Thursday, 9 April 2015

21 years in sexual health: 3 days to go (updated 27th April)

I have now changed the sequencing of the updates around so the newest is at the top to make it easier to scroll through.

In 21 (now 3) days' time I will be packing up my things and leaving the Brook offices for the last time, after close to nine fantastic years. I have to keep saying it out loud to remind and prepare myself. Brook has changed a lot during that time. It is an organisational journey I am proud and feel privileged to have been on along with fantastic young people, volunteers, staff and trustees.  We have also been lucky to have the support of individuals and organisations such as CASS Business School and Bain and Company along the way.

I am very excited about going to work at the National Union of Students and a whole new sector  - the learning curve is going to be enormous - I will also be very sad to be leaving Brook and my colleagues here - I love the values, the passion, the commitment to putting young people in the driving seat, and the dogged determination to demonstrate the importance of trusting young people and their developing sexuality rather than have a relentless focus on the negative and the bad.  It is not just Brook and valued colleagues within Brook that I will be leaving - I will be leaving the sexual health sector after 21 years.

I first started working in sexual health in 1994 as one of the founding group of student volunteers who set up SHAG (sexual health awareness group) at Cardiff University, before joining Cardiff AIDS Helpline (1995), Family Planning Association (1995), Sex Education Forum (1999), National Children's Bureau (2002), Department of Health (2004) and then Brook (2006).

So, I figured – 21 years of working in the sector, 21 days to go, I must have 21 things to say or things I have learnt. I intend to publish my final 'sexual health blog' on the last day, so in advance of that I am going to add one thing I have learnt or think to this blog each day as I count down. It will be in no particular order of importance. In fact I have no particular idea where I am going with this. Some of it will be really obvious I am sure, but it is part of my ending process which may or may not be interesting: let's see what happens.

19. Pornography and body image - there is no doubt that it is easier to access pornography than it ever has been.  When I first started working in sexual health we had little knowledge about good sex and relationships education for boys and young men.  It quickly became apparent that in the absence of relevant sex and relationships education too many boys and young men were turning to pornography to learn about sex. Whatever you think about pornography, I think we can all agree,  it is not acceptable that boys or girls turn to pornography because we have failed to teach them about sex and relationships adequately, and pornography will never be the best place for young people to learn about sex.

So 20 years on we still haven't sorted sex and relationships education adequately, but we do have a growing narrative that all young people are watching pornography all the time, that increasing numbers of very young children are viewing it and that it is changing the nature of sexual attitudes and sexual behaviour and leading to greater exploitation, violence and abuse. The best review of the evidence that I have heard questioned the quality and robustness of the available research.

At policy level the adult conversation focuses on protecting young people from 'exposure' and the government's key policy intervention is the adoption of parental filters in every home.  Meanwhile young people are saying that they know the difference between fantasy and reality and what they need better education, better support and to be empowered to make choices and to seek help if they need it.  Despite this repeated plea from young people for better education, at national policy level, successive governments have largely ignored young people's requests for better Personal, Social and Health Education and the adoption of filters as the main policy intervention miss the much wider point that better education would address - that images of beautiful people are everywhere and most of them don't look like most of us.

Increasingly I hear and read more and more about both young (and old people) and body image. It seems to me this wider context of beautiful bodies being everywhere is having a pernicious impact on the way we think about ourselves and our bodies. Like with pornography and most other issues we best protect and empower young people to manage through education at home, at school and in the community.  At the heart of that education has to be the promotion of self esteem, self awareness and confidence that will build resilience to help young people navigate their way through the opportunities, thrills and challenges of their everyday lives.

18. We need to find a better way to talk about consent to sex - sometimes when you listen to people talk about, or you read academic and practitioner focused articles about sexual consent it would be easy to believe that there were other acceptable options - as if there are variations on consent.  Consent is consent. Full stop. There are no acceptable variations of consent and we need to find a language which enables us to express that clearly to young people. We don't love consent because it is loveable or want consent because it is desirable. We expect consent because anything less than consent is completely unacceptable and illegal. So let us find a better way to talk about consent, no ifs, no buts, no excuses.
   
17. It is not ok to lie to (young) people about sex and sexuality - yesterday there was an article in the Telegraph about a Catholic School in Croydon teaching young people that sex outside marriage destroys your soul and that condoms put your health at risk.  It is not ok to lie to young people.  Ever. Whatever our personal views and beliefs about different issues good teaching and learning will include the law and civil rights, health perspectives based on real science, not phoney made up stuff (abortion doesn't cause breast cancer or mental illness in the real books, condoms are not porous, men can control themselves even if they have an erection, we are a population with our souls largely in tact despite the amount sex that takes place outside marriage, gay people are not ill etc etc) and then different beliefs and values including humanist, religious,  cultural and personal beliefs.

If you don't like carrots you don't make things up about carrots to stop other people eating carrots. Likewise when it comes to sex we work with facts first and then be clear that people have different beliefs and values, we do not make up facts based on beliefs and it is not ok for people and organisations driven by ideological beliefs about sex and sexuality to scare young people in our classrooms.

16. Contraception - we need to talk about contraception because at both national and local level it often doesn't get enough policy attention and we don't big it up and value it enough. Contraception is amazing. The availability of contraception has changed women's lives and choices in ways that could only have been imagined a century ago. We need more focus on ensuring people know about and can access the full range of contraceptive choices. Contraception is cost effective medicine (for every £1 spent by the health service £12 is saved). Contraception needs just as much of a policy and practice focus as sexually transmitted infections.

I suspect some of you will read that and shrug your shoulders and say, "...and so?". That is the point. Too often shoulders are shrugged as if the way we educate, teach and provide contraception is sorted. Not quite yet. Think about this - 'contraception - worth talking about' is the first and only national campaign to promote awareness of contraception; high level policy meetings have a tendency to prioritise HIV and sexually transmitted infections and rarely is the cost benefit of contraception discussed; teaching and learning about contraception can be limited to facts about contraception an tends to focus less on motivations, drivers and barriers to using contraception; evidence shows that many (young) people will know very few different methods of contraception; too many (young) people do not really know how different forms of contraception including emergency contraception works and how or why condoms protect against sexually transmitted infections when hormonal contraception does not; often (young) people will only be offered a limited range of contraceptive choices; and sometimes commissioning arrangements mean there are limits on the number of long acting methods of contraception that can be provided in a period. Contraception is amazing. We need to talk about and big up contraception.

15. We can do more to encourage inter generational experiences - as a child I remember being bewildered that 'old' people could forget their age, go out dancing, have sex, not know their school grades or which year they went on holiday. I certainly didn't think they could teach me much about love, politics and relationships until I met Edith (more later). Now I am even older than those people I considered old and I too forget my age, have no idea about my school grades and indeed am known to dance sometimes albeit badly and with a distinct and allegedly adorable lack of rhythm.

At the same time as old people are a mystery to the young, us old people can be mystified, and sometimes scared by the young.

But inter generational conversation can change that. My experience with a wonderful woman called Edith convinced me of that. I used to do her shopping and in return she taught me a lot about love, relationships, happiness, heart break, dreaming big and equality.

Her tales taught, enthralled and inspired me. I, she said, gave her the chance to remember the good times, advise through the bad and live vicariously because her 'damned legs wouldn't take her anywhere anymore.'

I was in my late 20s when the age of consent was equalised. At the Stonewall party to celebrate I talked to two men in their late 70s who were sobbing with happiness. They had loved each other for a long time. Their love had first been illegal, then unequal. Their experience makes me value the rights I now have even more.

Lots of formal inter-generational work takes place in pockets, but do we really take advantage of all the wisdom available to young people. How can we maximise that invaluable resource - older people be engaged in school or community programmes talking about love, marriage, separation, rights and social change.

