Surrey Emotional Wellbeing and Mental Health Services for Children and Young People Needs Assessment Refresh

Full text

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Surrey Emotional Wellbeing and

Mental Health Services for Children and

Young People

Needs Assessment Refresh

January 2014

Updated April 2014

Authors:

Tina Fenwick

Commissioning Projects Officer,

Children’s Social Services and Wellbeing Commissioning

Julie Nelson

Public Health Lead

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Executive summary

Introduction

This document is a refresh of the 2009 Surrey Child and Adolescent Mental Health Services (CAMHS) Healthcare Needs Assessment (2009 CAMHS HNA). The aim was to refresh the information on need, identify gaps and to develop recommendations based on the findings.

The estimate of the total number of children and young people living in Surrey has increased from 268,500 to 276,000 between 2009 and 2012. Based on population data and population projections the areas of Surrey with the greatest requirement for health services for children and young people will continue to be Elmbridge, Reigate and Banstead, Guildford and Waverley. Woking has the highest percentage of children from minority ethnic groups in Surrey, and has a higher percentage of children from these groups than England, the South East and Surrey.

The numbers of children with Fixed Term Exclusions had been reducing but is now beginning to increase again. The number of children excluded for persistent disruptive behaviour remains high although this category is broad and covers a range of behaviours and potential needs. The number of Fixed Term Exclusions at the primary age range is increasing as the needs of this cohort are becoming more complex. The ethnic group with the highest number of Fixed Term Exclusions is of children from Irish Traveller and Gypsy Roma Traveller communities.

The number of children with English as a second language in Surrey has increased across all school phases with the highest numbers attending schools in Runnymede, Spelthorne and Woking. There is a need for a better understanding of the potential emotional wellbeing and mental health needs of children not in school.

There is an estimated increase in the number of children with mental health disorders in Surrey from 5,884 in 2009 to 6,014 in 2012 based on an increase in the population estimates.

Children with medical conditions have a higher incidence of mental illnesses that the average child population. Children with disabilities are more vulnerable to emotional wellbeing and mental health issues and their specific needs in this area are not always recognised in their own right. A holistic approach is emphasised to ensure consideration is given alongside their physical needs.

Recognition of emotional wellbeing and mental health and associated services will form part of the local offer as part of the SEN reforms under the Children and Families Care Bill (2013). 10 – 15% of children nationally live with a parent who has a mental health disorder. Data is not available on the number of children living with parents with a mental health problem in Surrey. The number of women in Surrey who are suffering from perinatal mental health problems is estimated to

be between 900 and 2,000.Both poor parental mental health and poor parenting skills have been

found to result in a 4 - 5 fold increased rate in onset of emotional/conduct disorder in childhood. The importance of a family focus approach is reinforced together with improved joint working between CAMHS and Adult Mental Health Services in order to ensure that the needs of children whose parents have mental health issues are identified and there are improvements in the transition from children to adult services and support for the post 18 cohort.

The particular groups of children and young people who may be vulnerable to increased risk of emotional wellbeing and mental health issues include young parents; parent and young carers; lesbian, gay, bisexual and transgender young people; refugee and asylum seeking children; children from the Gypsy Roma Traveller community; children from BME communities; recently adopted young people; children witnessing domestic abuse, children in low income families and those living in military families.

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The estimated number of children living in low income households in Surrey is over 21,200, an increase of 3,000 since 2009. The local authority with the largest proportion of children living in low income households is Spelthorne.

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Recommendations 2014

1. The Targeted Mental Health in Schools (TaMHS) approach will include support for specific disengaged schools and offer more attachment training. Consideration should also be given to extending the TAMHS approach into Further Education colleges

2. Explore and increase the provision of early help and support for emotional wellbeing and mental health to children aged two and a half to five and for primary age children

3. School staff, with support from the multi-agency e-safety sub-group, need to be aware of the impact that cyberbullying can have on the emotional wellbeing and mental health of children and young people , particularly those from vulnerable groups

4. Services need to ensure support can be made more accessible to all families and communities, for example exploring the community based language programmes as a means of increasing access

5. Consider development of a designated CAMHS Gypsy Roma Traveller (GRT) liaison post to raise awareness of all professionals of the particular needs of children from the GRT

community and to understand how access to services can be improved.

