early intervention - service delivery models and resilience lisa williams commissioning support lead...
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Early Intervention- Service delivery models
and resilience
Lisa Williams
Commissioning Support Lead
YoungMinds
ABOUT YOUNGMINDS UK’s leading charity for children and young
people’s mental health and wellbeing since 1993 National Campaigns – VIK, YoungMinds Vs
(23,000 individual supporters) Training – run training courses for
commissioners, professionals, parents and youth workers all over the UK – 6,700 individuals trained over 237 days
Parent Helpline – provides support to 12,000 parents and families
Provide research, consultation and engagement work with parents, families and young people for public sector bodies
TODAY
What YP say about mental health pressure and services
Challenges in implementing the Future in Mind vision for CYP mental health
Thinking about service delivery models and approaches
Where does resilience fit in?
YOUNG PEOPLE’S LIVES TODAY
• Sexual pressure• Technology• Bullying• Body image
Stats from YoungMinds survey of 2,000 11-25 year olds, 2013
• Poverty• Cuts to services • Family breakdown • Unemployment• School pressures
Find us, please, we need support before we lose
who we are.
Young Carer, 2014, YoungMinds Taskforce Report
PREVENTION & EARLY INTERVENTION
Friends 64% (1)
Online mental health app or website 63% (2)
Social media 63% (3)
Parents or other family members 56% (4)
From a mental health support service I used 54% (5)
N=967
Where do you go for information about mental health?
You know as well, you know what I was worried about? I thought if they find out [that
I’ve used a mental health information website] they're going to think I'm nuts and they're
going to lock me up. And that's what, it deters you more even though.
PREVENTION & EARLY INTERVENTION
• School teachers should be more able to recognise signs a young person is struggling and help them access support
• Schools need a clear point of contact for pupils to approach for help with their mental health
• When pupils are struggling, they should easily be able to access help within school.
When I got ill at school they treated it as a behavioural issue so I was formally suspended
twice to things related to my mental health when in reality I didn’t actually need to be
punished for it, I needed someone to help me, which they didn’t do.
CAMHS user, 2014, YoungMinds Taskforce Report
Young people found the most helpful schools-based interventions to be (n=904): 1. Counselling2. Lessons about MH delivered by
outside experts3. Online information4. Peer mentoring
POLICY CONTEXT - FUTURE IN MIND 2015
‘Children’s mental health services are stuck in the dark ages’ Norman Lamb, Minister for Care and Support (2014)
Report sets out an ambition for the transformation of CYP mental health services
Additional £1.25 billion funding over 5 years announced
Five key themes including ‘Promoting resilience, prevention and early intervention’
CHALLENGES
Funding – stability/good ideas lost or reinvented; current cuts
Changes of policy emphasis Fragmented system – commissioning;
delivery; experience e.g. transition Physical vs mental health status Prevention and EI - Who pays for what? CYP vs adult mental health status Large provider trusts
10th floor CAMHS
Children’s services street
Large provider trusts……and local community practice
Mental health ‘expertise’
Mental health expertise
Service ‘tiers’ 1 4
ACCESS to CYP
Access
Service ‘tiers’ 1 4
Future in Mind
Mental health expertise
Service ‘tiers’ 1 4
Access
.…Primary MH Worker model
Future in Mind
Mental health expertise
Service ‘tiers’ 1 4
Access
Whole system change
CAMHS
School
HOW DO WE ACHIEVE WHOLE SYSTEM CHANGE?
1. Elements – people and orgs – behaviour,
knowledge
3. Purpose – values, culture,
permission/mandate
2, Relationships – pathways, info, how we and orgs relate
WHAT DO CYP&F WANT THE SYSTEM TO DO?
Be friendly, warm and respectful Work better together Spot problems sooner Know where to go for help Respond to CYP needs not make CYP fit
in to the service Maximise impact through evidence
based approaches… and asking me
HEADSTART Big Lottery Funded 2013- 2021. 3 phases - £75m. Currently 12 local
partnerships Aims to improve the mental well-being of
at-risk 10 to 16 year-olds Cross-disciplinary, multi-layered and
integrated prevention strategy inc. digital; co-production
Preventing mental health problems through building resilience
Whole system change Ecological approach
BRONFENBRENNERS ECOLOGICAL MODEL
BUILDING RESILIENCE
Building assets in child and close environment – for now and the future
Who walks alongside the child or young person through the system?
How can we help them navigate their way to resources?
Are resources culturally appropriate? By resources – we don’t just mean
services!
MENTAL HEALTH SERVICES
Picking out the river
downstream
Specialist services
Prevention Earlier intervention
Stopping CYP falling in the river
Getting help
quicker
Resilience - children enabled to swim
OVERLAPS Resilience research evidence of what works and what CYP say they want….. Better able to manage when times get tough Someone to depend on over time who is enabled to help
them Problem solving skills Be themselves – free from stigma Help with the basics – transport, safe places, enough to
eat Sense of belonging Sense of control – participate, responsibility Develop and maintain good relationships – manage
feelings Positive activity – build on talents/interests Sense of purpose, hope for the future
RISK AND PROTECTIVE FACTORS
Risk FactorsProtective
Factors
What can the adults around CYP do?
ACADEMIC RESILIENCE: OUR DEFINITION
Academic resilience means students achieving good educational outcomes despite adversity.
For schools, promoting it involves strategic planning and detailed practice involving the whole school community to help vulnerable pupils do better than their circumstances might have predicted.
Strategy and leadership
Systems and structure
Parents and community
Pupils and staff
School culture
Academic resilience - a vehicle for culture change
“Our school’s work on Academic Resilience has begun a transformation. .. The work has opened a door that allows staff to genuinely care and nurture …It gave us “permission”. We are now designing and implementing systems that really support the “whole person .”
Mark Taylor, Dep. Head and lead for the project
SUMMARY
CYP and parent/carers turn to friends, families and the internet when times get tough
Next they look to adults in the system they know – school, professionals
In helping processes – how can we maximise resources (not just access to services) and elevate the status of the things that matter to CYP?
Using a ‘resilience lens’ in practice - assessing assets and building them, whilst we are visiting CYP lives
CONTACTS AND WEBSITES
Lisa Williams, Commissioning Support Lead. Email;[email protected]
Websites;www.youngminds.org.uk
www.boingboing.org.uk
Resources and information available on;
http://www.youngminds.org.uk/training_services/academic_resilience