14. We need a blend of online/digital and face to face activity. 
The digital revolution is truly a revolution and despite all the fears of cyber bullying and grooming or online pornography and the challenges of ensuring young people know what is reliable and good quality information the internet is an overwhelming force for good. Young people can find information, people they connect with and come together to provide peer advice and support in all manner of exciting ways.

The internet provides us with opportunities to really reach out and make information more relevant, more easily accessibly and in real time. Virtual classrooms, virtual seminars or clinics provide opportunities to be more efficient and reach more people. Utterly utterly fantastic.

But, and there is always a but, we cannot simply replace face to face services or hard copy leaflets with digital solutions. Young people need the right combination of both on and off line information and services to meet their wide and different needs. Some things can be done online but not offline, some offline and not online, some both.

13. Apply the same common sense and logic to teaching about sex, sexuality and relationships as we do with other areas of life - we expect children to learn about maths because we know that numeracy is important even though we know it doesn't stop people getting into debt. We expect children to learn to read even though we know it doesn't mean everyone will read books. We know that you teach children about nutrition in a way that is relevant to their age and maturity, i.e. at a young age they learn they must eat some fruit and veg each day, later they learn what and why.  In most other aspects of life we trust the intrinsic value of education, awareness and understanding and we accept without question that information will come from a combination of friends, parents, school and self learning.

Yet when it comes to sex and relationships sometimes we don't always apply the same logic and common sense.  We look at relationships and sexuality through an 'adult lens' rather than a 'child lens' so when a 5 year asks how the baby got in mummies tummy we fear we must explain the ins and outs of conception rather than talk about a special cuddle; when a 7 year old asks why Uncle John and Uncle Max or Auntie Jane and Auntie Rosa live together we imagine they need to know the nature/nurture debates on sexual orientation rather than a simple answer such as 'because they love each other'. We hear people say SRE in schools is difficult because children are at different stages of development. Yes they are, as they are when it comes to teaching Maths, English, French, Science or Spanish. We talk about the challenge of different community values and beliefs yet schools are working with diversity in their day to day life for example in the managing of bullying and curriculum choices, not just in SRE.

Sometimes applying the standard logic and common sense we apply in education to teaching and learning about sex, sexuality and relationships might help move us on from some of the circular conversations that for the sake of children and young people we really need to move on from.

12. We have to have a gender lens - my first role in sex and relationships education was to develop a community based project targeting boys and young men. This came off the back of the anti-sexist work in the 80s and a lot of the resources I could find started from a position of boys were bad. Of course we live in a society which affords privilege to (particular groups of) men, and some boys behaviour is bad, but as a culture we then bully boys up and seek to make them tough, and then criticise them for behaving in the way we have taught them to. I learnt a lot about the 'macho mask' that young men would put on in a group setting and how to work effectively in groups and how to promote more positive and diverse images of what it means to be a man.  I had a co worker who ran a project for young women and we used to compare notes, and very quickly realised that with boys it was acceptable to talk about masturbation, sex and orgasms but not about emotions at the start of a group, and with girls it was acceptable to talk about emotions but not about masturbation, sex and orgasms. Later if we had done our job well they would all want to talk about everything including that which was typically off limits at the start. All were limited by gendered expectations in different ways and with different pressures. Our job was to ensure that all young people knew there were a myriad ways of being that should not be limited by gendered expectations, that we reflected as many different role models as possible and that all young people had access to all the relevant information and opportunities for skill development and values exploration delivered in a safe and positive way.

Later I managed a project about gender issues in the secondary school which reinforced the fact that gender stereotypes and expectations are limiting for ALL boys and girls, young men and young women including those who identify as LGBT+.  There is an enormous amount of work to be done to address systemic inequalities. 20 years on from developing my own professional awareness of the pernicious impact of gender stereotypes and expectations it is clear that progress is simply far too slow (look at the pay gap, women's experience of violence).

Discussions about gender and sexual identity with young people are some of the most dynamic I have ever facilitated. All of us working with children and young people at the class, youth group and individual level we have the opportunity to explore positive images of people with different sexual and gender identities, different talents, dreams and experiences.  To enable all children and young people to live their dreams we have to tell them explicitly that we have ripped up the 'gender rules fax' that has gone before them; helping them articulate their dreams, make a plan and develop their skills and talents, including the skills to manage any backlash when pushing the boundaries and achieving their goals.
 
11. Shout loudly about the importance of, and help young people nurture friendships - I have just spent the weekend with fantastic friends.  It has been a fairly mixed few years with lots and lots of highs alongside our fair share of lows. Through both the highs and the lows everyone has rallied around, tried to laugh, and cried as necessary and as often as possible. There is, of course, little better than time with friends who know each other well enough to enjoy, love and trust each other, warts and all.

I remember vividly the moment that I read the section on friendship in Jo Adams' book, Girlpower, how far does it go? It described the importance of helping girls build friendships so they can be who they want to be, feel confident in who they are and when necessary get support to face any backlash if they behave in ways that challenge expected norms. This book inspired a lot of work on friendship with young men when I ran Strides the young men's project in South Wales and then training for professionals.

When I used to run the boys and self esteem training course for professionals at the Centre for Sexual Health and HIV we ran an exercise on the power of friendship as a catalyst for thinking about how to promote friendships amongst boys and young men. It was without doubt one of the single most powerful exercises I have facilitated in training as people reflected on the power of friendship in their own lives and how they can help young people nurture friendships so they can enjoy the good times and support each other through the bad times.

Already lots of good work with young people nurtures friendships, often though without naming that as an explicit objective. I think we could helpfully name the promotion of friendships amongst young people and an understanding of their importance as an explicit goal in youth work, Where we have chance to think about the importance of friendships in our lives and truly understand and value the importance of our friendships we will actively seek to provide shared experiences that nurture friendships and help young people understand the importance and value of friendship in good times and in bad. That has got to be a good thing.

10. Embrace the UN Convention on the Rights of the Child wholeheartedly - In 1989 the UK ratified the UN Convention on the Rights of the Child - remarkably the United States has yet to do so but that is another story. UNCRC sets out 42 core rights which should drive our domestic law and policy.  It sets out children and young people's rights to education, protection, freedom of expression, health services and involvement in decisions that affect them.  The UNCRC has triggered a significant and welcome culture change in the way we involved children and young people in decisions that affect them across the voluntary and public sectors that must be celebrated.

We do still have a culture that can demonise, infantalise and stigmatise young people and their behaviours - if challenged on this think whether we would allow the mosquito alarm, used in public spaces to disperse groups of young people, if it was targeting any other group in society.

Combine this culture with the impact of austerity on funding and public services, and the fact that young people are not able to vote until they are 18 and it is easy to see how achieving the rights set out in the UNCRC is slower than many of us would like.  UNCRC provides a frame for all of us involved in the health, education and welfare of children and young people. We can use it in our advocacy, organisational and workforce development and direct work with children and young people to improve the quality and quantity of support for children and young people, and to motivate, inspire and support children and young people to be advocates for their own rights.

Each of the four countries in the UK has a Children's Commissioner tasked with holding government to account for implementation of the UNCRC. Scotland policy makers, it seems to me, are better than their English and Northern Irish counterparts at framing policy in the context of UNCRC. Wales has gone even further and enshrined UNCRC in domestic law. The Children's Commissioner for England responded to the UN Committee analysis of the UK record on children's rights a couple of weeks ago. - read it here.

Like some other children and young people's organisations, at Brook we have formally adopted and work within the UNCRC and use it underpins our values, strategy, policy and practice. If you work with children and young people and your organisation hasn't adopted it yet, I recommend you start the dialogue about doing so and use it to frame the way you talk about children's rights. I believe it helps keep us focused on the 'right' things with a combined rights based and needs led approach.

I blogged about the importance of UNCRC and why we must talk about it more a while ago.

9. Remember what it feels like to be young - how often have you been in the pub, at a party or a meeting, seminar or conference where people talk about young people and young people's lives as if this generation of young people are a different species with completely different feelings and experiences?