6. Increase the resilience of emotional wellbeing and mental health in families of children with autism and teenagers through targeted parenting programmes

7. Ensure the emotional wellbeing and mental health needs of children with

disabilities/complex needs are recognised by all professionals as part of the holistic

assessment and care planning arrangements. Similarly for those children who may not be statemented such as those with high functioning autism, attention deficit hyperactivity disorder or dyspraxia

8. Explore how services can best respond to meet the emotional wellbeing and mental health needs of children who are overweight or obese

9. Parent and young carers play a key role in improving the emotional wellbeing and mental health of those they care for and services need to routinely provide an assessment of their needs in order to support them to continue in their caring role. Services should consider how to embed carers champions within CAMHS service provision

10. In order to ensure continued emotional wellbeing and mental health there needs to be accessible, effective, 24/7 early support and information for children and young people and their families

11. Develop joint working between Adult Mental Health Services and CAMHS to deliver a family focused approach

12. Work with Adult Mental Health commissioners to ensure the mental health services pathway reflects the needs of young people post 18, in particular the pathway from CAMHS to

Improving Access to Psychological Therapies (IAPT) to enable more effective signposting or support and information concerning self-help strategies for young people approaching adulthood, especially for the 19-21 age group

13. Adult Mental Health services and CAMHS to be aware of and respond to the emotional wellbeing and mental health needs of the children of service users following discharge from the local armed forces community and to ensure that the Armed Forces are aware of the civilian emotional wellbeing and mental health service provision

14. Increase the capacity of the Parent Infant Mental Health service (PIMH) and You and Your Baby connecting service to enable greater early intervention and development of stronger more secure attachments. Work with Adult Mental Health Commissioners to develop a local dedicated perinatal service

15. Services need to better understand the emotional wellbeing and mental health needs of young people in Surrey who are lesbian, gay, bisexual or transgender and review the support and treatment available locally for young people who are gender questioning and considering gender variance

16. Develop more and ongoing support for prospective adopters and newly adoptive parents regarding the emotional wellbeing and mental health needs (including loss, trauma and attachments) of the children concerned and for the impact on the wider family to enable placements to be maintained

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17. Further need for data regarding emotional wellbeing and mental health of children and young people: presenting at A&E with self harm and other emotional wellbeing and mental health related needs; children in GRT & BME communities; children affected by domestic abuse; unaccompanied asylum seeking children and young people; children not in school; children in military families; parents and young carers and better recording of emotional wellbeing and mental health on case management systems

