childrens mental health and emotional...
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Childrens Mental Health and
Emotional Wellbeing
An Overview: Local, Regional &
National perspectives.
£31million afforded to Childrens emotional wellbeing and mental health – 0.8% of the overall mental health budget – attributes to £45 per young person, £163 per adult.
50% mental health problems emerge by age14 years,75% emerge by 18years.
1:5 Adults - 45,000 children affected by mental illness at any one time in NI.
1:4 children live in poverty in NI.
19% increase in suicide since 2014 – disproportionately higher rates suicide U18 in NI.
Legacy of conflict – generational trauma.
Childrens Mental Health – NI
Context
Reform NI last decade guided by Bamford Review 2009-11 and
2012-15.
Calls for new 10 year mental health strategy for NI mental health
champion to promote.
Overarching policies Programme for Government 2016 –
2021;Making Life Better2012-2023(NI public health
framework);Transforming Your Care 2011;Direction for HSC in
NI health & Wellbeing 2026
Protect life2 Suicide Strategy
Mental Health Reform
Western Trust CAMHS -
challenges
Trust has undertaken a demand/capacity analysis for CAMHS based
on CAPA model.
Demand outweighs current capacity, increasing delays in accessing
Service.
Referral rates continue to rise 2016/17 increase 10%, 2017/18
increase 12%, 2018/2019 increase 36% - no additional funding.
Acknowledgment by HSCB of rising referral rates - commitment to
make case for additional funding
Complexity and intervention pathways for children known to the service
has expanded placing multifactorial demands on the service.
Reduction in step 2 Services
Recruitment and retention challenges for the Service – Specialist Area
CAMHS – actions to date
Implementation of Service transformation Model – CAPA
Comprehensive recovery plan in place / Data Quality Project / Youthlife
contract
Establishment SPOE / Referral Coordinator post
Establishment CAMHS Crisis Assessment Team
Recruitment to vacant posts successful – requiring significant
induction, mentoring and supervision
Implementation Quality Outcome Measures/Coproduction
Training to all GP practices in Western trust area/ regional stepped
care pathway -
Evidence based therapeutic modalities
Draft Action Plan – in response to NICCY ‘still waiting’ – A rights
based review of mental health services & support for young
people in NI.
8 key themes identified for action.
Inter-Departmental Project Board-
Established 2019
Clear governance structures for the development of CAMHS.
Full implementation of the CAMHS data set – Quality data to support strategic planning & decision making.
Progression of the prevalence study on child & adolescent mental health.
Sustainable investment in CAMHS is fundamental.
(Recurrent funding has been secured through demography and inescapable pressures).
Western Trust CAMHS – appointment of Mental Health Transitions worker being progressed currently.
1. Working Effectively &
Collaboratively
Full implementation of the CAMHS Data Set
(close monitoring of referrals and acceptance rate – regional acceptance rate 80%). Development of tracking methodology of referrals not accepted being progressed.
Full implementation of the regional CAMHS Stepped Care pathway.
Development of MHLS 16 plus acute care pathway.
Self harm Intervention Programme (SHIP) - regular monitoring of referrals.
Primary Care MDT teams – Mental health practitioner attached Gppractice.
Child Friendly Information – Western Trust CAMHS ‘Think about These’ booklet and DVD co-produced YOPIC & Health Promotion Agency.
2. Accessing Help
Mental Health Training for all people who work with Young
people.
Western CAMHS – training programme rolled out to all GP
practices Trust wide 2018/2019 by Primary Mental Health
Service (Step 2).
Primary Care MDT with a Mental Health Practitioner attached ( 5
of the 17 GP federation areas)
Progression of the Childrens Emotional Health and Wellbeing
Framework.
3. Supporting Adults working with
Children and Young People
Greater range of community based mental health support.
Self help support/social media/App.
Prescribing data.
Psychological Therapies Strategy.
The progression of 4 regional PICU beds Beechcroft Inpatient
unit.
Implementation & monitoring of minimum care standards of YP
presenting to ED with mental health concerns.
4. Specialist Support
Clear transition pathway arrangements in place, Western Trust
CAMHS/AMH complaint with NICE transition arrangements.
Recent Regional Transition workshop- Western Trust transition
pathway example of best practice – Regional transitions protocol
being progressed in all Trust areas.
5. Transitions
Production of Child friendly leaflets/DVDs.
Clear procedures with regards to Complaints.
Evidence based treatments in line with NICE guidelines.
6. Flexible Treatment Options
The education of children and young people about their
emotional wellbeing as part of the curriculum.
Childrens Emotional and Wellbeing Framework.
Adverse Childhood Experiences (ACE) – Trauma informed
schools.
CAMHS progressing pilot projects currently with local primary
schools.
Early Intervention projects.
7.Mental Health Awareness &
Understanding
Equal access for young people with a learning disability to
services and support.
Single Point of Entry (SPOE)
Access to address co- occurring mental health and drug /alcohol
problems.
Looked After Children.
8. Young people with additional
Needs
Historically physical health services have diverted resources
away from mental health services.
2012 UK Government commitment to halt this bias legislation in
place to ensure commissioning of appropriate physical and
mental health Services.
‘Achieving Better Access to Mental Health Services by 2020’
pathway and additional spending kick start change ‘parity of
esteem’
Estimated Mental health problems cost the country £100billion
each year.
Relevant Initiatives in other
Jurisdictions - England
Scotland’s Mental Health Strategy prioritised stigma and
discrimination
2016 saw the investment of £4.5million in 3 year anti-stigma and
discrimination national programme building on the ‘see me’
campaign
National mental health strategy 2012-2015
Scotland
‘Together for mental health’ – 3 year delivery plan 2016-2019
has been developed to embed the requirements of the ‘Social
Services & wellbeing (Wales) Act 2014.
Wales
Connecting for Life: Irelands national strategy to reduce suicide
2015- 2020. New strategic framework addressing the issues of
suicide in Ireland for the period 2015-2020.
Systematic evaluation on the progress of interventions will be
ongoing in order to refine the best approaches on a national
level.
Republic Of Ireland