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