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Contents

Page

Executive Summary

2

Recommendations 2014

4

List of tables and figures

7

1

Introduction

10

2

Aim and objectives

10

3

Current Surrey CAMHS

11

4

Local need for CAMHS

12

4.1

Demographics and population projections

12

4.1.1 England, South east and Surrey population estimates

12

4.1.2 Black and minority ethnic communities

20

4.2

Education

22

4.2.1 Schools in Surrey

22

4.2.2 Fixed term exclusions

23

4.2.3 English as a Second Language

28

4.2.4 Young people not in education, employment or training

30

4.3

Health

32

4.3.1 Children with mental disorders in England, South East and Surrey

32

4.3.2 Estimate of mental health conditions amongst BME

34

4.3.3 Link between physical ill health and mental ill health

34

4.3.4 Children with disabilities

34

4.3.5 Children and young people with limiting illness

39

4.3.6 Parents with mental health needs

41

4.3.7 Suicide and self harm

44

4.3.8 Mental health and obesity

45

4.4

Children and young people who are vulnerable or at risk

47

4.4.1 Unborn children

47

4.4.2 Children in need (CIN)

48

4.4.3 Young carers

50

4.4.4 Lesbian Gay, Bisexual, Transgender and Questioning young people

53

4.4.5 Children in poverty

54

4.4.6 Number/estimates of refugees and asylum seekers in Surrey

56

4.4.7 Homeless families

58

4.4.8 Gypsies Roma and Travellers in Surrey

59

4.4.9 Transition (preparation for adulthood) 59

4.4.10 Young offenders 60

4.4.11 Care leavers 63

4.4.12 Adoption 64

4.4.13 Children from Armed Forces’ families 65

4.4.15 Looked After Children 66

Appendix 1

Further information and gap analysis by Expert group

68

Appendix 2

Recommendations in 2009 CAMHS HNA

73

Appendix 3

Glossary

76

Appendix 4

References

79

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List of tables and figures

Tables Page

Table 1 Summary of services jointly commissioned by CCGs and Surrey County

Council, 2013 11

Table 2 Estimated number of children under 19 years in England, South East and

Surrey. Comparison between 2009 and 2012 13 Table 3 Estimated number of children under 19 years in Surrey by borough/district.

Comparison between 2009 and 2012 14

Table 4 Population projections for children aged 0 – 19 years 2015 – 2025, England,

South East and Surrey 15

Table 5 Population projections for children aged 0 – 19 years by 5 year age groups

between 2015 – 2025, England, South East and Surrey 16

Table 6 Population projections for children aged 0 – 19 years 2015 – 2025, boroughs

and districts 17

Table 7 Number of children in schools in Surrey by type, January 2009 22 Table 8 Number of schools in Surrey by school type and number on roll, 2013 22 Table 9 Number of children in schools across Surrey boroughs/districts, January 2009 23 Table 10 Number of Fixed Period Exclusions (FPE) and percentage of school population

for schools in Surrey, 2009 to 2012 24 Table 11 Reasons for Fixed Term Exclusions in state-funded primary, secondary and

special schools in Surrey in 2009/10 and 2011/12 26 Table 12 Comparison of percentage of pupils with EASL in Surrey by borough/district,

2008 - 2012 29

Table 13 Comparison of percentage of pupils with EASL in Surrey by school type, 2008 –

2012 30

Table 14 Young people aged 16-18 years who are NEET in Surrey, 2008 to 2013 30 Table 15 Estimate of children and young people with specific conditions – comparison of

2009 with 2012 estimates 32

Table 16 Estimates of children and young people with specific conditions per borough/district, comparison of 2007 (from CAMHS HNA, 2009) with 2012 33 Table 17 SEN national picture, 2008 to 2012 35

Table 18 Statemented national picture 35

Table 19 Age range and numbers of statemented children & young people January 2012 36 Table 20 Age of children and young people in Surrey with SEN statements, 2008 and

2013 36

Table 21 Total numbers of children (0 - 18 years) registered on the Surrey Children's Disability Register (SCDR), 2009 to 2012 37 Table 22 Different Disability categories used in Surrey 2009 and 2011 37 Table 23 Number of children and young people with SEN statements, maintained by

Surrey, whose primary need is physical disability, 2009, 2012 and 2013 38 Table 24 Children aged 0 – 5 years with a limiting illness and level of limitation in

England, South East and Surrey 39

Table 25 Children aged 16 – 24 years with a limiting illness and level of limitation in

England, South East and Surrey 39

Table 26 Children and young people in Surrey boroughs and districts aged 0-15 years

with limiting illness 40

Table 27 Children and young people in Surrey boroughs and districts aged 16-24 years

with limiting illness 40

Table 28 Adults in Surrey with various mental health disorders, 2012 42 Table 29 Parents who are attending treatment for substance misuse, who live with their

child or children, rate per 100,000 children aged 0-15 years in the area Parents who are attending treatment for alcohol, who live with their child or children, rate per 100,000 children aged 0-15 years in the area 2012-2013

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Table 30 Estimated prevalence of peri-natal mental health illnesses in Surrey using the Prevalence and Benchmarking from NICE tool (NICE, 2007) 43 Table 31 Number of deaths by suicide in UK 2009- 2011; 15- 19 years of age 44 Table 32 Recommendations from NICE ‘Managing overweight and obesity among

children and young people: lifestyle weight management services’ (2013) 45 Table 33 Number of unborn children in Surrey as of 01.11.13 by Children in Need (CIN)

and Child Protection (CP) 47

Table 34 Number of unborn children open to Surrey County Council Children’s Services,

