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127 SEPTEMBER 2009
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Balance of Power: Making sure Youths are Seen and Heard

CeCelia Nation and Lauren Stevenson

A young woman discovers that youths can make themselves heard, and that they can change the way adult professionals view them.

In the fall of 2000 I was invited, along with 10 other young people, to be a youth representative at a major national conference on children's mental health. I traveled with my mom from Alaska to Washington, D.C., and I was excited when we met other youths and families who were participating “they came from all over the country and represented many different perspectives. I headed into the experience feeling very privileged. I saw it as an honor for me and these other young people to be invited to share our ideas and assist in making a national agenda for children's mental health. I did not yet know what was in store for me.

After a welcome dinner the first evening, we were taken through some guided activities. One of the activities – the “mirror exercise” – sticks in my mind because it seemed to capture what was at the heart of the experience I had at the conference, an experience with the dynamics of power.

The mirror exercise
During the mirror exercise, our facilitator asked us to find a partner we hadn’t known before arriving at the conference, and to agree about which one of us would be partner “A” and which one of us would be partner “B.” I partnered with one of the adults in the room. Our facilitator then gave us the following instructions: Stand face-to face with your partner. A's, move slowly in whatever way you would like. B's, physically mirror your partners” activities as closely as you can. She then had us switch places: leaders became followers and vice versa.

This part of the exercise was pretty easy. Most of us are used to situations where one person leads and another person follows. I realized, though, that I was more used to following, especially to following an adult. I was used to having adults tell me what to do. I was not used to telling adults what to do, however, and I felt very uncomfortable when the roles were switched and I was supposed to be leading the adult.

For the last part of the exercise we were asked to continue moving but not to have either person as the leader. This part of the exercise was really hard. When we both had to lead, I didn’t know what to do. We took turns, but you could tell when people were going off on their own. What was hard was that you had to pay attention more. You couldn’t go off and do your own thing or let others go off and do theirs. No one had the power or the control: We had to work together. But we didn’t quite know how to do that. When no one was supposed to take control, everyone sort of sighed, like “how do we move, then?” It takes a lot more effort, effort from both sides, to share the lead and work together. When I talked to the facilitator about this later, she had a great explanation. Our facilitator was Lauren Stevenson, and I asked her to write her explanation out for this article:

Most of us are unaccustomed to working in the dynamic represented in the second part of the mirror exercise “where the lead or power is shared. We are generally more familiar with a unilateral power dynamic, where one person has the power and leads while the other person follows, as represented in the first two parts of this exercise. The unilateral power dynamic is something most of us are introduced to, and become enmeshed in, as children. Adults, after all, have power that children do not. Adults can drive; they can vote; they have money; they have legal rights (of their own and over youth); they have control; they are physically bigger; and they have rights over the home or property. Youth are, in this arrangement, the non power group. Youth are often kept in this position by adults who tell them that they are “too young,” that they “wouldn’t understand,” that “someday they’ll know what it’s like,” or that their opinions “don’t matter” This power dynamic too often leads to youth being denied power and control over their own lives, and to the experience of young people being negated.

One of the reasons I was at this conference was that I was hoping to be heard. I was hoping I might have some say for myself and maybe for other young people, and that what I said might have a useful effect on the mental health services that are provided to us. I had ideas I really wanted to share with the people who could make a difference, but this turned out not to be so easy to manage. Sure, youth representatives had been invited to the conference, but the adults who had invited us had done it without an awareness of their own power in the situation and without a way of sharing that power with us and making sure we were included and heard. The conference was simply not designed in a way that really would allow us to contribute.

Seen, not heard
On the first day of the conference I was exhausted from travel and from a four-hour time difference, but I was excited. Lots of people were there to discuss children's mental health; there were a lot of suits and ties. I didn’t understand much of what they were talking about; a lot of it was statistics stuff “numbers, numbers, numbers. The speakers didn’t seem like they had their hearts in what they were saying. It didn’t seem like some of them even wanted to be there.

