St Helens Future in MindReport from the Child Health and Wellbeing

Summit10th March 2016

Welcome and Introductions

120 people attended the summit, including parents, young people and representatives from

various stakeholder groups

from across education,

health, children’s services,

commissioners and the

voluntary sector to discuss

improvements to the

system of support.

Cllr Jeanie Bell, Cabinet

Member for Public Health &

Wellbeing, opened the day

and encouraged everyone

to fully participate in

developing and improving the support available for young people.

Hear Our Voices The summit started with input from Jen a young person and

her mother Judith. Jen who has accessed services for mental

health issues spoke about the need for tailored support,

delivered locally and in venues which are young people

friendly. Jen talked about the importance of schools in

creating safe and caring environments and the need to

support families where children have mental health issues.

The Summit also heard from Harry, a young student with

Attention Deficit Hyperactivity Disorder (ADHD) and Elisha

who accessed support through the Tuition Service of their

experiences of what worked for them including understanding

their condition, listening and caring professionals, negotiating

shared strategies between school and home etc.

Finally the Summit heard from Mia who shared a poem she had written about how Child and

Adolescent Mental Health services (CAMHs) can help if you have a problem, and the need

for children and young people to be kind to each other.

Current Context

Professor Stephen Cox, Clinical Chief Executive St Helens Clinical Commissioning Group &

Liz Gaulton – Director of Public Health St Helens Council presented the current

developments across the mental health and wellbeing system and on going challenges,

using an experience of one of his patients. Steve presented the changes made following

feedback from the Child Health Summit in October 2014, which included the establishment

of a Single Point of Access for Mental Health Support, 100% of crisis or urgent responses

seen within 12 or 24 hours, waiting times for routine CAMHs specialist service now reduced

to 12 weeks with plans to reduce further and an Early Help Service jointly commissioned

from Barnardo’s in July 2015. He outlined that further improvements were underway for

16/17 examples of which include improving the assessment journey and support for children

with ADHD/Autism, a new community based Eating Disorder Service, and improvements in

perinatal mental health.

Liz outlined the improving picture for children’s health including childhood obesity, smoking

and teenage pregnancy rates but in terms of some of the wellbeing indictors the picture is

less positive including rates of hospital admissions due to mental health, rates of self harm

both at A&E and admissions to hospital, numbers of children subject to child protection

plans, adult alcohol harm and rates of domestic abuse with significant numbers of incidents

observed by children.

Listening to feedback from the previous Child Health Summit, investment had increased,

pathways and access to services had been re-looked at with an integrated approach to

commissioning children’s health in St Helens. Whilst there were some fantastic examples of

innovative services and programmes to improving outcomes to sustain improvements in

health, we need to tackle the cause of the causes such as child poverty, impact of adverse

childhood experiences and focus on building resilience and empowerment rather than fixing

and protecting children and young people. To tackle this, developments in 16/17 include a

Tackling Stigma Campaign, piloting a whole school approach to mental health and wellbeing

with Rainford High Technology College, producing a Mental Health Training Prospectus,

developing an Attachment Pathway, providing Books on Prescription for young people and

enhanced online access and support through the BOSS website.

2020 Vision for Children and Young People’s Mental Health and Wellbeing

The summit used an appreciative enquiry model to imagine a new better system, using the

following process:

Discovery

The Peer Ambassadors from Rainford High Technology College asked delegates to start the appreciative approach to the day by reflecting on what they valued, what difference they have made and high point experience. Delegates were also asked what was working well:

Nature/culture towards mental health was slowly changing with more awareness - means people are more willing to ask for help and help each other

Increased investment i.e. Sunflower Sensory Programme, Time for Me Postnatal Group, Barnardo’s, Mind Matters etc.

Quicker response from clinical services once you get accepted into themOne point of

access welcomed

Networking is good within St Helens between voluntary and statutory services

Parental involvement

Pastoral system in schools

Recognising early difficulties with under 5s

Good liaison with some agencies

Services are better at identifying mental health issues

Dreaming – What could it be?

i-THRIVE – Re-thinking approaches to the mental health system

Dr Anna Moore (MBChB, MRCPsych), Implementation & Innovation Fellow at the Evidence

Based Practice Unit, Anna Freud Centre, was invited to give a presentation on a new model

for mental health services being developed, which aims to address some of the problems of

the current model which relies on a tiered model of services.