2012/13 47

Table 35 Number of CYP subject to a CPP in Surrey as of 30.06.2012 48 Table 36 Number of Children in South East England on Child Protection Plan

comparison 2009 with 2012 49

Table 37 Number of children subject to a Surrey CPP by category of abuse as of

31.03.2012 49

Table 38 Estimated Young Carers in Surrey by borough and district, 2011 52 Table 39 Percentage of Surrey children living in poverty aged under 16 years, trend data

2006 – 2011 55

Table 40 Percentage of children (under 16 years) living in workless families, trend data

2006-2012 56

Table 41 Unaccompanied asylum seeking children (UASC) in Surrey under the age of 18 years as at 18 November 2013 (non-validated figures) 57 Table 42 Number of UASC in Surrey by area, 2013 58 Table 43 Families with children in Bed and Breakfast accommodation for more than 6

weeks, excluding those pending review, by local authority as of 31 December 2012

58

Table 44 Mental Health Core Asset scores Apr 2012 to Mar 2013 62 Table 45 Numbers of Care leavers in Surrey, October 2013 64 Table 46 Rate of LAC per 10,000 of the 0-17 population 67

Figures

Figure 1 Estimated percentage change in population in England, South East and Surrey,

comparison between 2009 and 2012 13

Figure 2 Estimated number of children under 19 years in Surrey by borough/district.

Comparison between 2009 and 2012 15

Figure 3 Percentage change in population projections between 2015 and 2025, England,

South East and Surrey 16

Figure 4 Population projections for children in boroughs and districts aged 0 – 4 years,

2015 to 2025 18

Figure 5 Population projections for children in boroughs and districts aged 5 – 9 years,

2015 to 2025 18

Figure 6 Population projections for children in boroughs and districts aged 10 – 14

years, 2015 to 2025 19

Figure 7 Population projections for children in boroughs and districts aged 15 - 19 years,

2015 to 2025 19

Figure 8 Percentage of children aged 0 – 15 years in ethnic groups, 2011 20 Figure 9 Percentage of children aged 0 – 15 years in ethnic groups excluding White

British group, 2011 21

Figure 10 Fixed Term Exclusions 2009/10, 2010/11, 2011/12 25 Figure 11 Percentage of children with the highest percentage Fixed Term Exclusions in

Surrey by ethnic group 25

Figure 12 Difference in the range of languages spoken in Surrey expressed as a

percentage, variance 2008 to 2012 29

Figure 13 Pupils with statements in Surrey, 2009 to 2013 35 Figure 14 Surrey Children‘s Disability Register, 2013 38 Figure 15 Hospital admissions for self harm for people under 18, 2006 to 2012 45 Figure 16 Map of Surrey IMD 2010 rankings at Lower Super Output Areas by Surrey 54

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deciles

Figure 17 Percentage of children living in income deprived households, 2010 55 Figure 18 Percentage of children under 16 years of age in Surrey living in poverty, 2006 -

2011 55

Figure 19 Percentage of children (under 16 years) living in workless families, trend data

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1.

Introduction

This document is a refresh of the 2009 Surrey Child and Adolescent Mental Health Services Healthcare Needs Assessment (2009 CAMHS HNA). It provides up to date information on issues requested by the CAMHS Commissioning group. It is envisaged that a full CAMHS HNA will be undertaken in the near future. Please read this document in conjunction with the 2009 CAMHS HNA.

The Government’s Mental Health action plan ‘Closing the Gap: Priorities for essential change in

mental health’ was published on 21st January and is a key document for the future development of mental health services.

2.

Aim and objectives

The aims and objectives of the 2009 CAMHS HNA were:

Aim

To review the Child and Adolescent Mental Health Services available to residents of Surrey

Objectives

 To identify and address National Guidance on CAMHS

 To assess the current evidence base for prevention and treatment of mental health problems in children and adolescences

 To undertake an epidemiology needs assessment to identify the needs of the population and vulnerable groups in Surrey

 To detail current provision and usage of CAMHS for Surrey residents

 To compare the available service provision with the estimated needs to identify gaps in the current service

 To undertake a corporate needs assessment to gather views of all stakeholders (including children, young people and families/carers), and identify strengths, weaknesses and gaps in current service provision

 To make recommendations about gaps and improvements required in CAMHS.

