Local democracy

Agenda item

CHILDREN'S MENTAL HEALTH

The Future in Mind Locality Transformation Plan was developed in the context of Bradford and Airedale with reference to the Joint Health Needs Analysis of Emotional and Psychological Wellbeing of Children in Bradford (Public Health 2015).

 

The Director of Strategy, Bradford Districts Clinical Commissioning Group will present a report (Document “A”) which answers some specific questions asked of the commissioners in relation to access and waiting times.

 

Recommended -

 

That the development of services in line with the Future in Mind Local Implementation Plan aligned with priorities within Journey to Excellence, Integrated Early years Strategy and the Early Help approach for children 0-19 years be supported.

 

(Mark Vaughan – 01274 237290)

 

 

Minutes:

The Director of Strategy, Bradford Districts Clinical Commissioning Group (CCG) presented Document “A” which provided information on the key messages, wrap around services for children and ensuring that access to services was timely and appropriate.

 

The Healthy Minds Participation Co-ordinator, Barnardo’s, introduced documents compiled by young people and a video.  The young people present at the meeting then commented on their experiences and provided suggestions which included issues such as:

 

·         Intervention from parents and schools.

·         Referrals to Child and Adolescent Mental Health Services (CAMHS).

·         Lengthy waiting lists to be seen and diagnosed.

·         A support person should be assigned when young people were placed on the waiting list.

·         Being supported was beneficial and eased the situation before being diagnosed.

·         The support did not need to be from a professional person.

·         Involvement in the Wellness Recovery Action Plan (WRAP) was beneficial.

·         Pre-sessions would be beneficial prior to seeing a Mental Health Professional.

·         The ‘drop-ins’ were daunting but provided a good service, however, they needed to be less formal.

·         Shorter waiting times were required.

·         It would be helpful if the school nurse had a knowledge of mental health.

·         More information should be available in schools.

·         Support workers listened and all young people needed some support.

·         Not notified of support worker absences and loss of staff.

·         A project to highlight mental health issues in primary schools was needed so pupils could understand the issues.

·         The ‘First Response in Bradford’ service was good.

·         Help from CAMHS had not been received in time.

·         Only three CAMHS sessions had been provided over three months and they had not helped.

·         Teachers had tried to organise additional Mental Health Care.

·         Young people were working on the recruitment of CAMHS workers.

·         The fear of uncertainty led to further issues.

·         CAMHS was an excellent service and should be reinstated in secondary schools.

·         Referrals were not always available, but if new support workers were placed in schools there would always be someone there to talk to.

·         There had been a five month gap in seeing a support worker and there should be help in place in between appointments.

·         Barnardo’s Participation Service had been very helpful compared to the services provided by CAMHS and support workers.  It was important that the support worker could made links for the young person.

·         WRAP worked well for some young people.

 

In response to the points raised, the Healthy Minds Participation Co-ordinator, Barnardo’s informed Members that:

 

·         Barnardo’s were looking at a ‘buddy’ system with a ‘buddy’ co-ordinator, which they believed would be beneficial for young people as formal approaches were not the best way forward. 

·         Crisis work in the District was looking at ‘drop- in’ facilities and working with young people.

·         Specialist support workers were not required, just someone with the correct knowledge.

·         Some support workers should be retained and replacements were required if they left.  It could be detrimental for the young person if their support worker left.

·         There wasn’t an advocacy system for young people and there should be.  Barnardo’s proposed ‘buddy’ system could become an advocacy service.

·         First Response was a crisis helpline and a request had been made for it to become available on an email ‘chat’ basis.

·         Young people were assisting in the interviewing of support workers for CAMHS.

·         It was important that young people were kept informed throughout.

·         Young people needed a continuous service and if a two tier service was stronger it would be beneficial.

·         Investment should be made in young people and they should be provided with better support, which would build a better Bradford.

 

The Chair then thanked the young people present for sharing their experiences with the Committee. 

 

The Director of Strategy, Bradford Districts CCG, echoed the sentiments of the Chair and acknowledged the powerful points put forward.  He stated that it was all about relationship building and the support worker did not need to be in a senior role, but just have empathy.

 

In relation to the Future in Mind report, the Director of Strategy, Bradford Districts CCG explained that the views of children and young people had been collated and the stories were consistent with the views given.  He stated that the clear message form young people was that one size did not fit all and the services provided needed to be tailored.  It was noted that a £1.1 million recurring fund had been secured for five years and it had been proposed to assist children’s mental health.  Members were informed that a local needs assessment tailored towards Bradford had been undertaken.  The link between deprivation and mental health had not been recognised and it needed to be acknowledged that children and young people from poor backgrounds were more likely to develop mental health issues.  A higher proportion of looked after children also suffered. 

 

The Director of Strategy, Bradford Districts CCG gave a brief overview of the issues detailed in Document “A” and confirmed that the service had strong support workers, however, work was required in relation to the targeting of service provision.  The Head of Commissioning, Bradford Districts CCG reported that new funds had been identified to reduce waiting times and the proposed buddy system would be put forward.  He stated that the Government and NHS England were releasing money in a targeted sporadic way. 

 

The Service Manager, Bradford District Care NHS Foundation Trust, thanked the young people present and stated that the checklist they had compiled was very helpful.  It was noted that the links to other services had been made clear for young people in schools and the proposed buddy system would be progressed, as it was believed that it would have a huge beneficial impact.  It was hoped that the stigma linked to mental health could be reduced. 

