Valuing health

I recently went into the West End for some new clothes and apart from the crowds (I am from Cornwall) I loved the big stores. I started thinking about advertising and what attracts us to buy things or catches our attention. Young people, like adults, are bombarded with sophisticated advertising, and when they go shopping, it is a real experience. Stores are exciting, slick and cool and researchers have spent thousands and thousands working out what will appeal to their audience. I was left wondering how do adolescent health services fare in comparison and if they don’t fare well what message does that give to our young people – that their health is not as valuable as fashion or music? And if that is the case, what do we have to do better to make health an important asset for young people that they value and ‘invest’ in?

Brilliant relationships education

The other day I was just walking home from the bus. A few feet in front of me two women were holding hands, and between the two women and I, a man was walking with two children aged probably about 4 and 6. The older one asked, ‘daddy why are they holding hands?’ and he simply said, ‘probably because they love each other and so it is nice to hold hands’. And then they carried on talking about what they had done at their friend’s house. Brilliant, brilliant relationships education. I am not a fan of listening in to other people’s conversations but I am glad I couldn’t help but overhear this one – it set my day off to a flying start.

Why the words 'sex' and 'secret' don't go together

Last week I was given some publicity about a condom scheme for young people. Generally it was brilliant. But there was a sentence that worried me. It described their policy on confidentiality as being about keeping a secret. I fully understand the message it was trying to convey to young people and yet to me the words ‘secret’ and ‘sex’ should not go together. Too many people with huge courage and dignity who I know personally and professionally have told me that as a child they never told anyone about the sexual abuse they experienced because they were told it was a secret between them and the adult who hurt them.

About a decade ago, Brook published a poster with the simple and powerful statement, here to listen, not to tell. It was produced because young people told us they worried their parents or carers would be told if they asked for contraception or sexual health advice. Ten years on, confidentiality continues to be one of the top concerns of the young people who come to us. Brook is the leading advocate for confidential services for young people and I believe absolutely and passionately in young people’s right to confidential services. But still I am unsettled by the word ‘secret’.

If sex is not talked about openly and sensibly children learn to be embarrassed and ashamed by it. Nowadays many live in two worlds – one where sex is everywhere, with sexually explicit images easily available via new technologies; and another where sex evokes virtual silence. With silence there is inevitably shame, embarrassment, guilt and secrecy.

So when I read publicity for services that says ‘we keep everything secret’ I worry about the message this gives young people about sex. Yes, we must recognise where we are now and the importance of confidentiality. But to really change the world, we must also open up the conversation and help create an environment in which young people can talk about sex so they can enjoy it, take responsibility for it, and get the help they need from parents and professionals. I look forward to the day when young people are as confident about going for sexual health and relationships advice and counselling, as they are about going for a haircut or to the dentist.

A bit of respect!

I was leaving a Brook Centre yesterday just as it was opening. About 12 young people had settled in the waiting room within the first few minutes. As always I listened and watched for the intimidating young people that the papers write about – I couldn’t see them. I looked for the noisy and uncontrollable youth that people talk about on the bus – I couldn’t see them, and I looked for the sexually irresponsible young men that dads warn their daughters about – there were none to be seen.

The young women and young men sitting in this waiting room were waiting patiently for their turn, talking to each other and supporting one another. They were excited, nervous, worried, brave, responsible and respectful. Are they unusual? Not in my experience. As I left the Centre I said to the receptionist that I would love to bring those adults who fear or condemn young people to observe this waiting room. Her response: ‘as long as you are good to young people, they are good to you. The trouble is, if you bring someone who doesn’t like young people into the room, they smell it and the mood changes, so it wouldn’t really work’.

Many of our European neighbours have very different attitudes to young people. They want young people to be happy, to be safe and responsible in their intimate relationships. We rightfully continue to look for evidence of the effectiveness of our work but how do you measure the impact of care, respect and attention on young people’s sexual health? A randomised control trial won’t do it – but if you want to visit a Brook waiting room you will see that it works. As Dona Milne said in her reply to an earlier blog yes we need to involve young people and listen to their views, but they don’t really ask for much, a bit of respect, a friendly service and people who like them. I agree with her and in my experience when you really enjoy young people’s company you keep on learning, you keep on living and you keep on laughing. A win-win situation.

