowledge about me.

includem.org

Page 7 of 13

Young people discussed their first experience of foster care as being difficult for them because they
didnt know where they were going and felt unprepared one young person said, my mum didnt
have a case for me so I had to take a black bag, I didnt know where I was going.
One young person observed some ways to improve the experience of young people going into
Foster Care in future. It would have been good to have met the foster carer to explain why I was
going to live there. It felt like I was living with strangers as I hadnt had a chance to say how I was
feeling before I went there. I was sad and disappointed that I had to move away from my home. I
think young people need to feel that we have some control or you just think I dont fit into someone
elses house.
Alcohol/Drugs/Tobacco
A number of views were expressed by young people regarding alcohol, tobacco and substance use.
They stressed the importance of the following issues:

Young people take too many drugs even though there is some education about the
dangers and risks at school.

Too many young people start drinking alcohol and smoking at 11 or 12 years old.

There was a clear view that stress in young peoples lives was a major factor in why
many smoked tobacco and used drugs. One young person said there is a lot of
information about drugs at school but we still take them because of stress we have in
our lives.

Young people were clear that smoking can kill people and causes cancer and that
more investment is need to combat cancer now and in the future. As one young
person put it Prevention is better than cure.

Legal Highs (NPS). No education work had been done at school with the young
people interviewed on Legal Highs

Alcohol is too cheap and very easy to get access to for young people

Street drinking was perceived as a safety issue for young people and it was noted
that it can often lead to violence between young people. Its better to drink alcohol
at home where it is safer and you are in good company.

There were some suggestions about how to limit alcohol, tobacco and substance misuse by young
people in the future:

includem.org

More information that is easy for young people to understand about the dangers of
alcohol, tobacco and other illegal substances

Prevent shops from selling alcohol like cheap cider. One young person said shop
owners should have posters in their windows saying that shop owners will be fined or
go to jail if they sell booze to under-age young people. Another young person said
close down the shops that are selling to under-age people. Adults should protect
Page 8 of 13

young people and there should be more police checks on shops to stop this
happening.

Putting up the price of tobacco on its own doesnt work. My friend picks up cigarette
butts from the street so just putting up the prices wont help him.

Community Engagement and Safety in Communities

Sport and Health in the Community
All of the young people interviewed recognised the key role that sport and exercise can play in
improving physical and emotional well-being. The list below outlines some of the key benefits that
young people were able to identify:

Sport keeps you fit and healthy

It gets you more fresh air and gives you a clear head

Helps with anger and controlling your emotions

Sports help you make new friendships and breaks down barriers within and across
different communities

Sport gives you more confidence

Sport encourages you to eat more healthily

Sport is fun and helps you feel part of something

In terms of the future of sports and recreational facilities provision the young people raised a
number of observations and recommendations:

includem.org

Certain areas dont have access to sport. Provision of facilities should be the same
regardless of where you live.

More support is needed for young people to feel included in their communities
most young people felt that sport services were not aimed enough at young people
e.g. yoga classes, mother and baby groups but not enough youth clubs.

Sport is more than just football. More effort should be made to encourage different
sports in schools and local communities.

You should not have to pay to take part in sport in your communities, although some
young people talked about how buying you sports bag, football strip and water
bottle helped you to take more ownership of your involvement and contributed to
making a serious commitment to sport.

Page 9 of 13

Provision of more local youth clubs with a range of sports like Karate, netball, boxing
and gymnastics should be available to young people. One young person commented
that there is a gap in my community centre. It doesnt offer things for teenagers to
do. Its mainly for adults and younger children Yoga is not for me.

Provision of indoor and outdoor sports facilities to allow for engagement throughout
the year in all seasons.

Provision of more organised sporting events like tournaments in local parks. One
young person described how I like to walk places and practice sports with my friends
in the local park where I live. It would be good if there were more planned sporting
events to get involved in. Another young person from the Dumbarton area said we
need more alternatives to hanging around the streets like midnight football in
Glasgow. This will give us something enjoyable to do and help keep us out of
trouble.

Schools should have more resources to run more sports clubs. At the youth club
theres too many people there who bully us at school; so its good to have teachers
who can take charge and help keep you safe.

More spaces for young people to go at night like a youth caf with internet access,
laptops, a re-fuel refreshments bar, music, arts and crafts, with people to talk to
(counsellors, volunteers) in different areas within the caf a protected place for
young people.

More local places and activities for 18 year olds to go to as there is too much focus
on under 16s age group.

More recognition of young people who like playing computer games and how to
make these promote fitness. The wii-fit and X-Box Connect are a really good way for
our generation to keep fit through video games.