Yes of course the context changes but the underlying feelings of being human - of falling in love for the first time, feeling confident or unconfident about our bodies, ending a relationship, deciding whether to have sex and negotiating it, talking about sexually transmitted infections, pregnancy or abortion with a partner or health professional or fears of not being good enough at sex - remain the same. If we remember and connect with how we felt when we were young, not only will it often make us smile, but more importantly will ensure we are not unhelpfully scared about not knowing, not understanding something or worse by young people themselves. Fear can impact our judgement negatively and mean we don't respond with empathy or care. Young people often tell me that they felt judged by professionals or were frightened they were going to be judged and so didn't talk to them in the first place - training of course is essential but most important is starting from a position of trusting and liking young people.

When you are young you do not have the luxury of developing empathy through remembering what it is like to be old, it is therefore incumbent on us - the older and the old - to ensure that we remember what it felt like it to be young and demonstrate due empathy, care and respect.

8. Abortion - it is time to trust women - the majority of the country is pro choice. The scientific evidence is clear.  So why is abortion and women's right to choose still so politicised - see recent calls for women to have counselling and a cooling off period to ensure they don't make the 'wrong' choice,  two signatures required from doctors to approve the procedure , mischief making undercover journalism, propaganda masquerading as pregnancy choices counselling, inequitable access across the UK, 1967 Act doesn't apply in Northern Ireland and whether it is easy or hard to get an abortion will depend on your postcode, protestors outside clinics harassing women, visitors allowed into schools to tell lies to young people in schools.  It is absolutely right that people hold their own views and make their own choices about abortion.  That is why I am pro choice. But it is not right  to frighten young people, harass women going to abortion clinics and making dubious claims about links between abortion, breast cancer and mental health in counselling services without being clear about the organisations position on abortion.  Women deserve more than that. It is time we trusted women to make choices about their bodies without ifs or buts.

7. We get what we expect and we have to expect more for young people - about 15 years ago I went on a sex education study tour to the United States with Gill Frances. We met with the academic Kristin Luker whose book Dubious Conceptions, the politics of teenage pregnancy, is well worth a read if you haven't read it. She spoke a lot of sense but one of the most powerful things she said was that we get what we expect from young people and we spend a lot of time expecting too little from them and for them when it comes to relationships.

We know that people dramatically over estimate the number of young people who have sex before the age of 16, how many young women get pregnant each year and more recently we are all consumed by the amount of pornography young people are accessing. And so it goes on - we tend to lurch from one 'moral panic' to another. We need to reflect on whether our problem focused approach to relationships and sex in the UK means we focus on the issues that worry us such as abuse, exploitation, pregnancy, HIV, pornography, (so called) sexting etc etc at the expense of setting out high expectations and hopes for young people's relationships and helping them develop their confidence to make decisions that are right for them.

When I worked at the FPA I was one of the workshop facilitators for a touring theatre in education production. The play was about relationships. It was fun to watch and exciting, but it was inadvertently showing young people how not to communicate or negotiate well in a relationship, what happens if you don't use a condom and what not to do when one of your friends tells you they are gay. In one of the workshops a young man said something along the lines of 'great show, but didn't really teach us how to be good in relationships did it'.

If we were to really to have high expectations, focus on the positive and identify what we DO want for young people - to be active decision makers about sexual and reproductive health, to have healthy relationships, to be equal and free whatever their gender and sexual identity, to only have sex they choose when they can enjoy and take responsibility for it, to have the skills and confidence to get help - what would good education look like, what would good campaigns look like, how would services work, what information would we be providing, how might we need to communicate differently with young people about sex and human sexuality?

When we ask young people what they want to learn about they will say they want to be good at relationships, to know about consent and to understand about sex, sexualities and identities. They often say adults spend a lot of time thinking all young people are a homogenous group and have the same feelings, experiences and beliefs and telling them not to do something they weren't going to do anyway, or that our perspective is a world away from their realities. If that remains true we will continue to fall short in our shared goal of protecting and empowering children and young people.

We must have high expectations for young people so they have high expectations for themselves. All the evidence shows we can trust that with the right information and tools young people will be active decision makers. My challenge to all of us, including Brook, is to continually review our own websites, our lesson plans, our campaigns and our ideas and reflect on whether the balance between the positive and the empowering and the dangerous and the protection is the right one, and if not to involve young people in changing it.

6. Ensure young people are active partners at the heart of the organisation - Article 12 of the United Nations Convention on the Rights of the Child sets out their right to participate and to be involved in decisions that affect them. In my teens I had volunteered as a support worker for young people with disabilities, and then went on to be a peer educator so it made intuitive sense to me when I go to to FPA that young people would be in the driving seat in the design and delivery of sex and relationships education programmes. Then at Sex Education Forum and National Children's Bureau the Children's Development Department were at the heart of building new approaches to involving young people in all of our work, and building an organisational culture of participation.

When you engage well with children and young people they are able to articulate what they needed better than we could as professionals. At SEF and NCB we wanted to make sure that policy proposals and evidence were built upon young people's views and voices. We therefore realised early on that the more routes and platforms we could establish to ensure their voices were heard directly, rather than mediated through us the better. Initially we sought to make short films and booklets to provide to policy makers and professionals who were not as effective at listening to children and young people's voices as now.  And even now we have a very very long way to go before they are truly listened to.

Two of my favourite participation projects at Sex Education Forum and National Children's Bureau were Please Minister can we have better sex education - a video and young people's charter for sex and relationships education produced in response to Mr Blunkett's consultation on the sex and relationships education guidance, and Journeys: young people's experiences of bullying -  a comic book mapping young people's stories of bullying and how they managed to get help and support to stop the bullying published by the Office of the Children's Commissioner.

They are my favourites because Please Minister subverted the process to make the consultation relevant to what they wanted to say.  The video and charter was sent directly to Secretary of State with a letter saying along the lines of 'we didn't think your consultation questions about the guidance were the right ones so we have made this film for you to watch and this Charter to read.'  And with Journeys we were able to start changing the nature of the debate from one which was seeking to find the one best way to stop bullying and start putting young people's voices at the heart of policy by understanding their experience of being bullied, as well as what enabled or stopped them from getting help and what worked and didn't work in the process. The project was important because it started looking to young people to help us find the answers to tackling bullying.

I am enormously proud of the work that we have done at Brook to ensure young people are at the heart of the organisation from design, delivery and evaluation of services, to advising on our business strategy and resource allocation, designing and delivering campaigns including control of the Be Sex Positive campaign (@besexpositive). They are right at the top table with allocated places for young people on the board and we are in the process of establishing one of the young people's places being a joint Chair role. Brook is a much better organisation as a result of the involvement and leadership of young people - as we have got better at building strong partnerships with young people together we have been able to keep ourselves focused on the issues that are important to them.  They challenge our thinking and old orthodoxies  - if they don't think it is important should we still be doing it?

Through a range of mechanisms young people keep us grounded in their realities in which they are actively seeking to manage their relationships and health well. They want to ensure we present a positive perspective about young people and sexuality. They are mindful of the discourse of 'young people = all sex is bad sex' position and are clear Brook must never fall into that trap and that whilst the media headlines do not deal in shades of grey, young people's diverse experiences are definitely many shades of grey and we must reflect that in all our work.

About 5 years ago we had the most fantastic opportunity through a partnership with V Inspired to hand over our campaigning function to a group of young people.  They were very clear that they wanted a different approach to campaigning.  Less about safer sex and contraception (they are ten a penny) and more about sex (challenge to orthodoxy number 1). They were clear we must tell people what they need to help young people manage their relationships and created the Be Sex Positive campaign www.besexpositive.org.uk (@besexpositive).  Through this work and having young people in the office all the time we became even more acutely aware of how often young people are demonised, how often their views are ignored and how deeply ingrained society's negative attitude to young people and sexuality can be.  We felt the brunt of their anger when they were asked to input into the Bailey Review on sexualisation of children and they didn't think the report addressed their concerns at all. I felt the joy when they felt their voices had truly been heard as was the case with Amber Rudd's inquiry into pregnancy and contraception.