 

The Chair stated that the additional funds were welcomed, however, not all the suggested ideas would require money.

 

Members then raised the following points:

 

·         Why was there such a huge disparity in waiting times?

·         Was work ongoing to provide information for young people that had been compiled by young people?

·         Two tier services needed to be made stronger.

·         Over 2700 referrals had been made to CAMHS.  How could this be tackled?

·         Drop-in services were not being used.  How could they be promoted?

·         WRAP was successful.  How long was the funding for and could it be continued?

·         Could CAMHS be renamed?

·         There was no advocacy service for children and young people.

·         There were inconsistencies in schools regarding bullying.  How could it be strategically managed when some schools were Academies and how could a consistent approach be attained when schools were not controlled by the Local Authority?

·         Safe- guarding should be looked at as part of the Ofsted report.

·         Was the funding being used to recruit or retain staff?

·         How many primary mental health workers were there in schools across Bradford?

·         The funding ceased in 2020, what would happen after this?

·         The draft leaflet compiled by young people mentioned self referrals.  Would they be accepted and how would the process work?

·         An update was required by NHS England by 31 October 2016.  At what stage was the work at?

·         With regard to the austerity reductions, which services had been reduced and which were not addressed by the Future in Mind funding.

·         How could young people be expected to wade through the referral process?

·         When would there be zero tolerance in relation to bullying and would Ofsted be involved in the process? 

·         What was the percentage of young people that had been failed due to staff attitudes?

·         How many young people had opted out of the treatment process?

·         CAMHS provided a good service.

 

In response the Healthy Minds Participation Co-ordinator, Barnardo’s reported that:

 

·         Young people usually asked for help a long time before they were taken seriously and did not see the difference between specialists and lower levels.

·         11 weeks was a long time for a young person to wait.

·         The WRAP was undertaking peer to peer work.

·         If teachers were under less stress, pupils would be too.

·         The WRAP was a self referral scheme and families could decide whether to access it.

·         The draft leaflet was designed by young people in order to try and re-address the situation.

·         A website had been developed that detailed the available information and a school planner was available.

 

The NHS representatives confirmed that:

 

·         The Care Trust received reports that identified when a young person had not been seen in 11 weeks.  The access route to referrals needed improvement and the suggested buddy system was key.

·         Information provided by young people was a good idea and the Care Trust could look at developing ‘sound bites’.

·         Referrals would probably increase, however, it was hoped that the early intervention service would be progressed.

·         The tier two service problems had been highlighted and the service would be improved.

·         The buddy system could be looked at and would be based in the Voluntary Sector.

·         It was beneficial to get involved quickly with young people.

·         Workshops were to take place and they could look at the renaming of CAMHS, as first impressions counted.

·         The use of WRAP was advocated and Bradford District was a pioneer in using the scheme for young people.  The involvement of WRAP could negate the need for other services and the buddy system could be used as an advocacy service.

·         The Future in Mind project was trying to recruit mental health champions in schools and a collective standard way forward was required to deal with bullying.

·         Schools were not responsible for all the bullying issues, parents’ perceptions needed to be looked at. 

·         There were 11 mental health workers in schools.  They had to be seen as system wide process and their skills used to their best advantage.

·         Finances would be stretched after 2020.

·         There were some elements of the referral process that needed to be self referral.

·         The report had to be submitted to the Bradford and Airedale Health and Wellbeing Board by the end of November 2016.  NHS England had accepted that it could be submitted to the next available Health and Wellbeing Board for consideration. 

·         One service had been replaced with another.

·         The specialist CAMHS service had a major part to play and there was a mental health champion in every school.  The perceptions surrounding mental health needed to be changed.

·         The information needed to be communicated so people were aware of the help available and did not have to search for it.

·         Work had been undertaken with Barnardo’s and the issues were being embedded with CAMHS.

·         The figures would be provided after the meeting.

 

The young people present added the following comments in relation to bullying:

 

·         If bullying was admitted by the school they could gain a bad reputation, so it was preferable for the victim to leave the school.

·         The issue of teachers’ bullying pupils needed to be looked at.

·         Some teachers were not supportive.

·         Splitting pupils into ability groups was not always beneficial.

·         Teachers could be dismissive of young people.

·         Teachers undermined both older and younger pupils.

·         Teachers were not always able to empathise with students. 

 

Resolved –

 

(1)       That the young people be thanked for their attendance and the contribution that they made to the meeting.

 

(2)       That the development of services in line with the Future in Mind Local Implementation Plan aligned with priorities within the Journey to Excellence, Integrated Early Years Strategy and the Early Help approach for children 0 -19 years be supported.

 

(3)       That a sub-committee, which maintains the Council’s political proportionality, be convened from Members of the Health and Social Care and Children’s Services Overview and Scrutiny Committees in order to receive a response to the young people’s “Help Today’s Youth to Help Tomorrows Bradford” document for discussion at a meeting within four months.

 

(4)       That the “Future in Mind” document be produced in an easy read format.

 

ACTION:       Director of Strategy, Bradford Districts Clinical Commissioning Group/ Strategic Director, Children’s Services/ Strategic Director, Health and Wellbeing/ Overview and Scrutiny Leads

Supporting documents: