Decision details

Emotional Wellbeing and Mental Health of Children and Young People

Decision Maker: Education and Children's Services Scrutiny Committee

Decision status: For Determination

Is Key decision?: No

Purpose:

To receive a presentation delivered by NHS and local authority partners providing information on the impact of Covid 19, partnership response and future development plans.

Decisions:

The Chair welcomed to the meeting Dave Carr, Head of Service: Policy, Information & Commissioning (Start Well), Lancashire County Council; Sally Nightingale, NHS Midlands and Lancashire Commissioning Support Unit; and Barbara Edwards, CAMHS Transformation Manager, Blackpool Teaching Hospitals NHS Foundation Trust.

 

Also welcomed to the meeting were K Murray (Deputy Member of the Youth Parliament for Lancaster/Fylde/Wyre) and M Graham (Member of the Youth Parliament for Hyndburn/Ribble Valley/Rossendale).

 

The report presented provided the Education and Children's Services Scrutiny Committee with information on the impact of the Covid-19 pandemic on the emotional wellbeing and mental health of children and young people in Lancashire and the response of partners and future plans.

 

During the pandemic mental health issues for children and young people such as anxiety and depression had increased. Disruption to young people's sense of control and meaning had contributed to this. There were also concerns about returning to schools. It was pointed out however, that for some, the pandemic had had positive mental health impacts due to a sense of support and potentially reduced stressors, such as social pressures at school.

 

Lancashire County Council commissioned a service called Child Action North West Partnership Early Help Service which had provided a focus on younger children for emotional health and wellbeing. Half the requests that came to this service were primary age children. Much of the partnership's work had moved online.

 

There were pressures on the workforce due to the pandemic, particularly in schools. Schools in Lancashire had stayed open in Lancashire during the pandemic, providing support to vulnerable and valuable young people and also key workers.

 

In terms of NHS services, Lancashire and South Cumbria Care Foundation Trust had found that for its Child and Adolescent Mental Health Services (CAMHS), there had been a 46% rise in demand for their services in September and October compared to last year.

 

Many services had gone online as children and young people were now turning to online support. Lancashire and South Cumbria Healthy Young Minds website had been expanded to include Covid-19 specific resources. There was also Kooth which was an online service providing free access to online support and counselling for young people.

 

Members were informed of the CAMHS THRIVE redesign journey. It was a framework that provided practical strategy and integrated pathways to support children when they started to struggle. THRIVE provided wrap around support to children and young people when they needed it. Before THRIVE there were too many confusing routes to get into CAMHS. What was needed was a single point of access with one phone number. Due to Covid, services which could be accelerated were looked at. The Care Partnership had now a fully signed off THRIVE model and now needed resources to implement it. The partnership needed to invest in children's mental health at a greater rate and make things better for young people.

 

Comments and questions raised by the committee were as follows:

 

·  On evaluating the redesign and evidence of outcomes it was reported that the Child Action North West Partnership was looking at the evaluation of families to see if things had improved for the family and the young person. There were no evaluations for this year but in previous years they were positive. There were case studies of families to see if the support they had received had made a difference and these had been positive too. Feedback from families had helped the redesign of the service and helped measure the impact of the services going forward.

·  The committee requested evidence on why the service was being redesigned the way it was. Whilst officers could not provide the evidence at the meeting, it was acknowledged that evidence should be presented at future meetings. Officers could also come back and demonstrate the impact of the redesign as elements were being implemented.

·  The redesign would provide a single point of access phone number which would help children and young people to get to a local service. Discussions were taking place to determine whether referrals for both adult mental health systems and children's systems should be directed to the single point of access number. The team had managed to establish this with a single Covid response 24/7 helpline that would translate into the single point of access number for CAMHS. There was more work to do before the single point of contact phone number could be implemented, though it was hoped the number would be live during Quarter 1 of 2021. In the meantime all points of contact were listed on the Healthy Young Minds website: https://www.healthyyoungmindslsc.co.uk/home.

·  Members were informed that there were not many self-referrals that had come to CAMHS from children and young people. Referrals tended to come from family members or GPs. Self-referrals were only implemented in August 2020. At the end of December 2020 data could be provided on how many self-referrals had come through.

·  There were concerns about the amount of suicide cases with children and young people. This could be down to a number of things such as stresses in households, financial problems, domestic abuse or pressures at school. There was no data on specific reasons.

·  The committee was informed that the THRIVE service was not just for children, it was also for parents and carers. A lot of work had been done with parent groups concerning the THRIVE redesign. There needed to be a robust communication plan in place around THRIVE.

·  The purpose of the THRIVE redesign was to make children's mental health everybody's issue. The redesign was about working more effectively with schools, youth groups and voluntary sector partners.

·  There had been lots of information from young people to help with the THRIVE redesign.

·  There were Early Help services available that people could access. The committee was informed that 88% of access to the services in 2019/20 had made a difference. If children and young people accessed the services earlier there was a better chance for positive outcomes.

·  Members were informed that CAMHS was a specialist mental health service. The purpose of the THRIVE redesign was to move away from all mental health issues being solved by CAMHS. There were many other interfaces for children and young people to access regarding mental health.

·  Regarding digital services and children accessing them, the committee enquired if these services were effective. These services were evaluated and information on these evaluations would be brought to a future meeting. There were concerns about the amount of services to access. It was felt that one point of access would be better.

·  The question of relationships with other agencies was raised. The team was working with partners across the whole system and was working with partners around children who had gone missing. The team worked closely with local CAMHS providers and children's homes. There was also close work with the British Transport Police.

·  It was noted that technology had moved on so quickly and there were concerns over safety issues. Schools were taking a huge responsibility in making sure children and young people were digitally safe.

·  It was pointed out to the committee that CAMHS had currently got a negative reputation amongst young people.

·  There was concern over the self-referral scheme and would it be actively used by young people.

·  The social aspect for children and young people was the biggest problem during the pandemic. Returning to school had helped with this.

·  There was a lot of anxiety during the pandemic and young people were more aware of mental health issues.

·  It was stated that schools were a good point of contact for young people. Teachers should be aware of the single point of access number if they identified issues with young people.

·  The NHS needed to be conscious of giving schools the skills to deal with mental health issues.  The NHS was investing in Primary Mental Health workers for schools.

·  There were concerns about vulnerable families who had no online access.

 

In addition to the request for evidence to be presented at future meetings of the committee on the redesign of CAMHS, officers acknowledged that more detail about outcomes evaluation should also be included. It was also acknowledged that the local NHS needed to expand on how the service offer is communicated going forward.

 

Resolved: That the;

 

1.  Presentation be noted.

2.  Progress on delivering the THRIVE redesign be noted.

3.  An update report on progress with establishing the single point of access phone number, and the work on engagement with children and young people and schools be presented to the committee in three months' time.

 

 

 

 

Contact: Dave Carr, Director of Policy, Commissioning and Children's Health Email: Dave.carr@lancashire.gov.uk Tel: 01772 532066.

Report author: Dave Carr

Date of decision: 16/12/2020

Decided at meeting: 16/12/2020 - Education and Children's Services Scrutiny Committee

Accompanying Documents: