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Working with the London Vanguard in North Central London – Dr Fatima Bibi.

Clinical Psychologist, Dr Fatima Bibi, talks to us about working with the London Vanguard in North Central London. 

What aspect of the Vanguard model do you enjoy working with the most?

The process of consulting with, and engaging communities in the development of the service. It’s invaluable to tap into the knowledge, skills, expertise and wisdom they bring in relation to what’s helpful for people and also not helpful. It allows me to think outside the box as to what the solutions can be

I’m amazed with how creatively people are in coming up with ideas on engaging with marginalised children and young people. I’ve been to wonderful events, I’ve been to people’s homes, they’ve cooked food for me. It’s amazing to grow a partnership with the community whilst developing this model.

How do you think clinicians can support young people to engage in the service, when they may feel reluctant or have had negative experiences accessing other NHS services?

It helps to just be really respectful, understanding and having compassion for the fact that people really do have reasons not to trust services. I think it’s important to be genuinely interested and curious about people, not through the lens of what can I offer, but asking what it is that people really need.

It makes such a difference for young people because there aren’t many spaces where people are asking what it is someone really needs. What I always do with people who are on the fence about engaging with services, or people who are explicit in saying they don’t want to be part of the service, is offering them help anyway and being transparent about what we can offer.

Children and young people may say they don’t want help and I can just tell them that it’s OK, that they can get in touch in whatever way that feels comfortable for them. People can engage at their own pace depending on when they feel it’s safe to access the service.

For those children and young people who are ambivalent about engagement, it’s important to emphasise their skills, strengths and resources.

What referrals do you find most rewarding to work on?

Those people that opt into our service at a point of transition or crisis at point of real need. We often pick up children and young people from police or court custody. But we also support people who are transitioning out of the criminal justice system. The mental health needs for people when they transition out of prison is extremely high.

It is challenging and there’s a lot of distress that needs to be worked through and people need to be willing and open to engage. Those have been some of my most challenging cases, but they’ve also been the most rewarding as well.

The reason I find it really rewarding to work with people in that transition, there’s a real sense of openness about unmet needs, support for mental health challenges or navigating services or even support around stability, it’s usually all the above. People want a little bit of everything.

For example, I had a young person who was quite severely dyslexic and really had challenges with basic literacy and numeracy and he was navigating the criminal justice system. He came out of prison and was working with probation and was unable to comply with the requirements asked of him. His needs weren’t acknowledged, and he had lots of challenges. Him sharing that with me and being able to deal with this delicately and sensitively, it enabled him to do the things he was genuinely ready for. 

How has working with the Voluntary, Community and Social Enterprise (VCSE) and community partners helped in the delivery of the Vanguard model of care?

It has been essential in being able to develop a service that meets the needs of the cohort we are trying to engage with. VCS partners have such in-depth knowledge about the areas they work in, the local needs and they are much more engaged with why and how some of the young people in their communities end up on the fringes.

Being able to tap into that existing knowledge and skillset is invaluable in ensuring our interventions are targeted where they’re most needed.

They have their own youth work-based and creative ways of engaging marginalised and vulnerable people. Working alongside caseworkers with expertise in working with children and young people in the criminal justice system enables us, as clinicians and psychologists, to work in ways that feel appropriate and helpful.

In my experience, some of the younger people we work with often aren’t interested in sitting in a room with a psychologist having a chat. There’s something really helpful about drawing on practitioners and caseworkers in engaging with young people. It makes services more engaging and fun. It’s about engaging that skillset that has been incredibly helpful.

What does community mean to you, and what do you feel is supporting community embeddedness?

I really value a sense of community. To me, community means belonging, inclusion, acceptance, safety and support and importantly, being able to give back.

Lots of communities have lost children to horrific violence. Being able to connect with those communities, understanding and sharing, connecting to the enormous strength communities have, it feels natural to work like this.

An important part of the work is being able to support the community to ensure their challenges and struggles are being heard. If we are better able to resource communities, we are better able to resource young people. That’s the way we should be working.

If you had to describe the Vanguards in three words, what would it be?

Inspiring, challenging, essential.

Dr Fatima Bibi, Clinical Psychologist and Service Lead, Gateway, Enhanced Liaison and Diversion, Barnet, Enfield and Haringey Mental Health NHS Trust.

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