Transcript
Future in Mind:
Prevention &
Early
Intervention
Sarah Brennan; Chief Executive
Vision and MissionWe champion the mental health and wellbeing of children and
young people across the UK.
Driven by their experience we create positive change so that
children and young people can cope with life’s adversities, find
help when they need it and succeed in life.
WHY DID FUTURE IN MIND HAPPEN?
Among people under 65,
nearly half of ill health is
mental illness.
Less than 50% were treated
appropriately at the time
23% CYP turned away from
CAMHS
No health without mental health (2011):
“Improved availability of early intervention
services for C&YP could prevent 25–50% of
adult mental illness”
FUTURE IN MIND REPORT ON NATIONAL TASKFORCE
Launched March 2015
‘Children’s mental health services
are stuck in the dark ages’ Norman
Lamb, Minister for Care and Support
(2014)
Ambition for the transformation of
CYP mental health services
Built on a consensus across all
sectors
To be delivered through Local
Transformation Plans – LTPs
INCREASED FUNDING FOR CYP MENTAL HEALTH
£1.25bn
Increased
investment into
Child and
Adolescent
Mental Health
over the next
five years
£32m
Rollout of CYP IAPT
across the country
£30m
Community Eating
Disorder Services
£15m
Improving
perinatal
mental
health
services
FUTURE IN MIND AND THE FIVE YEAR FORWARD VIEW
KEY THEMES
• Promoting resilience,
prevention and early
intervention
• Improving access
• Care for the most vulnerable
• Accountability and
transparency
• Workforce development
• Promoting good mental
health and preventing poor
mental health
• A 7 day NHS – right care,
right time
• Complex need services
nationally
• Hard-wiring mental health
across the NHS
5 BUILDING BLOCKS WE KNOW WORK….
Courtesy : NHS England
Prevention
Early Intervention
THE MENTAL HEALTH RIVER
Picking out the
river
downstream
Specialist
services
Preventio
n
Earlier
intervention
Stoppin
g CYP
falling
in the
river
Gettin
g help
quicke
r
RESILIENCE METAPHOR?
Can not always
control for risk
So make sure children can swim…..wherever they are in the river.
EXAMPLES OF EARLY INTERVENTION PLANS:
Liverpool includes mental health community
hubs
Joined up pathways of care with voluntary
sector
Named specialist inks for GP practices and
schools
Croydon includes proposal to co-design a
programme of support in schools
KEY GOAL:
For 70,000 more children and young
people to be accessing CAMHS by 2020
in the context of rising referrals to
specialist services – 64% increase 12-13
and 14-15 :(EPI Report)
Children
& young
people
with mental
health or
emotional
needs
Who pays? NHS pays NHS pays
Tier 2
Services
Tier 3
Specialist
CAMHS
Tier 4
Inpatient
Care
T
H
R
E
S
H
O
L
D
T
H
R
E
S
H
O
L
D
CAMHS Care Pathways: whose need, what support?
Universa l
Serv ices
Un
ive
rsa
l
Se
rvic
es
HOW THE £143M IN 2015-16 WAS SPENT:
Only £75m given to CCGs for frontline services
£21m HEE
£15m Perinatal care
£12m CYP IAPT
£10m Hospital beds
£5m NHSE and DH Admin
£2m Youth Justice care
£2m DfE for schools
£1m LD and long term
EPI COMMISSION* - POSITIVE CHANGE
Every area of the country has developed a plan: 123
plans covering 211 CCG areas
Local health and care leaders have worked together
Much needed transparency delivered
Data being collected nationally
Some excellent examples of LTPs.
Participation at the centre
LTPs will be refreshed, republished each year and
included in Sustainability and Transformation plans
Raised profile of CYP MH locally and nationally
Report of the Education Policy Institute’s Mental Health
IS IT WORKING?
• Young people seen more
quickly; time between
referral and assessment
decreased by 73%
• YP achieved significant
clinical improvement over
fewer sessions; number of
days between assessment
and discharge decreased by
21%
Improved access through self-referral routes, single point of
access, outreach services, evening and weekend appointments.
Courtesy : NHS England
EPI IDENTIFIED 6 KEY BARRIERS TO EFFECTIVE
DELIVERY OF FIM*
Workforce (recruitment and training)
Funding
Commissioning
Data (fog)
Fragmentation (complexity & gaps between)
Intervening too late
KEY CHALLENGES
Workforce planning and capacity
Variable leadership, commissioning and
collaboration
Joint commissioning – how rather than why
IT planning – need for compliance with
requirements to be able to flow data and use
outcomes
Anxiety about spending the money in the best
possible way
EPI FOI ON WORKFORCE DIFFICULTIES:
83% trusts had recruitment difficulties e.g.
multiple adverts
82% increase in temp staff
£50m nearly spent on agency staff by 32 trusts
Regional variation; Midlands and Northern
trusts better with 6 experiencing no problems
41 trusts mentioned 51 instances of re-adverts,
and 2 or fewer applicants
MH Nurses most difficult, then consultant
psychiatrists
WORKFORCE CHALLENGES
CQC reported low morale and in addition: “A
recurring theme of our inspections of CAMHS is
the difficulty in recruiting nursing staff to cope
with the demand placed on services”
“Of the CAMHS consultant posts advertised last
year,one advert received no applications and
the other advert 1 application – the candidate
declined the offer…”
INVOLVEMENT OF EDUCATION
Most schools unaware of LTPs
ASCL found few colleges aware or involved
Very different cultures hinders communications
Schools complain they cannot refer to CAMHS
Taking action alone
What is their role??
Buy in
‘expert’ help
Workwith
external agencies
School’s own culture, capacity and
approach
What schools do
Counselling
Additional support
Assessments
Greatest
sustainable
impact
Statutory
services e.g.
mental health
services, social
care, etc.
Manualised
Programmes
Strategy and leadership
Systems and structure
Parents and community
Pupils and staff
School culture
Academic resilience - a vehicle for whole school change
WELLBEING IN SCHOOLS CAMPAIGN
Bringing together under one umbrella
campaign for recognition of the good work
that is carried out in schools and colleges
and ensure the responsibility for wellbeing is
required as well as recognised.
Legal changes plus public momentum and
call for change
GOING FORWARD
It is STILL early days – change takes time,
persistence and determination
Inspiring local leaders are creating change in
pockets – how to encourage, support and grow
Recognition of the complexity, and steepness of
the challenge but keep it simple
Maintain pressure
Maintain collective consensus
Act locally
WE HAVE VISIBILITY….
NUMBER OF MENTIONS OF CHILDREN’S MENTAL
HEALTH IN UK NEWSPAPERS 2008-2015
Source : Lexus Nexus
Website:
www.youngminds.org.uk
Twitter: @YoungMindsUK
Sarah.brennan@youngminds.org
.uk. Wellbeing in Schools
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