The aim of this CAMHS HNA refresh is to update specific information in the previous CAMHS HNA as requested by CAMHS Commissioning group

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3.

Current Surrey CAMHS services

Table 1 – Summary of services jointly commissioned by CCGs and SCC, 2013

Primary Mental Health Service

A targeted service providing a combination of direct therapeutic time-limited intervention to children and young people with mild to moderate mental health problems and their families, consultation, training, joint working with universal services and community CAMHS teams. Including interventions with young offenders/those at risk of offending, children who are looked after, children in need preventing them becoming

accommodated, children with learning disabilities and those placed in pupil referral units (PRU) and behavioural, emotional and social

difficulties (BESD) schools to prevent or minimise escalation of need and referral to specialist services

CAMHS Extended Hours Service

Aim of service isto prevent children from being accommodated and work

with families at high risk of (mental health and) family breakdown CAMHS Weekend

Assessment Service

Weekend assessment provision for children and young people presenting at Accident and Emergency (A & E) 9-5 Monday to Friday weekends and Bank Holidays

Parent Infant Mental Health Service (PIMH)

Service aim is to promote positive, secure early attachments between babies and their parents where a mental health vulnerability or risk has been identified

You and Your Baby connecting Service

Aim of service is to support and offer intervention for young mothers in care or care leavers to promote positive, secure early attachments between babies

Children in Care (3Cs)

Service aim is to provide a single referral and care pathway for Looked After Children (LAC) with significant mental health and emotional difficulties or displaying signs of emerging complex emotional and

psychological difficulties and mental health needs. The service is for 0-18 year olds and includes training; advice and consultation to LAC teams and residential teams & fostering teams; assessment and treatment of complex or high risk cases; therapeutic intervention; transition planning to adult service and therapeutic support groups for foster carers

Targeted Clinical Service

To deliver targeted family interventions providing direct therapeutic work with children and young people with mild to moderate mental health problems and their families within Community CAMHS

Sexual Trauma Assessment Recovery and Support (STARS)

To provide a therapeutic and support resource for children, young people and their parents/carers who have been affected by sexual abuse, using a trauma focused approach, which aims to eliminate or reduce symptoms specific to sexual trauma.

CAMHS Community Nurses for schools

To deliver mental health interventions to children and young people with mild to moderate mental health problems and to support the school nursing teams offering consultation and advice in a school setting and contributing to the delivery of the TaMHS approach

Everybody’s Business training for professionals in universal services

To deliver mental health awareness training for professionals and volunteers working in universal services to build capacity and develop skills and confidence to support early intervention and appropriate referrals to targeted and specialist CAMHS

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4.

Local need for CAMHS

The local need for CAMHS depends on the prevalence of mental health problems and disorders in the local community; to estimate this we can use local population figures and projections, national figures, local data about those with risk factors for mental health problems and current service use.

4.1

Demographics and population projections

4.1.1 England, South east, Surrey, district and borough level population estimates

The 2009 CAMHS HNA included 2008 demographic data. Comparison between 2008 and 2012 data is not possible because the age categories have altered i.e. 15- 18 in 2008 has been changed to 15 – 19 years. It is possible to compare 2009 and 2012 data.

The estimate of the total number of children and young people living in Surrey has increased from 268,500 to 276,000, an estimated increase of 7,500 in a three year period. This is an estimated 2.8% rise in number of children during this period which is greater than the England estimated increase of 1.3% and the South East estimated increase of 2.0%. Surrey shows a similar pattern in terms of increase in estimated populations for the younger age groups of 0 – 4 years and 5 – 9 years and a decrease in the estimated populations for the older age groups of 10 – 14 years and 15 – 19 years as for England and the South East. However there is a slightly larger percentage increase in Surrey for the 0 – 4 year age group and smaller percentage decreases in the two older age categories than for England and the South East.