Safety in the Community

A significant theme emerged during the interviews about the importance of feeling safe in local
communities. Many young people reflected on their own experience of not feeling safe in their own
communities.

includem.org

One young person said Lots of people get stabbed in my area last week someone
was stabbed and it was on the news, Facebook and Internet. Another commented
thatmy area has lots of Junkies someone who takes drugs, weed, they are adults.

One young person said There are too many gangs in some of the parks and its not
safe for me to go there as I am not in a gang.

One young person said I took up Karate so that I could defend myself if I needed to
go to my local shop.

Page 10 of 13

One young person said I am in a gang because we are loyal to each other and you get
friendship and a feeling that you belong to something.

There were some recommendations regarding how to make communities safer for young people
and adults alike:

More effort to get young people who are in gangs off the streets by opening more
youth clubs with activities that they can join in with.

Having youth workers in local areas that know gang members and can encourage
them to stop fighting and do enjoyable activities

Having police officers who talk to young people with respect and in ways that we can
understand

Ensure young people get to know other communities other than just their own. One
young person commented that I have lived in lots of different communities. This can
be helpful to break down barriers between young people and you can make new pals
doing this too.

Some Priorities for Improvement in the Future

Education - putting in the right support at school the future

All teachers should be trained and able to identify problems and give good emotional
support to young people
o

Teachers need to listen more. Having good ones that arent cheeky and that respect
me is good.

Some young people did not know of any specialist teacher support for emotional
problems and recommended better information about what extra supports are
available at school

Reduce the number of young people being excluded from school. Exclusions make it
harder to get proper support at school if you are not allowed to attend.

School should be more aware of wider family health issues and stress issues at home and
how these can affect homework and school work.

Shorter school days: they are too long, I am annoyed by end of the day, even one hour
earlier would help, so we would be less stressed out.

Recipe for a Good Teacher

All of the young people agreed that the relationships with their teachers were of high importance to
enable them in feeling positive about school and themselves. Many of those interviewed highlighted

includem.org

Page 11 of 13

common themes about what they considered to be a good supportive teacher and some of the
unhelpful characteristics that they considered to be unsupportive from teachers. These included:

Teachers who are good at listening are helpful

Teachers who you can talk to at school about bullying are helpful

Teachers who are too strict are not helpful

Teachers who call a spade a spade are helpful

Teachers are too busy with paper work to listen to us when we need them and that is
unhelpful

Having special teachers in school to talk to us about our problems would be helpful
Getting support at the time you need it most works well, especially with teachers
and other pupils giving you the support you need.

Primary school makes lots of effort to get to know you personally but when you go to
secondary school it is not so good.

Having teachers who make you feel good and positive can help you learn that all is
not lost and you can come back from mistakes you have made. A good teacher is
one that talks to us, does what they say they will and listens to us. Its ok to be strict
but nice, its called tough love. Another young person stated We need teachers to
be people that actually talk to young people and want to understand us - to ask us
why, provide solutions, make us feel good after talking to them.

Homelessness
Helping homeless people was identified as a priority by several young people. One young person
commented We need more quality houses built in our local communities. Nobody should have to
live on the streets especially those with young kids.
Another said We need to be able to afford the rents for houses and we need help with our benefits
and support to survive.
Another said We should build new safe centres for homeless people and you should be allowed to
take your pets to live with you too.
Welfare Benefits
One young single parent expressed anxiety about the age of Housing Benefit entitlement for young
people being raised. I could lose my home if my benefits are taken away. This would have a massive
impact on me and my young childs health.

Cultural Integration in Communities

Several young people recommended more education in communities about understanding different
cultures, overcoming language barriers and getting to know new people who were now living in
their communities.
includem.org

Page 12 of 13

Improving Health and Social Care

There was a general view expressed that knowledge about good health and well-being has
improved. One young person stated Knowledge is better than 10 years ago but it needs to keep
improving, so fewer people die with illnesses like cancer. Illnesses should be prevented and more
money should be spent on preventing them in the first place Prevention is better than cure
Conclusion
All of the young people who took part in the group and individual interviews were enthusiastic about
getting the opportunity to express their views and opinions about health and social care provision in
their communities. One young person said after an interview thanks for giving me the chance to
spill my brain onto paper.
The interviews with the young people not only demonstrated a keen interest in protecting the
services they felt were valuable to them; they also illustrated a clear vision about what is currently
working well across a range of services and what changes can be made to improve health and social
care for the whole of society in the future.
There was also a desire amongst the young people to be kept up to date with the findings and
actions coming out of the National Conversation and work of Our Voice as it develops. The wide
range of views on display in this report further reflects on the value of continuing to make coordinated efforts across services to promote ongoing meaningful engagement and participation of
young people in the future.

includem.org

Page 13 of 13