Transformation plans for children and young people’s mental health services

Improved and expanded mental health services for children and young people across Norfolk and Waveney are in the pipeline.

The NHS is planning to invest an extra £1.9m million per year in Norfolk and Waveney to transform access and support for children and adolescent’s mental health services (CAMHS). It is part of a national funding pledge that is recurrent – meaning the new money will be made available year after year.

The funding will bring more specialist mental health workers, improvement of existing services and building new services across both the NHS and voluntary sector. The planned transformation will also enable specialist workers to support schools and colleges with young people who have emerging mental health concerns as well as improving on-line support for children and their families.

The plans have been worked on for months by the Norfolk CAMHS Strategic Partnership, consisting of NHS Clinical Commissioning Groups, Norfolk County Council, Norfolk and Suffolk NHS Trust, Ormiston Families and other providers and patient groups.

Clive Rennie, from the mental health commissioning team said: “This is really good news for Norfolk & Waveney. In particular this is great news for young people with eating disorders.

“Our plans are ambitious and it will be challenging to deliver everything we aspire to. But there is a commitment from all of us in health and our partner organisations to make some vital improvements for our young people.”

“We are really excited at the prospect of re-shaping pathways of treatment and care for children and young people. We know if we intervene earlier in the course of a mental health problem, the chances of children and young people recovering and staying well are much higher.

“In particular, both locally and nationally we’ve seen an exponential increase in demand for specialist Eating Disorders teams over recent years and resources have been stretched. The increased capacity this funding will pay for should lead to shorter waiting times and a more responsive service that is able to intervene earlier and more intensively.”

In Norfolk we want 80% of children and young people to be seen within 8 weeks of being referred to our mental health services – whereas the national standard is 18 weeks.

Mr Rennie stressed in particular, recruiting to the range of new posts proposed will be challenging. There is a national shortage of qualified mental health staff. Norfolk & Waveney will be competing to recruit good staff with all the other areas in England that have also been allocated additional funding. The CAMHS partners are working closely to attract good staff to the area and to explore ways of developing local staff.

Brian Watkins, Chair of the Norfolk Health and Wellbeing Board, said: “This additional funding is crucial if we are to ensure that there is the right support for children and young people in the right places in the county.

“We now have a clear plan on where this money can best be spent, developed in consultation with young people themselves. New and improved services will support children and young people with a whole spectrum of needs, including those seeking their own help via online support and requiring specialist crisis support out of hours.

“A key element is work to eliminate the stigma that can still exist around mental health because we want children to feel they can speak out and seek the help they need to live happy and healthy lives.”

The plans will take many months or even a few years to fully deliver. They have been approved by NHS England, which released the additional funding required for 2015/16, with further funding planned in future financial years.

Some money has already been invested – in advance of this national funding - to recruit more staff to help children who have eating disorders.

A local transformation plan plan covers four key areas which were identified both by experts and by children and young people in Norfolk who took part in a major consultation programme. 

They are:

Early Help and Prevention

What we know:         

There is a rich supply of providers and services in Norfolk and Waveney, some of whom are nationally recognised - the plan sees them working together to harness their power and skills for the good of young people.

Young people themselves have told us:

They want better information and emotional wellbeing support in school, that is accessed fast and is non-stigmatising. They would like more places to access support at convenient times where mental health is one of a range of services provided. They think self-referral is important and it would be good to have peer support to the right person to help. They want to see help in place to reduce isolation, exam stress and anxiety.

Plans include:

  • Every school and other setting where children’s services are offered should have a named ‘lead’ with identified time for emotional well-being and mental health. Every setting will have access to a specialist, who will support them, promote the mental health services available, share good practice and ensure joined up working with other services such as school nurses, safer schools and the healthy child programme.
  • Core training for practitioners in universal settings that is coordinated centrally and includes evidence-based emotional literacy and attachment training.
  • Promoting the “Time to Change” anti-stigma campaign. Children and young people will be involved in its design and delivery.

 

Making access to services easier and equitable

What we know:

Referrals to mental health teams for 0-18 year olds are increasing significantly, which is stretching resources. It can be hard to find out how to get advice, support or treatment. The partners want to improve mental health services for children in care, for those who have been abused and for those who display sexually inappropriate or harmful behaviours.

Young people have told us:

They want one-stop shops where mental health is one of a range of services provided, including ‘virtual’ one-stop shops that provide outreach across the county. They want services to be open outside school and college hours. They want to be protected from abuse and harm.

Plans include:

  • A single point of contact in Norfolk

  • Online platforms for self-help

  • More capacity in existing services and more integrated working by providers including co-locating staff

  • Better communications so families know what is on offer and how to access services

  • More training for staff so services are even more effective.

Eating Disorders

What we know:

The Care Quality Commission and our own self-assessment tell us that we are doing a good job on eating disorders but that provision is very small considering the number of referrals we receive – in line with the national average, referrals are increasing year on year. We know that it’s a complex system and a large challenge to ensure that services are consistent across Norfolk, but also take into account local arrangements. We want the capacity to work on early intervention services that would help recovery.

What young people have told us:

They would like more support in schools, be able to self-refer, get advice from other young people who have been through similar problems

Plans include:

  • Recruiting more staff and parent support workers.
  • Planning for community based services and improve online support offered online.
  • Considering how colleagues in the voluntary sector can play a bigger role.
Help for when children are in “crisis”

What we know:

Specialist assessment and support for children and young people in crisis is very limited, in and out of hours. There are a growing number of children and young people who experience a mental crisis but services are not always there for them or clear how to access. Families need clearer information that is easy to find and the “pathway” of a patient’s treatment needs to be reviewed.

What young people have told us:

There is not enough capacity in the community to support young people and sometimes they felt their concerns were not listened to or even dismissed. Waiting times for treatment are too long. They want to self-refer for treatment and there is an overwhelming desire for increased crisis services to be available in the community. Frequently mental health call outs turn out to be to young people who have very recently been discharged from specialist services. Often crises follow withdrawal of services.

Plans include:

  • Building a service which offers increased reliability and availability, extending the core hours of specialist CAMHS from the current 9am-5pm, Monday-Friday, to 8am-8pm Monday-Friday, with additional dedicated routine treatment slots over the weekend.
  • Provision of specialist out of hours CAMHS face-to-face assessment of crisis cases in the community and hospitals and establishing a bank of staff who can be deployed at short notice.
  • Increasing the proportion of Approved Mental Health Practitioners who specialise in child and family mental health.
  • Funding a proportionate amount of the Integrated Mental Health Team in the Police Control Room.
  • Delivery of a rolling programme of training and consultation to ‘first responders,’ acute hospital ward staff and others who respond to young people with a mental health crisis.
  • Revising protocols in Norfolk and Waveney to ensure that arrangements are planned in advance for those people approaching 18 for whom it is predicted there may be ongoing concerns and potential further crises.
  • Improving online support.

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