The i-THRIVE model aims to:

o Have a whole system approach focusing on needs and preferences

o Build on & draw from community resources and individual’s resources to create a

diverse range of options for care

o Identify resource-homogenous groups of young people with common needs and

preferences, rather than an escalator approach with increasing severity

o Focus on early intervention & building resilience in young people & families

o Shared decision making and preference sensitive care are core principles, ensuring

young people are actively involved in determining the best approach

A copy of the i-THRIVE presentation can be found in Appendix One.

Input offered

Description of the THRIVE Groups

Delegates were asked to consider the input on i-THRIVE and they felt that the model made

sense, moved away from tiers, was child centred and considered how to help young people

cope with early information/advice and support. Delegates also described a number of

‘thrive’ features which were already present in the current system. A summary of the

responses are contained in Appendix Two.

Following a Question and Answer session with Anna, the Summit was asked to vote on

whether Thrive is a model which St Helens should start in explore. Whilst it was

acknowledged that there were real challenges and we would need to create an environment

capable of support services to work differently, this received a very positive response from

delegates.

Design: What should it be in St Helens?

Delegates were asked to imagine the children’s mental health and wellbeing system in St

Helens in 2020 and key themes include:

o Importance of leadership, at all levels, including from children and young people in

following through on a commitment to make a difference.

o Co-production – system developments will be based on involvement of young people

and parents.

o Young people will feel more resilient, greater self-esteem, connected and have a

range of coping strategies available to them and positive promotion of mental

wellbeing

o People will be more aware and there will be no stigma attached to mental health

o The system of support will work together – a one stop shop where the Single point of

access (SPA) will be an integrated, co-ordinated multi agency front door to support.

o We will innovatively use technology to extend support, promote self-care and self-

help with one website, one telephone number, apps and podcasts.

o Young people will not need to wait for

appropriate support.

o Services will be delivered where young

people want them, in venues which are

young person friendly, and schools

providing all year round community

services for education and health and

wellbeing.

o The workforce, particularly school and universal services, will feel confident,

competent and supported to support young people.

Improving the Mental Health and Wellbeing of St Helens Children and Young People: Themed Discussions

Delegates had the opportunity to attend a session to discuss particular themes and to

propose priorities for further development/improvement. The following is a summary of the

key themes from the discussions:

Theme Priority ThemesPrevention, early intervention and tackling stigma

o Promote education, awareness and self-care o Getting it right in the early years through improved

attachment o Role of schools

Improving access to quality services

o One stop shop - integrated services, joined up support based on what young person wants and telling their story once

o Promote wellbeing through access to holistic provision/activities etc.

o Shared decision making o Waiting lists o Brief interventions

Care for the most vulnerable

o Tailored responses to vulnerable groups ie Looked after children, young offenders, LGBT young people, Autism/ADHD

o Hidden harm - support for children where parenting is compromised i.e. substance misusing parents

o No door is the wrong door o Role of CAMHS to provide consultancy particularly

in schools Developing the workforce

o Build awareness o Training programme o Ongoing support

Close

Geoffrey Appleton, Chair of St Helens Clinical Commissioning Group, thanked delegates,

presenters and young people for attending, for their passion evident during the event and

commitment to continuing to make difference to children’s mental health and wellbeing.

Next Steps

A report from the summit will be

circulated to participants and the ideas

and suggestions will be incorporated into

the 2016/17 Children and Young

People’s Mental Health and Wellbeing

Plan. The outputs will be presented to

the Children and Young People’s Mental

Health and Wellbeing Partnership.

Conversations will continue using the

#STHPositiveMinds42020 so that we

can continue to encourage discussion

and debate with young people, schools,

parents and other professionals.

Delegates were asked to continue to

engage and a list has been compiled of

those who wish to be involved further in

focus groups, workshops, task groups or

to receive further information.

Watch the Summit Video: https://www.youtube.com/watch?v=bhr7loNBxOg&feature=youtu.be

Appendices

Appendix One: i-THRIVE presentation

CHS - I Thrive presentation.pptx

Appendix Two: summary responses from delegates to i-THRIVE

Response to Thrive input.docx

Appendix Three: Child Health Summit Evaluation Summary

An evaluation of the event was conducted by 49.5% of attendees.

50% of those that completed evaluation had attended the summit as it was relevant to their current role with 12% seeking improvements in services.