I have learned that young people's voice and view is supremely powerful and compelling - their stories and perspectives are real and they can win hearts and minds in ways that we as adults simply cannot.  I have watched as young people have held audiences attention with such power you can hear a pin drop and I have seen light bulb moments as professionals as young people cut through the fluff and get to the heart of the matter fantastically well.

It is our duty to work in partnership with young people to ensure we truly work for them, to ensure their voices are heard first hand wherever possible, that we create platforms for them to influence decision makers on their terms as much as possible. We must open up our organisations to young people and actively invite them in to work in partnership with us, share power and to truly shape what we provide, offer and say.  My experience of doing this at Brook is that it is a real game changer for the young people involved and the whole organisation. I very much look forward to watching Brook's youth leadership and participation work continue to flourish.

5. Help (young) people imagine their futures and dream of possibility -  The Teenage Pregnancy Strategy in England identified raising aspirations as an important aspect to young people making choices about contraception, sex and relationships. This has been echoed as critical in other areas of youth policy, too.

I first started working with young people in sexual health in the South Wales Valleys in the mid 90s not long after the communities were devastated by the closure of the mines.  Very quickly it became apparent that many of the young men had not been encouraged to dream about their futures and we spent a lot of time in sessions talking about the art of the possible.  It took a while for people to be comfortable talking about their dreams, some time to nurture and develop their skills and confidence to name their dreams for lots of reasons including lack of belief about their options, school and community dampening down the dreams and in some cases a lack of experience and resources from which to draw.

I learnt that good sexual health work isn't always straightforward when I was working with one young man who was in his final year at school. He had been repeatedly excluded ffom school and was in alternative education. I was doing one to one work to support him particularly around appropriate behaviour. We were struggling to build a relationship. I was part of the system and the system was crap. He resented having to spend an hour a week with me. I had been on holiday and so had been away for two weeks. The following week he was so furious with me he couldn't speak. I asked him what he had been doing when I was away. His response 'nothing'. I responded with a gentle challenge that you couldn't do nothing in two weeks. He assured me he could and told me I didn't know how lucky I was to be able to go on holiday.

After a lot of talking he said he would really like to go on holiday abroad one day and would really like to get a passport. He didn't believe he would ever be able to go abroad and that was something he really wanted to do.  And so our sessions changed a course - we got travel brochures and picked dream holidays and then holidays that were more immediately affordable; we worked out budgets and travel routes, we did a photo project with my passport. He became animated and interested. I discovered he could really draw when he brought in a fantastic cartoon style story board. We filled out the passport form and wrote to the Head to ask if she could help fulfil part one of his dream by paying for the passport. She did. Through this work we built a relationship and we did work on behaviour and attitude and motivation. It was easy because the dream was a springboard and motivator for change. I know he went to France four years later. He made sure he told me so.

I learnt a lot from that experience. Dreams help us think big. Sometimes our life experiences can suppress our imagination, under nourish our capacity to dream, or worse knock our dreams out of with talk of being 'too big for your boots'. All of us working with (young) people and with our staff teams do well to nurture imagination, cultivate dreams and build the confidence and skills to believe they can turn dreams into plans. Often time we won't have the experience of dreaming out loud and so don't immediately have the resources or language to dream. Dreaming is a skill that can be nurtured and is an essential pre-requisite for a life well lived.

Right now I am dreaming of finishing the Brighton Marathon today. Rob helped me think this was a possible and even sensible goal when I couldn't even run 5 kilometres and patiently helped me build the confidence and skills to run the distance.

4. We don't have to wait for government, we, the experts, should lead the way - sometimes government will develop policy that is supportive and helpful - a driver for change with resources attached - and sometimes government makes policy that is unhelpful, counter intuitive or a road block to change.

Either way rarely is government really radical or right at the forefront of innovation. It is not a criticism. Just fact (in my view). This is ever more true in the context of localism where more and more decisions are being made locally. Despite this often time we wait for government to tell us we are allowed to do something, what to do or how to do it.

I am not suggesting that government policy is not important. Of course it is. Take the recent focus on Mental Health, it has really shone a light on the importance of mental health - some areas will be providing better education, advice and services as a result. But for those areas that were already doing excellent work the policy focus will probably not have made much difference to their work. So depending on our role and what we want to achieve, it is our responsibility to be mindful how change can best be achieved, to consider how much time to invest in influencing policy, who we seek to influence and how best to influence them. It is up to us to ask whether the investment of time and energy would be better spent in direct work with our client group, working with governors of the school or the Local Authority.

We can, I have learned, liberate ourselves from believing government knows best and that we need to be told what to do - if you believe it is right to do something, if there is evidence about what works or there is a need to innovate and develop approaches then you probably won't and don't need national policy to provide you with the mandate to do it. There are often plenty of partners from across the private, public and voluntary, community and social enterprise sector to work with and help achieve the goal.

P.S I finished the Brighton Marathon in 4 hours 16 mins. I remembered that 26.2 miles is a long way. The unfortunate thing is that this time, unlike the last time I ran a marathon, I didn't say never again.

3. Process is important to get right but it is not the task - I first learnt about the theory of group processes on FPA's group work course. How fascinating to understand why introductions and closing rounds, warm up games and icebreakers were important and why to focus on knowledge at the beginning of a groups life and do the really hard work when the group were comfortable together and operating at their best.

Process is important but it is not the task itself - for example in education and training with young people or adults the purpose of a group working well together is so they can learn new knowledge or skills.  Similarly in consultation and engagement about sex and relationships education the process of consulting with children, young people, parents and communities is not the task - the task is to build confidence and support and get the content right.

Sometimes, probably too often, process becomes the task itself - especially in a time when everyone knows that user participation and involvement is important - but as young people tell me time and again there is no point asking us what we want and then not make any changes as a result. Too often you see the same questions asked time and again of different groups of young people without any evidence of change.

And whilst we are on process it would be remiss of me not to call time on the ludicrous national PSHE policy process over the last 8 years.  We have more reviews and reports on why PSHE is important and cost effective etc than we can shake a stick at. Parliamentarians, there is no need for any further process or consultation about whether Personal, Social, Health and Economic Education should happen, or what it should include. We are collectively 'processed' and consulted out on this.  There is a clear consensus about the importance of PSHE. Process is stopping progress. This is starting to be silly. It is not possible to claim to be doing all you can to tackle mental health, FGM, Child Sexual Exploitation, teenage pregnancy, body confidence, substance misuse, relationship violence and domestic abuse or online safety whilst simultaneously refusing to make PSHE a statutory part of the national curriculum. It is incongruent. PSHE in schools is sensible, cost effective, early intervention. Everyone from us, Brook, the Children's Commissioner, ParentZone, UK Youth Parliament, NSPCC, the Teaching Unions, Sex Education Forum, PSHE Association, Mentor UK and Royal Colleges such as the Royal College of Obstetricians and Faculty of Sexual and Reproductive Health. Take heed of professional expertise and wise counsel based on evidence. Stop wasting time, acting against the UN Convention on the Rights of the Child and leaving children and young people without the education and support they need to navigate childhood and adolescence well. Be bold. You will be universally thanked for it.

No further consultation on PSHE is required. Saying we must call the sex and relationships education bit of PSHE relationships and sex education is a distraction from the task (call it whatever, I don't mind, I just want it to happen). The task is making PSHE statutory in all schools to ensure there is enough curriculum time, teachers are trained and it is inspected.

National PSHE policy is an exemplary case study in making the process the task, but it happens a lot. Whether it is organisational mergers, governance reviews, national policy, changes to employment contracts, PSHE in the classroom or youth club, the process of design, delivery and evaluation is important if it is focused on achieving the task. Process is exciting as long as it is genuine, iterative, agile and proportionate. It is dull and potentially harmful if it becomes the task, is unnecessarily unwieldy and nothing improves as a result.

