Sheffield Health & Wellbeing Board

Discussion Forum: Thursday 31st March

2016

Emotional Wellbeing & Mental Health

Sheffield Transformation Plan

www.england.nhs.uk

• Published March 2015 - continues to set direction of travel for Government

• Consensus across the whole system – built on principles of CYP IAPT

• Clear steer: a full spectrum of interventions and key principles about how to make it easier for children and young people to access high quality mental health care when they need it.

Key themes:• Promoting resilience, prevention and early intervention• Improving access to effective support• Care for the most vulnerable• Accountability and transparency• Developing the workforce

Future in Mind

• 50% of mental illness in adult life (excluding dementia)starts before age 15 and 75% by age 18.

• In Sheffield it is estimated that approximately 7,000 children between the ages of 5-15 years have a clinically recognisable mental health disorder.

• 36% of Y10 young people in Sheffield have had feelings so bad that they couldn’t cope at least once (Every Child Matters Survey)

• We also know that levels of self harming and eating disorders are increasing in Sheffield

• Comprehensive Health Needs Assessment and CATCH 22 assessment of vulnerable C&YP’s services

Why is Children & Young People’s Emotional Wellbeing & Mental Health

Important in Sheffield?

Sheffield Health and Wellbeing Board Event with Chilypep, Sheffield Futures, Young Health Watch

What C&YP want in Sheffield

So what could we do? Some ideas kept coming up again and again: Improve working with schools: better support to be available to help

young people talk about how they feel, have protection from stigma, and be enabled to continue in education

Provide someone to help: it’s not always about medical support; instead, it’s about having one person who is responsible, who advocates, who cares, who listens – this person could be a ‘keyworker’ or it could simply be another young person who is able to provide support

Commission better services and a clearer pathway: it’s not being unfairly negative to say that services need to improve so there’s provision for 16-18 year olds, so that services are more generally age-appropriate, so that waiting times are reduced, so that preventative care and support is available, and so that services are infused with more warmth

Campaign: We need to give positive stories from young people for young people that promote compassion and understanding

What are some of the difficulties young people face?• They’re afraid of being

judged and insulted in a context of stigma, negativity and misunderstandings around mental health

• They’re passed around from one person to the next, often abandoned

• They have to wait a long time to receive the care and support they feel they need – and at that age, waiting for a year means a whole year of education affected

• They’re not taken seriously: services (if they exist at all) aren’t tailored appropriately to their needs and age-group; often they have to meet in an office rather than somewhere more comfortable and less intimidating

What’s next? The Health and Wellbeing Board will discuss and feedback in spring 2015. Thanks to everyone who came!

EvaluationINFLUENCING & CONSULTATION

• We looked at priorities and local need • We considered the views to date of young

people and stakeholders • We aligned the initial priorities to that of FiM • We created a vision • We acknowledged the need for wider

stakeholder engagement

Our Local Plan

• In Sheffield we want every child and young person to have access to early help in supporting their emotional wellbeing and mental health needs. As a city we want to develop children and young people’s resilience and coping strategies. We will transform the quality and availability of our services from early help through to specialist provision. We want services to be delivered in the community, closer to home, targeted to the most vulnerable and for fewer children and young people to require specialist mental health services.

Our Transformation Vision

• This enabled us to run a number of pilot projects for early intervention

• It also enabled some investment into mental health treatment to improve access and reduce waiting times

From transformation funds we managed to invest in a balance of priorities across early intervention

and mental health treatment

• Increasing CYP-IAPT • Increasing access and reducing waiting

times • Developing models of care to reduce the

need for inpatient services

For investment into improving access to specialist CAMHS our

focus has been

CAMHS Activity and Waiting Times

Apr 13- Mar 14 Apr 15 - to 24/30

500

1000

1500

2000

2500

3000

ReceivedAccepted

This graph shows that more referrals in total were received and accepted by CAMHS in the current financial yearWork is ongoing with MAST to smooth pathways for children not accepted by CAMHS

2015 20160

5000

10000

15000

20000

25000

30000

Total attended activity

Total attended activity (NOT appointments)

Mar-14 Mar-16

Longest wait for a first appointment 33wks 20wks

% waiting over 14 weeks 26% 27%

% of people waiting over 18 weeks 11% 1%

Numbers of people waiting 235 299

This information shows that more people have been seen and the longest waits have reduced significantly –the next piece of work is to reduce Sheffield CAMHS waiting times working to an 18 week maximum wait in line with acute physical health services

EvaluationINVOLVEMENT – SERVICE DESIGN

For Early Intervention and Prevention we have

• Run 2 early intervention pilots into schools • Extended the primary mental health worker offer • Commissioned a number of early intervention

programmes for eating disorders • Developed the Youth Information and advice

offer • Developed the model of early intervention

• Whole School approach (Healthy Schools)

• Healthy Minds Framework/Quality Mark • EWBMH, developing resilience, healthy

settings and ethos for all C, YP and staff

• Audit & benchmarking (Healthy Schools approach)

• Workforce transformation – universal CAMHS Core training offer for all schools & settings to access

• Healthy Child Programme 0-19 Years Services

• Flower 125 Health Programme (Building resilience and self esteem)

Our Prevention Approach: Universal Offer – Building Resilience

Schools Pilots• Aim to develop a model, reduce fragmentation, quality assurance• Interchange Pilot involving 40 schools across 3 localities• Standardised referral pathway through MAST• Bespoke offer including 1:1 counselling, training, capacity building,

group work (anger management, bereavement, anxiety, eating disorders)

• Evaluation – Sheffield University• CAMHS School Link (National) Pilot (DfE and NHSE) to raise

awareness and improve knowledge of mental health issues amongst school staff;

• Improve CAMHS understanding of specific mental health and well-being issues within schools; and

• Support more effective joint working between schools, CAMHS & MAST.

• Develop, implement and evaluate the Healthy Minds Framework: Roll out a universal whole school model across all schools in the Future

We held a Stakeholder event in February to further develop the Strategy and Plan

which highlighted• A need for a co-ordinated system with clear

pathways of communication• Equity of access to provision across the city• Early Years, prevention with pro active assessment

of need • Workforce development and enablement is needed • Keep engaging young people and parents

A continued journey of co-creation & Partnership Working

Transforming the System • Evaluate school

pilots• Develop the

consultation, training & advice model

• Develop the workforce, skills & expertise

• Report back to NHSE

• Reduce the need for care inside hospital

• Improve access and reduce waiting times in community services

• Develop the consultation model within our specialist services