Charlie Howard

Ashoka Fellow
United Kingdom,
Fellow Since 2013


This profile was prepared when Charlie Howard was elected to the Ashoka Fellowship in 2013.
The New Idea
Charlie is transforming mental health delivery for the most marginalized young people, bringing “street therapy” to where they are, when they need it. Charlie founded MAC-UK to take mental health work out of the clinic and into the context of young gang members’ daily lives. Her team of mental health and youth workers remove the stigma and logistical obstacles around seeking help, with young people deciding when, where and for how long they would like to meet. Street therapy can take place in stairwells, at a bus stop, or while a young person is waiting to be seen in court. In this way Charlie is making mental healthcare accessible to deprived young people who are most in need of support but least likely to access it.

Unlike other mental health services MAC-UK does not take any referrals from professionals such as doctors or social workers. Instead young gang members who are involved in crime and highly antisocial behavior and who suffer from poor mental well-being self-refer. These young people have a history of non-engagement with services but join because they are given the opportunity to invent and run a project they find interesting, whether that might be setting up a boxing club or writing and recording music. MAC-UK staff work collaboratively with the young people on their chosen project, helping them to develop leadership and employment skills. By using youth led activities as tools to successfully engage young people aged 16 to 25, Charlie has found a mechanism to build trusting relationships with gang members over time. At their own pace they then peel off into one-on-one street therapy sessions in their local area. Through this highly flexible model, Charlie is transforming mental health delivery, working intensively for up to three years with the 5 percent of young people who commit 50 percent of youth crime.

Instead of just focusing on expanding the delivery reach of MAC-UK itself, Charlie’s long-term strategy is to fundamentally change the way mental health services are delivered to the most marginalized young people. In fact, Charlie’s aim is to shut down MAC-UK’s direct delivery work within ten years once her model has been adopted by mainstream mental health services. To this end, she has evolved street therapy into a multistakeholder model called Integrate. Here, Charlie unites the various statutory bodies that are falling short of their aims to engage young offenders and reduce youth crime, and creates a more effective multiagency team that delivers MAC-UK’s model locally.
The Problem
The Strategy
The Person

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