2. We have to learn, relearn or discover how to trust - to trust young people and their developing sexuality, to trust women to make their own choices, to trust teachers to deliver good sex and relationships education, individuals to explore and develop their own moralities and to explore and understand their gender and sexual identities; trust health professionals to provide timely and relevant advice and treatment for young people. Trust is the starting point and a necessary pre-condition for quality thinking, for setting high expectations, for developing good policy, protocols and training and for protection and empowerment.

On all things sex and sexuality young people tell me time and again that many adults tell them what to think or what not to do, instead of helping them understand an issue, develop their views and understand how to navigate relationships well; on sex and relationships education we still read that '4 years olds to be taught about sex'; on homosexuality and equal marriage, that it will lead to incest, beastiality and the sky falling in and still, remarkably after a land mark judgement in the mid 1980s young people's right to confidentiality is contested.  We are, it sometimes seems, forgetting the art and importance of trust.  It is one of the most important tools we have. 

1. Sexual rights are human rights as shown in this Charter from IPPF - http://www.ippf.org/resource/IPPF-Charter-Sexual-and-Reproductive-Rights

Next to be updated on April 28th. I will put the date in the title each day. I have swapped round the lessons so that the most recent is at the top of the list to try and make it easier to read as it is starting to get quite long!

Monday, 16 February 2015

Life Lessons: PSHE and SRE in schools

Today the Education Select Committee has published a landmark report Life Lessons: PSHE and SRE in schools that recommends government take action to provide statutory PSHE.  The link to the report is here and I recommend reading it - an excellent analysis and joyful conclusions http://www.publications.parliament.uk/pa/cm201415/cmselect/cmeduc/145/145.pdf

In calling for statutory PSHE it rightly recognises the importance of system change, which Brook articulated in our 21st Century SRE report in 2011.  The Committee stated "statutory status for PSHE would not in itself guarantee an improvement in the quality of teaching, but we accept that 'system change' is needed to raise the status of the subject - particularly in terms of dedicated curriculum time and the supply of suitably trained teachers".

So, this really is a landmark report that demonstrates just how strong the consensus is - the Education Select Committee is a cross party group - and just how small the vocal minority that objects to high quality sex and relationships education really is. The Education Select Committee must be congratulated on their excellent analysis and robust, common sense recommendations.

We cannot assume that the job is now done, however. Government ordinarily would publish a response to the report within 60 days, but that of course will probably not happen because we have a General Election this year, so it is my expectation that the next Government, whoever that is, will decide how to respond to the recommendations. We will be waiting and watching to ensure government does respond in due course, and that this report does not get kicked into the long grass.

I want to thank colleagues Lucy Emmerson (Sex Education Forum), Alison Hadley (Teenage Pregnancy Knowledge Exchange), Joe Hayman (PSHE Association) and Roger Ingham (Centre for Sexual Health Research) who also gave oral evidence and an enormous amount of follow up collaborative work to ensure the Committee had the facts and evidence about PSHE and SRE.

And here the link to the Supplementary Advice published by Brook with PSHE Association and Sex Education Forum almost exactly a year ago, which the Education Select Committee recommends Department of Education formally endorse www.brook.org.uk/supplementaryadvice


Sunday, 8 February 2015

Did we change public opinion? You bet we did!

These were the words of Caroline Woodroffe, General Secretary of Brook from 1971 - 1986 at the 50 Years of Brook Witness Seminar hosted by the Wellcome Trust on Friday 6 February to launch the Brook archive, which is now held at the Wellcome Library and is available for researchers to access. It was an honour to be asked to Chair this Witness Session in which the following witnesses told some of their personal memories of Brook.
  1. Dilys Cossey, who was at the Family Planning Association AGM in 1964 when it was agreed that Brook would be established, then become an employee and later Chair of Brook
  2. Caroline Woodroffe, General Secretary of Brook 1971 - 1986 
  3. Christine Watson, a doctor at Brook and a funder of our services in South East London between 1982 and 1997
  4. Wendy Thomas, Chief Executive of Brook London 1988 - mid 1990s
  5. Suzie Hayman, Press Officer, 1976 - 1984
  6. Polly Goodwin, Trustee, Birmingham; Chair, Brook Birmingham; Vice Chair, Brook late 90s - ongoing
  7. Mary Crawford, Director, Brook Northern Ireland 1992 - ongoing
  8. Alison Hadley, Nurse, Brook London, Press and Information Officer and Policy Manager - 1986 - 2000
  9. I also read out a memoir from Dorothy Keeping (Bourbas) who was general secretary of Brook Avon 1974 - 1984 and David Paintin who was a board member in the early 90s.
Dilys kicked off the proceedings with memories of the FPA AGM in which it was agreed that a separate service for the unmarried woman should be established. And hence Brook was born. Dilys reflected that she thought FPA rather stuffy at the time for not wanting unmarried women to use their services, but realises with the passage of time that this was a necessary approach to secure contraception free of charge on the NHS. Dilys reflected on her personal experience of accessing services which illustrated the need for a non judgemental service like Brook offered.

Caroline continued talking about the early days of Brook and the importance of contraception in achieving equality for women. She reflected on the societal changes that happened during the first few decades of Brook - the disgrace of 'young unmarried sex' gone, mother and baby centres closed, adoptions reduced and the place of women in society improved. Within Brook, the range of services offered varied across the different services: some groups of people paid for certain services and others received services free of charge. Caroline talked about the brilliant people who worked so hard and so passionately to set up and develop the services in BristolBirminghamCoventryEdinburgh and London. My favourite line from Caroline: Did we change public opinion? You bet we did!

Christine Watson went next and talked about what an inspiring bunch of people worked at Brook and how important it was to recognise that the services Brook provided complimented those services provided by the health trust, and the early days of educating young women before they got to the clinic. Christine told a rather joyful story about a school that is delivering very good, up to date and helpful sex and relationships education and how this had been very encouraging, given the inadequacy of sex and relationships education in the 80s and 90s.

Wendy Thomas started her talk with her memories with a reminder of Helen as both wonderful company and in need of managing, particularly in the media. She talked lovingly of the hazardous East Street building which saw thousands and thousands of clients and really emphasised, like the witnesses before her that it was the people who made Brook such a wonderful place for clients and for staff. She also talked about the generosity of Brook's supporters including Pamela Sheridan.

Suzie Hayman next talked about her proud moments - a paper about sex and how bizarre it was that you could not advertise condoms on TV kicked off her tenure, while her time at Brook concluded with overseeing the production of just such an advert. She also talked of how Brook became the 'go-to' place for media to go to for comment about young people, sex and sexuality. She then focused on Brook's response to Victoria Gillick's legal challenge to young people's confidentiality, and how personal it sometimes became, and how important it was to be robust in defence of young people's right to confidentiality but never personal however personal the 'anti crew' got - which they did (sounds familiar!).

Polly Goodwin took up two of the previous themes; the importance of being feisty and the importance of Brook's core values including confidentiality. Polly talked about her dismay and surprise that some of the issues in the late 80s and early 90s - consent, exploitation, gender equality - had not moved on as much as she wished they had, and thought they might. Polly also talked about the importance of being open and transparent, inviting those who object to your work in to see what you do.

Mary Crawford continued with the theme of protestors and objectors, Northern Ireland, of course being the Centre that has received the most objection and challenge during its 22 years. Mary showed photos of graffiti on the building where Brook was described as scum, a letter from an objector sent to every person in Mary's home street accusing Mary and Brook of killing babies, and pictures of Brook picketers with inaccurate images of foetuses. Mary also reflected that the first time you get a horrid letter sent to your street, your lock superglued or any other incident it can take you by surprise, but soon you become wise to the 'tricks' and incredibly resilient because the work is based on values and on the rights of young people.