The boroughs of Guildford and Runnymede have seen the greatest increases during this period and both have an estimated increase in the number of children and young people of over 5%. Only Surrey Heath has an estimated decrease in the total number of children but this is small at less than 1%. All boroughs and districts show an increase in children 0 – 4 years in particular

Runnymede and Woking, both with an estimated increase of over 10%. Spelthorne and Woking have an estimated increase of over 10% for children aged 5- 9 years. In the 10 – 14 years age group ten boroughs and districts have had an estimated decrease or no change; only Guildford has an estimated increase, which is of 1.4%. Eight boroughs and districts show an estimated decrease or no change for the 15 – 19 years age group. The highest is Woking with an estimated decrease of – 8.9%. Guildford has the highest estimated increase of 4.7%.

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Table 2 - Estimated number of children under 19 years in England, South East and Surrey, comparison between 2009 and 2012 Numbers in thousands Region 0 - 19 years 0 - 19 years % change 0-4 years 0-4 years % change 5-9 years 5-9 years % change 10-14 years 10-14 years % change 15-19 years 15-19 years % change 2009 2012 2009 2012 2009 2012 2009 2012 2009 2012 England 12,607.5 12,771.2 1.3 3,211.9 3,393.4 5.7 2,911.8 3,083.6 5.9 3,128.8 3,007.9 -3.9 3,355.0 3,286.3 -2 South East 2,050.6 2,092.0 2.0 510.6 545.7 6.9 479.3 507.4 5.9 517.3 502.7 -2.8 543.4 536.2 -1.3 Surrey 268.5 276.0 2.8 68.3 73.2 7.2 64.5 68.4 6.0 67.6 66.6 -1.5 68.1 67.8 -0.4

Source: Office for National Statistics (ONS), 2013 accessed from Surrey-i 15.10.13

Figure 1 - Estimated percentage change in population in England, South East and Surrey, comparison between 2009 and 2012

Source: ONS, 2013 accessed from Surrey-i 15.10.13

-6 -4 -2 0 2 4 6 8

0-19 years 0-4 years 5-9 years 10-14 years 15-19

Esti m ate d p e rc e n tage ch an ge in p o p u lation Age groups England South East Surrey

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Table 3 - Estimated number of children under 19 years in Surrey by borough/district, comparison between 2009 and 2012 % c ha ng e 3 .6 3 .9 5 .8 0 .0 3 .1 5 .0 2 .8 - 0 .5 0 .0 2 .3 3 .4 0 19 2012 34,3 0 0 1 8 ,7 0 0 3 2 ,7 0 0 1 9 ,8 0 0 3 3 ,8 0 0 1 8 ,8 0 0 2 2 ,0 0 0 2 1 ,0 0 0 2 0 ,0 0 0 3 0 ,6 0 0 2 4 ,4 0 0 0 - 19 2009 33,1 0 0 1 8 ,0 0 0 3 0 ,9 0 0 1 9 ,8 0 0 3 2 ,8 0 0 1 7 ,9 0 0 2 1 ,4 0 0 2 1 ,1 0 0 2 0 ,0 0 0 2 9 ,9 0 0 2 3 ,6 0 0 % c ha ng e - 2 .7 2 .2 4 .7 0 .0 - 1 .3 3 .9 - 1 .9 - 3 .7 - 1 .9 2 .6 - 8 .9 15 19 2012 7,2 0 0 4 ,7 0 0 8 ,9 0 0 5 ,1 0 0 7 ,8 0 0 5 ,4 0 0 5 ,3 0 0 5 ,2 0 0 5 ,1 0 0 8 ,0 0 0 5 ,1 0 0 15 19 2009 7,4 0 0 4 ,6 0 0 8 ,5 0 0 5 ,1 0 0 7 ,9 0 0 5 ,2 0 0 5 ,4 0 0 5 ,4 0 0 5 ,2 0 0 7 ,8 0 0 5 ,6 0 0 % c ha ng e 1 .2 0 .0 1 .4 - 3 .7 - 1 .2 - 2 .4 - 5 .6 - 1 .8 - 5 .6 0 .0 0 .0 10 14 2012 8,4 0 0 4 ,6 0 0 7 ,5 0 0 5 ,2 0 0 8 ,1 0 0 4 ,0 0 0 5 ,1 0 0 5 ,4 0 0 5 ,1 0 0 7 ,6 0 0 5 ,6 0 0 10 14 2009 8,3 0 0 4 ,6 0 0 7 ,4 0 0 5 ,4 0 0 8 ,2 0 0 4 ,1 0 0 5 ,4 0 0 5 ,5 0 0 5 ,4 0 0 7 ,6 0 0 5 ,6 0 0 % c ha ng e 6 .0 4 .7 9 .7 0 .0 5 .0 7 .3 1 0 .0 3 .9 4 .3 5 .6 1 0 .5 5 9 2012 8,9 0 0 4 ,5 0 0 7 ,9 0 0 4 ,8 0 0 8 ,4 0 0 4 ,4 0 0 5 ,5 0 0 5 ,3 0 0 4 ,9 0 0 7 ,6 0 0 6 ,3 0 0 5 9 2009 8,4 0 0 4 ,3 0 0 7 ,2 0 0 4 ,8 0 0 8 ,0 0 0 4 ,1 0 0 5 ,0 0 0 5 ,1 0 0 4 ,7 0 0 7 ,2 0 0 5 ,7 0 0 % c ha ng e 8 .9 8 .9 7 .7 4 .4 9 .2 1 1 .1 8 .9 0 .0 4 .3 1 .4 1 0 .5 0 4 2012 9,8 0 0 4 ,9 0 0 8 ,4 0 0 4 ,7 0 0 9 ,5 0 0 5 ,0 0 0 6 ,1 0 0 5 ,1 0 0 4 ,9 0 0 7 ,4 0 0 7 ,4 0 0 0 - 4 2009 9,0 0 0 4 ,5 0 0 7 ,8 0 0 4 ,5 0 0 8 ,7 0 0 4 ,5 0 0 5 ,6 0 0 5 ,1 0 0 4 ,7 0 0 7 ,3 0 0 6 ,7 0 0 L o c a l a u th o ri ty El m b ri d g e Ep s o m a n d Ewel l G u ild fo rd M o le Va lle y Rei g a te a n d Ba n s te a d Run n y m e d e Sp e lth o rn e Su rre y He a th Ta n d ri d g e Wa v e rl e y Wo k in g

