How Digital can Support

System ChangeElaine Bousfield, Founder & Director – XenZone

Dr. Phil Ferreira-Lay, Clinical Director and Consultant Child Psychiatrist - Surrey and Borders NHS Trust

15th September 2016

The Beginning

• It all began with the Samaritans in 1999

• XenZone started to deliver counselling online to men – dial up modem

• Within 18 months, 35% of traffic were young people aged 18 and under

• PCT

• 3 high schools

• Consultation with young people –how do you want your services delivered?

Today

• Kooth is in 32 areas across England and Wales and growing

• Between Jan –May 2016, we had over 20,000 new users

• The service currently has 99,241 registered users

• Every year our team of counsellors and emotional wellbeing practitioners deliver thousands of chat sessions, message sessions and moderate thousands of forums

New Kooth web app

The challenge facing us in the UK

• How to increase access

• Getting the interventions right for the CYP

• Defining what we mean by mental health, emotional wellbeing and mental illness – what we do where

• Properly involving CYP in service design and learning

• Finances - what to spend money on

• NHS and Social Care

What have we learned?

Online counselling widens access

Online services widen access

• Future in Mind – making it easier for CYP to get the help they need at the time they need it

• Proportional numbers of BAME -14% - in f2f its around 7%

• How you do it is important – a drop in facility rather than appointment only

• Open access with assessment -11-25 age range

• Widen access upstream but further down as well if designed well (more to come)

Forums and peer support enable coping

Articles

Newsfeed

Community, participation and communication

is key

• Provide self-help, peer support – live forums where CYP talk about a range of issues – learn from CYP digital pressures and resilience

• Popular on Kooth are the forums and magazine and live moderated discussions

• Building of an Ambassador Programme -offline and online

Stepped Care Approach

You can’t run digital services in CYP in isolation

• System wide approach – ‘nobody said it was easy’ but the embrace has arrived

• Online services need excellent clinical staff, governance, safeguarding, multi-disciplinary team and case notes system

• Digital can be a key

• Digital needs to be joined with the wider system of support and integrated with the NHS

• CAMHs in Surrey re-tendered last year

• SABP Incumbent provider but took nothing for granted

• Substantial increase in funding –with a substantial increase in service

• Included completely new Behaviour and Neurodevelopmental Service

• Expectation that there is ‘no wrong door’

• Single Point of Access - CAMHs One Stop

• All of this within an 18 week mobilisation

• Live on 1st April 2016

Wellbeing and Resilience Pathway

• These will be available across all pathways as early support and as a step-down from targeted/community CAMHS; every CYP discharged will have a wellbeing and resilience action plan to help sustain recovery and prevent re-referral. These services include:

• Guided self-help and support materials – digital (CAMHS website and kooth.com) and paper-based

• Primary Mental Health Workers (PMHW) – supporting CYP and professionals in the community and in schools

• Voluntary Sector Counselling/peer mentoring and schools education and resilience programmes

• Kooth.com – online counselling – out of hours, no stigma –IP work alongside PMHT

• Parental support

Change of Focus

• SABP are Prime Provider – entered into a series of subcontracts with partners

• Activity and outcomes are therefore aggregated to contribute to overall contract performance

• Ranges from straightforward triage to a partner by our One Stop or a very quick appointment straight into clinic or face to face counselling partner

• CYP self refer to kooth – or referred by One Stop

How our partnership will feel different and

provide better services

• Convenience

• Choice

• Help and support

• Transparency

• Flexibility and responsiveness

What is Different

• ' CAMHS One Stop' - Referral & Information Centre for all referrals, which will

navigate children and young people to the most appropriate service and through the system

• A “no wrong door” i.e. all children, young people and families will be supported to find the right help at the right time

• The threshold criteria for acceptance into CAMHS will be lowered and volumes are expected to increase significantly

• Expanded operating hours 8am-8pm Monday to Friday and 9-12 on Saturday

• Services will be made more accessible and user friendly through convenient locations and online services open to 10pm seven days a week

• Automated clinical scheduling will ensure capacity, appointments and room availability is transparent and easier to manage

• Many other current CAMHS pathways will be enhanced

• Continued work with CAMHS Youth Advisors and development of an employment pathway for young people.

Questions?

Visit our market stall

Elaine BousfieldFounder & Director - XenZoneelaine@xenzone.com

Dr. Phil Ferreira-LayClinical Director and Consultant Child PsychiatristPhil.ferreira-lay@sabp.nhs.uk