Alison Hadley concluded the witness statements by returning to the theme of confidentiality and how the Gillick case had rocked young people's and professionals' confidence, which was why it was so important that Brook led such a major programme of work on confidentiality, working in partnership with the BMA, RCN, Health Education Authority and others to produce a confidentiality and young people briefing that went to all GP practices and specialist services, a leaflet for young people, and a number of guides and training events to help ensure professionals and young people were confident about confidentiality. Alison picked three key stand out Brook features: keeping the balance between the positive (sex as healthy and enjoyable) and the challenges (exploitation, abuse and harm); involving young people in all that we do; and ensuring we have people who enjoy working with young people and are committed to the aims and values of Brook.

It was a privilege to read the memories of both Dorothy Bourbas and David Paintin. Dorothy, now 90 years of age, described Helen Brook as a revolutionary with a quiet voice whose achievements have had far reaching positive implications. She concluded that she has seen many social changes, and how she wished Brook had been around when she was 18. David reflected on how he had learnt about the importance of sex education at Brook and really understood how central the ethos of providing confidential services was at Brook. He congratulated Alison Hadley on taking the ethos and approach of Brook into the government's teenage pregnancy strategy and applauded the progress of the strategy.

The audience were a mixed group of researchers and people including some who had worked at Brook including Margaret Jones who had been Chief Executive through the 1990s. Their participation also focused on their personal memories including the care and attention clients received, the joy of expanding services across the North West and the importance of being open to the critics and also asked when Brook chose to exclusively focus on young people and what drove the move from working from the unmarried to the young.

To conclude I asked all the witnesses to ask what they would like to see Brook be and have achieved in 25 years. They included - to still be here, being innovative and strong; to have finally got Personal, Social and Health Education on the curriculum; to continue being brave and speaking out for young people, and helping young people speak out; to remain at the forefront, showing how it should be done; to see the 1967 abortion law protected in Great Britain and extended to Northern Ireland; to continue being positive about sex and maintaining that mission of enabling young people to enjoy their sexuality without harm.

After thanking all involved I closed with the words of Rosa Parks: "You must never be fearful about what you are doing when it is right." It seemed a fitting way to end given how the fantastic women on the witness panel, many who participated in the seminar and many more who were unable to be there, have demonstrated tenacity, wisdom and courage to improve the lives of women and of young people because they know it is the right thing to do.

Thank you to Dilys Cossey, Caroline Woodroffe and Stephanie Whitehead who worked so hard to make the archive happen from Brook's end, and to Dr Lesley Hall, senior archivist at Wellcome for her work in diligently creating the Brook archive so the truly stunning and life changing work of Brook is on record. Another one of those days when I felt enormously proud, privileged and humbled to be part of the Brook movement and a powerful reminder that all of us working at Brook now stand on the shoulders of giants.

A number of people suggested we need to do a second session focusing on the last 15 years or so - what happened during the time government was broadly supportive of Brook's work, and what can we learn from that period about what needs to happen next in a different policy, political and fiscal environment? I will talk to Dr Lesley Hall and see if there is an appetite for a second Witness Seminar focusing on the later years of Brook.

In the meantime, this has made me want to produce a compilation of people's experiences and stories about Brook through the decades. If you want to contribute email me at simon.blake@brook.org.uk.



Tuesday, 30 December 2014

As 2014 comes to an end my ten lessons for 2015

For the last few years I have done my own partial and subjective review of the year as it relates to young people, sexual health and well being. This year that feels like an unhelpful and almost impossible task – impossible because operating in the context of localism means it is rather difficult to state whether there is progress or otherwise so instead here are ten things I believe we must keep front of mind as we move into 2015. 

2014 has been an interesting and in many ways peculiar year – on the plus side there is so much activism and noise in support of young people’s sexual rights including PSHE and services, so many reports emphasising the importance of efforts to promote positive relationships and good sexual health outcomes.  Yet again it is a year where lots of people have worked really damn hard with results at local and national level and I am grateful for all the work done by Brook teams, colleagues and collaborators which set us on course to deliver our mission of enabling young people to enjoy their sexuality without harm.

So here are my ten lessons as we move into 2015.  In no particular order I believe we must;

1.       Ensure the UN Convention on the Rights of the Child underpin and foreground all our work: this year was the 25th anniversary of the UN Convention on the Rights of the Child. We can really helpfully talk about children and young people’s rights more and use them to frame our policy and practice and drive improvements in participation in decision making, education, protection and delivery of services.  

2.       Talk about contraception and abortion as much as we can and emphasise the importance of both in women’s lives. Both are life changing and cost effective – we know that every pound spent on contraception saves £12.50 to the health system alone. Any reductions in access to full contraceptive choice are really short sighted as they will inevitably cost more in the not very far away long term as access to contraception is key to preventing unintended pregnancies (sounds obvious I know, but seemingly not to everyone).  Its time to call time on protestors harassing women accessing abortion services and continue to drive for equity of provision across the UK

3.       Decision makers must continue to invest in HIV Prevention and Sexual Health Promotion - HIV prevention and sexual health promotion works. It is cost effective. Crossed wires or otherwise despite the threat to the HIV Prevention England budget we have, for now, had reassurance from Minister for Public Health that the national HIV Prevention England budget will be protected. There are lots of reasons that funding should never have been in doubt. The fact that HIV infections have almost doubled amongst young gay men over the last 10 years is one of those. It is appalling and an urgent reminder that we must renew our prevention efforts.

4.       Put into practice our knowledge about how to identify, assess and prevent Child Sexual Exploitation - the increasing focus on Child Sexual Exploitation is really important and we must do all that we can to ensure this particular form of sexual abuse is eradicated. We have so much evidence about what places young people at risk of CSE and we must use that to inform the design of mainstream and targeted education and other health services.

5.       Stand firm together and insist that government make Personal, Social and Health Education statutory in 2015 – Brook, the Sex Education Forum and the PSHE Association and many others have demonstrated the strength of professional opinion (almost every relevant report and every credible body called for statutory PSHE in 2014) and public support (almost 9/10 parents showed support for statutory PSHE) for statutory PSHE.  Remarkable then that government has not yet taken this advice and still hasn’t committed to make PSHE a statutory part of the curriculum in schools so all children and young people learn the foundations about relationships, sex and human sexuality. Next year government simply has to catch up with public opinion, make PSHE a statutory part of the curriculum so organisations with limited resources can stop trying to influence government to make the right decisions and get on with the real job – helping parents and schools deliver high quality PSHE.

6.       Find ways to work with the new accountability frameworks: I was always a fan of national targets – taken with a healthy dose of scepticism, common sense and professional accountability they drove many improvements in sexual health at local level as seen with the 48 Hour Waiting Time for GUM and the Teenage Pregnancy targets. Recognising the challenges that are emerging in the context of localism the All Party Parliamentary Group on Sexual and Reproductive Health set up a much needed inquiry into accountability for sexual and reproductive health outcomes.  I look forward to the report which I hope will shine a light on the challenges and identify some solutions which can be easily implemented.

7.       Listen to young people and involve them in everything we do: in November young people told the board of Brook that they want high quality SRE, online and face to face services they trust and feel confident accessing, and parents to be trained to talk openly about relationships and sexuality. They weren’t that interested in how we make it happen and believed that if as a society we decide it is important we will find ways to make it happen. It is refreshing having young people present in more policy meetings because they cut through the professional niceties but we cannot mistake their involvement in the meetings for delivering the change they demand.

8.       Make sure that all sex that young people have is not perceived as bad sex - whilst public health and policy drivers change there remains an undercurrent and tone that all sex young people have is bad sex, which of course is simply not true.  Whilst policy changes our task remains the same: to enable young people to enjoy and take responsibility for their sexual choices and be their staunch advocates – trusting them, empowering them and remembering what it feels like to be young. However old we are, if we remember what it feels like to be young, we will like and trust young people more which will doubtlessly improve our judgement.

