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;Lisa.williams@youngminds.org.uk

Websites;www.youngminds.org.uk

www.boingboing.org.uk

Resources and information available on;

http://www.youngminds.org.uk/training_services/academic_resilience