The risk of ruling out risk

As always March is proving a busy month for conferences. Recently I’ve spoken at two: one in North Yorkshire with a focus on personal development and well being, and the British Association for Teachers of the Deaf (BATOD) conference which focused on the need for positive and proactive support through all different transitions including puberty, adolescence, bereavement, divorce and separation.

A couple of themes came through at both - first, to be effective in all of this work we must remember what it feels like to be young - the excitement, the anticipation, curiousity and the fear.

Secondly - the lack of confidence some people have in pushing the boundaries and providing exciting opportunities for young people. In a risk adverse society, the perceived threat of litigation when things go wrong prevents them from 'taking risks' and trying new activities and new approaches. One delegate described a trust building activities where young people are responsible for catching one of their peers as potentially risky. What if they don’t catch the person, they fall and hurt themselves? School trips similarly off the timetable - too risky.

Engage with a group of people who feel this fear for an hour and you start to see the logic. But these activities are important because they help us learn about ourselves, the world around us and our interactions with others. They help us learn that trying new things is exciting, challenging, inspiring and affirming. And they help us to learn how to manage risk so that we can take responsibility for ourselves in potentially risky situations.

Understanding risk is a vital part of every young person’s development and learning to manage it will help them take informed decisions in many areas of their lives, including their sexual health, as they grow older.

If children and young people are constantly sheltered from the possibility of things going wrong are we really preparing them for their lives now and in the future?

Young people, pregnancy, punk and participation

Yesterday Brook launched its new evening and weekend sexual health services for young people in Stockton on Tees - a really exciting initiative funded by Stockton’s Teenage Pregnancy Partnership and the Stockton Renaissance and Neighbourhood Renewal Fund.

The launch was led by young people aged between 15 and 17 who had made a film about sex and sexual health for the event. They had also come up with ideas for a range of activities and entertainment, and got their friends involved (including an up and coming young punk band who covered songs by the Buzzcocks and the Clash). The energy and enthusiasm they all brought to the event was infectious and invaluable.

I listened to two of the young people talking to each other: 'just been talking to her [nodded head towards a woman on other side of the room] for ages. She was really interested in what I had to say about sexual health.' She beamed as she spoke - clearly pleased that someone had listened.

The same two young women were also part of a group interviewed by their local radio station, and did a great job of explaining succinctly to the reporter why young people in Stockton needed these new services. ‘We don’t want to go somewhere where you might bump into your mum or your friend’s mum’, explained one, ‘we need somewhere just for young people’. ‘Teenage pregnancy is really common round here’, explained her male friend, and another proudly told the reporter she had just done a chlamydia test, explaining why it was important that other young people did the same.

Later I spoke to them and asked if they had enjoyed the afternoon. They had - the best thing, they told me, was giving their views and being listened to by adults, and they were really pleased they might make a difference for other young people. So easy to do, so important and yet still so many young people are not involved in decision making and service development.

Do we really think we can get services and education right without seeking the ideas and help of those young people we are trying to support?

Contraceptive awareness week

This week is Contraceptive Awareness Week: an important opportunity to reflect on what more needs to be done to help people of all ages take control of their contraceptive choices, as well as welcoming the progress that has been made over the past 40 years or so.

We are still taking two steps forward and one step back. Currently we are seeing the constant threat to community contraceptive services as a result of the NHS funding crisis. This is an issue for us all. We must not let it happen without protest. It is short sighted and irresponsible, with undoubted personal, social and economic costs over time.

In this changing policy context, one fact remains true – far too many young people are growing up without the education, support and services to help them enjoy and take responsibility for their sexual choices and well being. In Contraceptive Awareness Week 2007, why not identify at least one thing you can do personally or professionally to promote an open and positive culture about sex, sexuality, contraception and sexual health? Tell us here what you think should be done. Share your ideas and inspire others.

At Brook we will continue supporting young people and providing a platform through which they can express their views and ideas and share their experiences. Watch this space.