9.       Use all the levers, systems and processes available to make sure we commission what we value, not value what we can measure and procure. I believe wholeheartedly that there is always room for improvement and innovation, and that we must invest in what works. Good commissioning lies at the heart of effective service delivery. There are some examples of really good commissioning, and there are too many examples where strict adherence to perceived procurement rules and an expectation to go out to market may prove to be counter productive. We must learn the lessons from those examples where commissioning and procurement practices have been financially costly, disruptive and worked against integration and against the provision of specialist services delivered by specialists. There are EU rules which enable specialist services to be commissioned in proportionate and helpful ways, and examples of best practice within Local Authorities which create exciting opportunities for change, and perhaps more radically examples where Local Authorities are doing what is necessary to protect and preserve what already works in their local sexual health economy.

10.   Trust technology as a driver for good and ensure we do not demonise it in the way we sometimes demonise young people. Technology did not invent misogyny, abuse, bullying and foul behaviour but it did open up new information channels and networks that can literally be life saving for young people. We must focus on developing positive attitudes and behaviours rather than be wrongly diverted by the medium through which those behaviours are expressed.

Brook turned 50 this year: I am grateful to everybody who has been involved in Brook’s efforts to improve the lives of young people over the last 50 years.  We have come a long way and we have a very long way still to go. Particular thanks to the staff teams, supporters, funders, donors and collaborators who have worked with us over the last year. If you, like me, believe we can do better to protect young people please do think about becoming a friend of Brook www.brook.org.uk/friends - we stand stronger and better together.

2014 – I blinked and you were gone. That is almost a wrap. Happy New Year! I hope 2015 brings you lots of contentment, learning and laughter (talking of which, have you got your ticket for our Comedy Sex night on January 10th – its hosted by Al Murray with a cracking line up and sure to get you in the mood www.brook.org.uk/events/sex-appeal-4-the-fourth-coming.

Saturday, 6 December 2014

(Young) Voices in my head

I read a lot of Doris Stokes books when I was younger and trying to work out the meaning of life -  or more specifically my life - but this blog is not about Doris.

10 days or so ago young people presented to the Brook board of trustees.  It was mind blowingly well prepared. Their message was clear and simple: We believe that all young people have a right to;
  • sex and relationships education - the type that Brook does in every school 
  • young people friendly sexual health services we can get to within an hour 
  • get access to interactive help using digital platforms 24 hours a day
  • grow up in a sex positive environment that trusts and values them whatever their sexual or gender identity, and whatever choices they choose to make, and whatever their mistakes
  • more opportunities to be involved in participation, volunteering, social action and routes into meaningful, paid employment
They also wanted Brook to train parents so parents understood young people and their sexuality more, and are therefore more confident helping young people as they grow up. 

None of this sounds unreasonable to me.  It all sits within their rights the UK has committed to as set out in the in the United Nations Convention on the Rights of the Child ratified over 25 years ago.

Since Joshua and Lisa's presentation I have constantly had their voices in my head as I discuss different ideas, consider options, strategies and plans about Brook's priorities and participate in external policy and partnership meetings.  It is a helpful discipline to hold those voices in our heads along with increasingly rigorous priority testing - is what I am doing really really going to achieve any of those goals - set to us by our beneficiaries - quickly enough. 

Its too early for new years resolutions but I have made one already - try to identify traditional processes and systems that don't bring about change - where the process gets mistaken for the task - and find other ways to deliver on the objectives set to us by young people.

Doris Stokes said it was a privilege to have voices in her head.  I agree it is a privilege to have the voices of Lisa and Josh on behalf of their peers in my head. I am holding on to them.

On a final note, our teams across the country have been doing some excellent festive health promotion and condom promotion in their waiting rooms - using different colour condom packs to build Christmas Trees and Rudolph.  Its fun and a conversation starter - and young people have responded really well to it.  Without any intention to whatsoever we seem to have upset a few anti choice people and we have been described as anti-life. An odd and inaccurate assertion.

http://i100.independent.co.uk/article/people-are-getting-really-really-upset-over-this-condom-christmas-tree--xJMBRkGTde

Sunday, 30 November 2014

World AIDS Day - I am wearing the Red Ribbon as an urgent call for action

Last week was National HIV Prevention Week and it was thrilling to see so many posters about HIV testing on the tubes and across London. Tomorrow it is World AIDS Day - and this is one of those awareness days, amongst the many days, weeks and months that I am so glad exists. 

The energy behind it continues, and each year people use the day to raise awareness of HIV that is too often falling out of view and off the agenda. Great that we now expect to see red ribbons being worn routinely on X Factor.  It wasn't long ago we rejoiced that ITV had ensured that judges and performers alike showed their solidarity. There is some progress. Shame it was only Chuka Umunna on Question Time last week.  Maybe next year the Chair and other guests will too given I think we established last year it doesn't contravene some peculiar BBC rule. 

But behind the red ribbon, and the excellent work that will go on over the weekend and tomorrow in schools, youth clubs and communities across the UK, there are some startling and frightening facts.  Sex Education Forum research done last year told us that young people do not have the factual information they need about HIV.  Combine that with prejudice and stigma young gay men face and no wonder then that the number of new HIV Infections have doubled amongst young gay men 15 - 24 over the last decade AND almost tripled amongst young people aged 15 - 24 over a 14 year period. 

We will all wear the ribbon for our own personal reasons. Just having it on my jacket this week has made me think about some special people, happy times and some horribly sad times.  I am wearing the red ribbon this week in memory of my friends and colleagues who died too young, and in gratitude for all the agencies, activists and scientists who have made change that 20 years ago we simply couldn't have imagined.   

I will be wearing my red ribbon as an urgent reminder that; 

  1.  for every day decision makers and politicians procrastinate about making PSHE, with all of the SRE bits included, a statutory part of the school curriculum we fail children and young people
  2. for every financially driven cut to specialist prevention and services for young people and communities at higher risk of infection, it is a false economy and we must challenge that wherever and however we can.  


I also wear the red ribbon as an urgent call for moral and determined leadership and action from everyone within the health system to ensure HIV alongside contraception, abortion and sexually transmitted infections gets the resources and priority it needs and deserves. The fragmentation of commissioning, the failure to make PSHE statutory, and the lack of media and public outcry when the infection data was published gives 'serious cause for concern'. That is why World AIDS Day is important.  A day to reflect, to celebrate and to galvanise our determination to ensure action over the next 364 days before WAD 2015.   

----------------------------------
The blog below was published in October 2014

I will say it again new HIV Infections have almost doubled amongst 15 - 24 year olds. I read my briefing over breakfast this morning and I cannot quite describe the feeling in my stomach.  How can we, how can I, allow this to happen and how did this data - www.gov.uk/government/statistics/hiv-data-tables - slip out and go largely unreported this week.

Almost 20 years ago I was in the early stages of coming out. It was exciting, exhilarating and scary.  HIV featured heavily in my consciousness.  Shortly after graduating I started working at Cardiff AIDS Helpline, FPA Cymru and was part of the All Wales AIDS Network. We were resolute and determined to do all we could to prevent another generation experiencing the impact of HIV in their communities.  Against a backdrop of sustained investment in education and campaigning from successive governments (some campaigns better than others, but awareness campaigns nonetheless) we developed innovative and exciting outreach and education programmes, we helped open up conversations about sex and condoms in clubs, in parks, in schools and in youth clubs to educate young people about healthy sexuality, choices and protection.

At that time we could not have imagined the advances in drug treatment that have changed the lives and life expectancy of people living with HIV beyond recognition. I am so grateful to all the scientists and activists who have made that a reality.  And we also never imagined it would be possible - morally or ethically - for another generation of young people to grow up not learning about sex, health and protection in ways that are relevant and meaningful to them.  Ways that help them develop the confidence, inner skills and self belief to manage their relationships and choices well, and to help protect themselves against HIV.