In the afternoon we separated into break-out groups. There were about 15 or 20 people in my group. We stayed in the main conference room with one other group across from us. There were a few long tables set up in such a way that you couldn’t really see who was there. Our task was to come up with a list of barriers to successful mental health services for children, and ways to remove those barriers. Doctors, professors, and other professionals were in the group. My mom and I and one other woman were the only family members there. I expected that everyone would be interested in what the three of us had to say since we were the ones they were providing services to, but they weren’t. These professionals seemed to feel no need to hear from the consumers of their services, because they had all the answers from their years of experience in providing services. My mother and I had a lot to say about the current services available for children, but we were pushed aside. There were three professionals in the group who did almost all of the talking. They cut people off. They cut us off and didn’t let us speak. They were really focused on the way things were, and not so much on coming up with new ideas. They argued about tiny differences in the meanings of words. I got upset that they weren’t listening to us. It didn’t feel like there was any reason for me to be there. I didn’t feel like listening to them argue. I was furious. Even more, I was hurt because I thought we had been invited to share ideas with these people, to talk about what was not working with their services and to come up with ideas, together, to help them provide better services. But now I felt as though we, the young people and families, had been invited only to sit quietly and allow the professionals to look good for having us there.

I went to the youth room and spoke to the youth advocate, Lauren Stevenson, and to a parent advocate who was there. I was really emotional and upset. Another young person and his mother came in and said that they were also being ignored and that it was ridiculous for them to be there. They were upset too. Before long the whole group of youth representatives came in. We talked about what we should do. They all shared similar stories. We decided that we should go back to our groups eventually, but that if we were really going to be heard, we should begin by working together. We started our own break-out group. We knew that each of the other groups was writing a statement to be read at the end of the conference, so we began working on our own.

Speaking out
The energy had been low, because of everyone’s experience in their groups, but as we started talking about what we’d do and say, the energy went way up. I was kind of scared because it was only us doing it and we didn’t want to mess up, but I was excited, too, because I knew we’d be able to say what we wanted to say. We went through the questions that were given to the break-out groups about the barriers to our mental health services and what works and doesn’t work. We were each able to say what we thought. But we still faced the problem of how we would get ourselves heard. Again, we didn’t have the power.

All the other groups would be presenting their views onstage. How would we get people to hear us and to take us seriously? Lauren and a group of adults at the conference (family advocates, youth coordinators, conference organizers, and government officials, among others) acted as our allies. They helped us work toward our goal and get access to the necessary power and resources. They allowed us the time and space to meet with our own group. They helped us organize thoughts and get them written down. They gave us skills to prepare us to go back to our other groups and be heard more effectively, and they spoke to the facilitators of the other groups to make sure that they had the skills and understanding to better include us and the other family members the next time the break-out groups met. Most important, they helped to get us onstage, where we would have a chance to offer our opinions, just like everyone else.

I spoke with Lauren Stevenson a little more about all this. We talked about how this experience showed that adults could share their power with young people and that, as she put it, “young people who empower themselves can effect extraordinary positive change in their lives.” We (the young people) had expertise, we worked hard, and we were prepared and articulate, but without having adult allies working with us we would not have been as effective as we finally turned out to be. As Lauren explains it:

Adults working with young people, even when they have the best of intentions, often forget to acknowledge the power dynamic that exists between youth and adults. We cannot afford to ignore the power adults have. Adults must learn how to share their power and build alliances with young people. As allies, adults can link young people to resources that they might not otherwise have access to that will help them make themselves heard, empower themselves, and make positive changes in their lives. As young people empower themselves, they will begin to conquer the hopelessness and helplessness that so often results from powerlessness. It is crucial that adults act as allies to young people and find ways to share power and resources.