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Figure 2 - Estimated number of children under 19 years in Surrey by borough/district, comparison between 2009 and 2012

Source: ONS, 2013 accessed from Surrey-i 15.10.13

Population projections

In Surrey the number of children between 0 – 19 years is due to rise during the period 2015 to 2025 from 282,700 to 306,200, an increase of 8.3%. This is lower than the projected rise for England of 9.1% during the same period. As the age range used for the most up to date projected population estimates is different to the age range given in the 2009 CAMHS HNA it is not possible to compare the projections.

Table 4 – Population projections for children aged 0 – 19 years 2015 – 2025, England, South East and Surrey

Population in thousands

Region 0 – 19 years 0 – 19 years % change

2015 2025

England 12784.1 13952.2 9.1

South

East 2090.5 2229.1 6.6

Surrey 282.7 306.2 8.3

Source: Population Projections Unit, ONS. Crown copyright 2012 accessed from Surrey-i 08.12.13 0 5000 10000 15000 20000 25000 30000 35000 40000 Esti m ate d p o p u lation ag e d 0 - 19 ye ar s

Boroughs and districts

2009 2012

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Table 5 – Population projections for children aged 0 – 19 years by 5 year age groups between 2015 – 2025, England, South East and Surrey (population in thousands) Region 0 - 4 years 0 - 4 years % change 5 - 9 years 5 - 9 years % change 10 - 14 years 10 - 14 years % change 15 - 19 years 15 - 19 years % change 2015 2025 2015 2025 2015 2025 2015 2025 England 3552.2 3485.0 -1.9 3274.5 3560.9 8.7 2912.5 3564.4 22.4 3044.9 3341.9 9.8 South East 552.0 525.7 -4.8 537.3 560.4 4.3 489.1 585.4 19.7 510.1 555.6 8.9 Surrey 75.2 72.7 -3.3 74.5 77.9 4.6 66.9 81.1 21.2 66.1 74.5 12.7

Source: Population Projections Unit, ONS. Crown copyright 2012 accessed from Surrey-i 08.12.13