Ofsted in 2002 reported that schools were not teaching about HIV, and the DfE commissioned Sex Education Forum and National Children's Bureau to produce a toolkit for Key Stage 1 - 4 - Teaching and Learning about HIV which you can find here - its 10 years old but the ideas remain good ones - health warning on some of the information though - it may be out of date so do check it. http://mesmac.co.uk/files/appendix-17-hiv-activitites.pdf

So in the prevailing decade since Ofsted found young people did not have good knowledge about HIV and the skills to protect themselves new infections have doubled. PSHE is still not statutory and Ofsted reports that in 40% of schools PSHE is not good enough. That is not a tenable position and we need step change so there is PSHE fit for the 21st Century. We know that homophobia is still rife within many schools, and that funding for targeted LGBT youth work is seen as a luxury and funding is being reduced in parts of the country- what a false economy.

We cannot allow another decade where the number of new infections amongst 15 - 24 year old gay men double so it was pleasing to hear Secretary of State for Education commit to tackling homophobic bullying in schools in her Conference Speech. I look forward to seeing action.

We also need all schools to be required to provide relevant Personal, Social and Health Education for all young people which will provide a solid base for all children and young people. Work like that of www.diversityrolemodels.org which take LGBT role models into school is an important contribution to promoting visibility of gay people. We also need targeted youth work such as Brook's LGBT youth group Work it Out which provides a safe space for young people as they explore and understand their developing sexuality.

And most of all we need visibility - last night i was at an event to celebrate the publication of Executive Diversity in the Financial Times - a list of the top 100 Executives and straight allies.  The founder Suki Sandhu reminded guests of the importance of visibility. If we are to prevent HIV amongst gay men we need to ensure visibility of gay men in schools, and we need to talk talk talk about HIV, about stigma, about infection rates and about homophobia and its impact.  In the public imagination it sometimes feels that HIV has all but become a thing of the past. This data is a big wake up call for all of us.

Saturday, 29 November 2014

Brook is 50

It has been a fairly hefty, fun and very stimulating week - In fact I now feel 50 too.  Monday started with chairing the Faculty Sexual and Reproductive Health governance working group; then two days of board and executive away days, our annual general meeting and Brook's 50th birthday party; panel member at the Charity Tech conference on social media, chairing a debate and seminar about young people and mental health, rounded off by Brook safeguarding training for senior decision makers and ending with an impromptu piece of short filming.

Board and Exec Meeting
A really helpful couple of days and so much thinking done, leading of course to how much more there is to do, particularly in the culture and commissioning environment we are in.  The Be Sex Positive volunteers (@besexpositive) had worked with one of the trustees, Pete Lawson, to think about what the 1 year olds of today would need as the 16 year olds of tomorrow and what Brook's priorities should be.  Joshua and Lisa facilitated an excellent discussion and represented young people excellently. There were some surprises - 3D printing machines for condoms (apparently you can make chocolate and make up...) and then the more familiar good SRE, people that like and trust young people as they experience at Brook, and accessible on and off line services. They made the moral and rights based case as well, if not better, than I have ever heard.  I was fantastically proud. And moved to (just a few) tears.

Brook's AGM and 50th birthday
In this archive interview with Helen Brook http://www.bbc.co.uk/podcasts/series/whnews/all
(available until 21st December 2014) she says Brook's first clinic was on a dark November evening.  Fitting then that Brook's AGM and 50th birthday should be too.

Brook supporters - i.e. people that like young people - are great to be around and so it was a real pleasure to see so many people who have been part of Brook over the last 50 years - from founding supporters through to people who had recently walked the Thames Path Challenge to raise money for us, our former trustees and our wonderful young volunteers.

At the AGM I reflected on some of the wide ranging achievements of the year including;

1. working directly with 277,000 young people in our education, clinical and support services
2. increasing the quality, quantity of participation/volunteering opportunities for young people
3. launching a new improved website (www.brook.org.uk)
4. relaunching our policies and procedures and a pioneering leadership and management programme
5. launching Supplementary Advice on SRE with the PSHE Association and Sex Education Forum
6. piloting and evaluating our 'My Life' work on emotional and mental health
7. working tirelessly to offer advice with the aim of influencing policy nationally and locally
8. bringing all Brook staff together in Manchester for the Being Brook celebration and training event

And much much more.  I know just how hard staff and volunteer teams work and the care with which they work with and for young people, but trying to put together a speech that summarised and captured the spirit of the full range of our work was, as ever, humbling.

Brook said goodbye to three board members this week - David Lock, Christine Townsend and Roger Gibson and welcomed three new board members Jo Youle, Leon Ward and Sue Ryrie.  Roger Gibson who has volunteered at Brook for over 20 years in a number of different roles was awarded an Honorary Life Membership of Brook. Vice Chair, Polly Goodwin confirmed to members that following a review process the board had reappointed Eve Martin as Chair for a second three year term.

Our treasurer, Alastair Bridges, gave an overview of our 2013/14 financial performance, emphasised the importance of the board investing well in our strategic priorities, and thanked staff for managing well within the resources available, finance team and our auditors, Saffrey Champness for all their work.

Business done after a short break we went into the 50th birthday celebrations.  I opened with an overview of some of the changes between 1964 and 2014, and a reminder that even though much had changed too many young people still tell us, as a poll we launched last week, confirmed  embarrassment can still be a barrier to accessing help and advice for many young people.

As a young people's organisation I believe deeply in ensuring we provide young people with platforms to talk from and shoulders to stand on, so it was right that some of the Be Sex Positive volunteers - Becky, Dan, Jodie, Brogan, Rebecca, Christian, George, Hayley and Duy - took on the evening from me and I didn't know what they had planned. Except someone had let on that I might be about to get my knowledge tested so I sat in the audience with an element of trepidation.

Choreographed beautifully young people told us - the 100 strong audience - time and again about how their confidence had grown, how Brook had helped them with their developing identity, how important it was to feel able to be them and to be valued for who they were, how Brook had provided countless opportunities to get involved and to give them opportunities and honest feedback to nurture their talents and strengths.

They also talked about how they wanted those young people that went behind them to have better sex and relationships education and access to all the services they need on and off line.  I got something in my eye again when one of the young people said (my paraphrase) 'I get the chance to be an expert at Brook and to have my views listened to. I have never had that before'. They tested the audiences knowledge with a true or false quiz (it would be fair to say as a collective the education was needed) and finally they set Brook a challenge to continue growing the young people's participation and volunteering pathways through to employment.  A challenge we recognise, accept and will continue working on with my personal commitment to it.  

Each of the group talked about what they were most proud of during their time participating and volunteering at Brook.  One of the young people Rebecca had been involved in the Good Sex Knowledge Exchange Project and had been part of the re-animating data process.  She had read Indiah's story which you can see here https://goodsexproject.wordpress.com/good-sex-the-film/ (I encourage you to look through the blog and all the films. Brilliant footage which can be used as materials and excellent learning).

Jules Hillier, deputy CEO had a hard act to follow and did it well.  She launched the new Brook friends scheme www.brook.org.uk/friends - please do become a friend if you can and closed the evening with a quote from a young woman who gave permission for her story to be told

“Brook has helped me to grow as a person. They have enabled me to conquer my fears, boost my confidence and literately saved my life. Without the help of Brook and the amazing work they do I don't think I would be here today. Before coming to Brook I was in a very negative place suffering from bouts of depression and was ultimately vulnerable to the outside world… Without the encouragement from Brook and the support I received I would never have dreamed of achieving so much and helping to follow in Brook’s footsteps and help those young people out there who need it just as I did. Without Brook I don't know where I would be.”

A film from the event will be available soon, in the meantime here is a storify https://storify.com/BrookCharity/our-50th-birthday-celebration

It has been a privilege and a pleasure to be part of the journey for the last 8 or so years. Thank you to everyone who works tirelessly for and with young people from a position of trusting them and liking them and seeking to protect and empower them.  Thank you to our moral and financial supporters and collaborators. Particular thanks to my team who organised the event and to Thomson Reuters for providing us with the venue.