Later that day I went onstage with the reporters from all the other groups, in front of hundreds of people, ready to deliver the youth statement our group had been working hard to polish. I was really nervous. I knew everyone was surprised that we had done our own thing. They hadn’t expected our innovation, and I kind of expected them to blow us off again. But it wasn’t like that at all. Not only did we get to say what we wanted to say, but the audience really responded. We got a standing ovation. It really seemed like they heard. A lot of people came up to me afterward. One woman told me she’d seen grown men crying. The leader of the conference, a very important federal official, told me how impressed he was and asked for a copy of the statement (Table 1). People seemed amazed that we could come up with something like that. One of the three professionals who had dominated my first breakout group came up to me and apologized for not listening.

Table 1


Written by 11 Youths from Grant Communities of the Comprehensive Community Mental Health Services for Children and Their Families Program

Presented by CeCelia Nation, age 17

We are young but need to be treated as human beings and not as a problem or a disorder. We are prototypes, not to be treated as stereotypes.

  • School officials and health care providers must be trained to recognize and understand mental illness and its effects on us. The ignorance of the people who don’t understand hurts us. For example:

  • Sometimes teachers who don’t understand that mental illness is not just a behavior problem say that we “choose” to act that way.

    Some professionals only take or only have a few minutes to deliver a diagnosis and figure the whole thing out.

  • People who are supposed to be helping end up hurting us because they are not prepared and their training and our lives have not been made a priority. They contribute to the stigma of mental illness, which is perhaps one of the biggest barriers to our service. It hurts even more when a doctor or teacher rejects you than when a peer does.

  • Now, I’m sure many of you are thinking that you would never do this to us, or that you are not ignorant in this way, so its not your concern. We tell you from our own experience of the professionals out there who are ignorant in this way that it is your concern “because it’s not going to change unless the system changes. And at least we hope that system change is why you are all here.

  • Too often, once we get services (after fighting for them, or hitting a breaking point, or waiting on a waiting list for months), our services are hurried and disrespectful, and they don’t respond to who we are as people, who we are in the context of our families and communities, and who we will one day become. Let’s not forget that a lot of this is about who we will become and whether or not we will be able to dream and achieve our dreams.

  • Young people will live up to or down to the expectations of adults, teachers, and professionals in their environment. Providers and systems must highly value and expect the best from us.

  • We need early prevention, better training for our parents, teachers, and other professionals, and more awareness about mental health so that youth with mental health issues are not stigmatized and thrown away.

  • We need systems that can and do work together. Families, schools, and healthcare providers must collaborate in a collective effort to mobilize and train our communities to work together.

  • We need accountability with checks and balances.

  • Services” goals should be developed by youth and families “before services are delivered.

  • Services must be evaluated according to how these goals are achieved. For example:

  • Has the provider established a connection with us that we can trust?

    Are we being treated like an ordinary person rather than a disability?

  • You can do all the research you want, but if you forget who we are and what we need as people, and if you don’t respond to our needs in the system and in our individual treatment, you will fail, the system will fail, and we will bear the burden as we do now. You must include youth, bring us to the table, and when we show up, you must listen.

  • Response
    The theme of youth involvement caught on like wildfire and took over the final part of the conference, which was an open-mike, town-meeting-style forum. Almost everyone who came to the mike spoke about young people. We had been heard, and you could feel the perspective in the room shifting. I think that we really reminded people why they were there and that they needed to be thinking about the young people they would be serving when they headed back home. It seemed they’d really gotten the message we’d sent, which included these words: “You can do all the research you want, but if you forget who we are and what we need as people, and if you don’t respond to our needs ... you will fail, the system will fail, and we will bear the burden as we do now. You must include youth, bring us to the table, and when we show up, you must LISTEN.”

    Later, after the conference, the federal official who had asked for our statement asked us to review his statement before he testified before Congress. He wanted to make sure that our opinions were included properly.

    It felt great. It felt like we had created a revolution.

    This feature: Nation, C. and Stevenson, L. (2001). Balance of power: Making sure youths are seen and heard. Reaching Today’s Youth, 5, 3. pp. 5-8.

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