Childrens Mental Health and

Emotional Wellbeing

An Overview: Local, Regional &

National perspectives.

£31million afforded to Childrens emotional wellbeing and mental health – 0.8% of the overall mental health budget – attributes to £45 per young person, £163 per adult.

50% mental health problems emerge by age14 years,75% emerge by 18years.

1:5 Adults - 45,000 children affected by mental illness at any one time in NI.

1:4 children live in poverty in NI.

19% increase in suicide since 2014 – disproportionately higher rates suicide U18 in NI.

Legacy of conflict – generational trauma.

Childrens Mental Health – NI

Context

Reform NI last decade guided by Bamford Review 2009-11 and

2012-15.

Calls for new 10 year mental health strategy for NI mental health

champion to promote.

Overarching policies Programme for Government 2016 –

2021;Making Life Better2012-2023(NI public health

framework);Transforming Your Care 2011;Direction for HSC in

NI health & Wellbeing 2026

Protect life2 Suicide Strategy

Mental Health Reform

Western Trust CAMHS -

challenges

Trust has undertaken a demand/capacity analysis for CAMHS based

on CAPA model.

Demand outweighs current capacity, increasing delays in accessing

Service.

Referral rates continue to rise 2016/17 increase 10%, 2017/18

increase 12%, 2018/2019 increase 36% - no additional funding.

Acknowledgment by HSCB of rising referral rates - commitment to

make case for additional funding

Complexity and intervention pathways for children known to the service

has expanded placing multifactorial demands on the service.

Reduction in step 2 Services

Recruitment and retention challenges for the Service – Specialist Area

CAMHS – actions to date

Implementation of Service transformation Model – CAPA

Comprehensive recovery plan in place / Data Quality Project / Youthlife

contract

Establishment SPOE / Referral Coordinator post

Establishment CAMHS Crisis Assessment Team

Recruitment to vacant posts successful – requiring significant

induction, mentoring and supervision

Implementation Quality Outcome Measures/Coproduction

Training to all GP practices in Western trust area/ regional stepped

care pathway -

Evidence based therapeutic modalities

Draft Action Plan – in response to NICCY ‘still waiting’ – A rights

based review of mental health services & support for young

people in NI.

8 key themes identified for action.

Inter-Departmental Project Board-

Established 2019

Clear governance structures for the development of CAMHS.

Full implementation of the CAMHS data set – Quality data to support strategic planning & decision making.

Progression of the prevalence study on child & adolescent mental health.

Sustainable investment in CAMHS is fundamental.

(Recurrent funding has been secured through demography and inescapable pressures).

Western Trust CAMHS – appointment of Mental Health Transitions worker being progressed currently.

1. Working Effectively &

Collaboratively

Full implementation of the CAMHS Data Set

(close monitoring of referrals and acceptance rate – regional acceptance rate 80%). Development of tracking methodology of referrals not accepted being progressed.

Full implementation of the regional CAMHS Stepped Care pathway.

Development of MHLS 16 plus acute care pathway.

Self harm Intervention Programme (SHIP) - regular monitoring of referrals.

Primary Care MDT teams – Mental health practitioner attached Gppractice.

Child Friendly Information – Western Trust CAMHS ‘Think about These’ booklet and DVD co-produced YOPIC & Health Promotion Agency.

2. Accessing Help

Mental Health Training for all people who work with Young

people.

Western CAMHS – training programme rolled out to all GP

practices Trust wide 2018/2019 by Primary Mental Health

Service (Step 2).

Primary Care MDT with a Mental Health Practitioner attached ( 5

of the 17 GP federation areas)

Progression of the Childrens Emotional Health and Wellbeing

Framework.

3. Supporting Adults working with

Children and Young People

Greater range of community based mental health support.

Self help support/social media/App.

Prescribing data.

Psychological Therapies Strategy.

The progression of 4 regional PICU beds Beechcroft Inpatient

unit.

Implementation & monitoring of minimum care standards of YP

presenting to ED with mental health concerns.

4. Specialist Support

Clear transition pathway arrangements in place, Western Trust

CAMHS/AMH complaint with NICE transition arrangements.

Recent Regional Transition workshop- Western Trust transition

pathway example of best practice – Regional transitions protocol

being progressed in all Trust areas.

5. Transitions

Production of Child friendly leaflets/DVDs.

Clear procedures with regards to Complaints.

Evidence based treatments in line with NICE guidelines.

6. Flexible Treatment Options

The education of children and young people about their

emotional wellbeing as part of the curriculum.

Childrens Emotional and Wellbeing Framework.

Adverse Childhood Experiences (ACE) – Trauma informed

schools.

CAMHS progressing pilot projects currently with local primary

schools.

Early Intervention projects.

7.Mental Health Awareness &

Understanding

Equal access for young people with a learning disability to

services and support.

Single Point of Entry (SPOE)

Access to address co- occurring mental health and drug /alcohol

problems.

Looked After Children.

8. Young people with additional

Needs

Historically physical health services have diverted resources

away from mental health services.

2012 UK Government commitment to halt this bias legislation in

place to ensure commissioning of appropriate physical and

mental health Services.

‘Achieving Better Access to Mental Health Services by 2020’

pathway and additional spending kick start change ‘parity of

esteem’

Estimated Mental health problems cost the country £100billion

each year.

Relevant Initiatives in other

Jurisdictions - England

Scotland’s Mental Health Strategy prioritised stigma and

discrimination

2016 saw the investment of £4.5million in 3 year anti-stigma and

discrimination national programme building on the ‘see me’

campaign

National mental health strategy 2012-2015

Scotland

‘Together for mental health’ – 3 year delivery plan 2016-2019

has been developed to embed the requirements of the ‘Social

Services & wellbeing (Wales) Act 2014.

Wales

Connecting for Life: Irelands national strategy to reduce suicide

2015- 2020. New strategic framework addressing the issues of

suicide in Ireland for the period 2015-2020.

Systematic evaluation on the progress of interventions will be

ongoing in order to refine the best approaches on a national

level.

Republic Of Ireland