The majority of those completing evaluation found the event useful with relevant material that was delivered well at an appropriate venue, only 4% of attendees felt that the summit left them without questions answered and only 3% unaware of where to get further information.

The involvement of young people was the most popular reported strength of the event followed by networking. Only 49% of those that responded reported any part of the summit to be least useful of which it was felt by some that the presentations/speeches were too long.

Various key messages were highlighted with the most common being the need for a single point of access / i-THRIVE model.

70% of those that had responded requested further involvement.

We would like to know why you attended today

o To hear service user opinion: 4%o Concerns over increase in young people accessing services: 2%o Relevant to post: 50%o To become more aware of health & wellbeing in St Helens: 2%o Seeking improvements: 12%o Standing in for invitee: 2%o Networking: 6%o To become more involved: 6%o To find out what services are available/needed: 10%o To have an impact on service improvements: 6%

About the Summit

Strongly Agree

Agree Neither Agree nor Disagree

Disagree Strongly Disagree

I found the event useful

55% 43% 2%

Content was easy to understand

45% 49% 6%

I understand more than I did beforehand

47% 43% 10%

The material was relevant

55% 41% 4%

Presenters delivered well

59% 37% 4%

Venue was appropriate

68% 28% 4%

The event was of the right length

53% 45% 2%

The event answered many of my questions

33% 41% 22% 4%

I know where to go to get further information

39% 47% 11% 3%

What are the strengths of the day?

o Interaction: 1%o DPH presentation: 1%o Prof Cox presentation: 1%o i-THRIVE model presentation and

discussion: 7%o Networking: 30%o Involvement of young people: 34%

o Sharing of opinions: 4%o Workshops: 14%o Icebreaker: 1%o Information available: 6%o Positive focus: 1%

Which parts were least useful?

o Speeches too long: 19%o Too much information: 11%o No critical analysis of model: 4%o Complicated model to present: 8%o I-THRIVE input: 11%o Newspaper activities: 19%

o Rushed workshops: 11%o Audio: 4%o No police representation: 4%o Lack of hand-outs: 4%o Rushed i-THRIVE presentation: 4%

What are the key messages that you took from the event?

o Effective communication is key: 8%

o Need to work on prevention and resilience: 4%

o Local help is available for children and young people’s mental health problems: 6%

o Collaborative and integrated working is essential: 8%

o Need comprehensive resource directory: 4%

o Still lots to achieve in relation to integration: 10%

o All services working towards the same goal: 10%

o Need to embrace new technology: 2%

o Early intervention is needed: 2%o Need to overcome stigma: 4%o There are many people working

together: 2%o Need more emphasis in schools in

relation to what is working well: 2%

o Children’s voice is important: 6%o Single point of access/i-THRIVE

model needed: 14%o Need to keep parents and children

informed: 4%o Services need to improve: 4%o Need to simplify systems/change

approach: 4%o Need more investment in children:

4%o Importance of addressing mental ill

health: 2%

Do you have any further questions that you need answers to?

o Update on progress towards using model and measuring success: 15%

o Voice given to third sector at future events: 7%

o How to ensure effective, efficient multi-agency working and information exchange: 7%

o Is St Helens planning to adopt this model and how will it be implemented?: 7%

o How will it be led and who will be accountable: 15%

o Continuation of working groups: 7%

o Better understanding of current system at future briefings: 7%

o Will there be feedback/regular updates?: 7%

o Transparency needed – difficult to find way through systems/services: 7%

o How to deliver services to most vulnerable/hard to reach groups: 7%

o How can I help?: 7%o Where to get help for under 5s?:

7%

Any other comments

o Caterers should indicate dietary options: 3%

o Excellent day: 6%o There is wider responsibility

involving other agencies to improve child health: 3%

o Good event: 16%o Keep the momentum: 3%o Good venue & cookies: 3%o Thank you: 23%o Enjoyed young people’s activity:

3%o Would have been good to have

further involvement from schools: 3%

o Inspiring: 3%o Include more young people for

insights: 3%

o Little focus on children with disability/SEN: 3%

o I-THRIVE – too much information: 3%

o Could I be invited to Health and Wellbeing Board: 3%

o Well organised: 3%o Good emphasis on early

intervention: 3%o Smaller groups – quality

discussion: 3%o Dedicate one website to St Helens

– update & maintain electronic resource: 3%

o Should this not have been prior to commissioning services in 2015: 3%

Further involvement: 37 responses