Figure 3 – Percentage change in population projections between 2015 and 2025, England, South East and Surrey

Source: Population Projections Unit, ONS. Crown copyright 2012 accessed from Surrey-i 08.12.13 -10 -5 0 5 10 15 20 25

0 - 4 years 5 - 9 years 10 - 14 years 15 - 19 years

Esti m ate d p e rc e n tage ch an ge in p o p u lation p ro jec tion s Age groups England South east Surrey

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Table 6 - Population projections for children aged 0 – 19 years 2015 – 2025, boroughs and districts Local authority 0 – 19 0 – 19 % change 0 - 4 years 0 - 4 years % change 0 - 5 years 0 - 5 years % change 10 - 14 years 10 - 14 years % change 15 - 19 years 15 - 19 years % change years years 2015 2025 2015 2025 2015 2025 2015 2025 2015 2025 Elmbridge 33,800 35,800 5.9 9,500 8,900 - 6.3 9,600 9,600 0 8,100 9,600 18.5 6,600 7,700 16.7 Epsom and Ewell 19,400 22,500 16.0 5,200 5,300 1.9 5,100 5,700 11.8 4,600 6,000 30.4 4,500 5,500 22.2 Guildford 34,200 37,000 8.2 8,700 8,300 - 4.6 8,400 8,900 6.0 7,500 9,200 22.7 9,600 10,600 10.4 Mole Valley 19,900 21,000 5.5 4,900 4,800 - 2.0 5,200 5,400 3.8 5,000 5,800 16.0 4,800 5,000 4.2 Reigate and Banstead 35,000 39,200 12.0 9,900 9,900 0 9,400 10,200 8.5 8,300 10,400 25.3 7,400 8,700 17.6 Runnymede 19,800 21,900 10.6 5,300 5,100 - 3.8 4,800 5,300 10.4 4,200 5,300 26.2 5,500 6,200 12.7 Spelthorne 22,100 24,200 9.5 6,200 6,000 - 3.2 5,900 6,200 5.1 5,100 6,300 23.5 4,900 5,700 16.3 Surrey Heath 21,000 21,400 1.9 5,300 5,000 - 5.7 5,500 5,500 0 5,400 5,900 9.3 4,800 5,000 4.2 Tandridge 21,000 22,400 6.7 5,200 5,000 - 3.8 5,500 5,700 3.6 5,300 6,300 18.9 5,000 5,400 8.0 Waverley 32,300 34,100 5.6 7,800 7,300 - 6.4 8,300 8,300 0 8,200 9,500 15.9 8,000 9,000 12.5 Woking 24,300 27,000 11.1 7,400 7,200 - 2.7 6,800 7,200 5.9 5,300 6,900 30.2 4,800 5,700 18.8

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Figure 4 - Population projections for children in boroughs and districts aged 0 – 4 years, 2015 to 2025

Source: Population Projections Unit, ONS. Crown copyright 2012 accessed from Surrey-i 08.12.13

Figure 5 - Population projections for children in boroughs and districts aged 5 – 9 years, 2015 to 2025

Source: Population Projections Unit, ONS. Crown copyright 2012 accessed from Surrey-i 08.12.13 0 2000 4000 6000 8000 10000 12000 Esti m ate d n u m b e r o f c h ild re n p e r b or ou gh /d istr ict

Boroughs and districts

2015 2025 0 2000 4000 6000 8000 10000 12000 Esti m ate d n u m b e r o f c h ild re n p e r b or ou gh /d istr ict

Boroughs and districts

2015 2025

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Figure 6 - Population projections for children in boroughs and districts aged 10 – 14 years, 2015 to 2025

Source: Population Projections Unit, ONS. Crown copyright 2012 accessed from Surrey-i 08.12.13

Figure 7 - Population projections for children in boroughs and districts aged 15 - 19 years, 2015 to 2025

Source: Population Projections Unit, ONS. Crown copyright 2012 accessed from Surrey-i 08.12.13

Implications for CAMHS

Based on population data the areas of Surrey with the greatest requirement for health services for children and young people will continue to be Elmbridge, Reigate and Banstead, Guildford and Waverley (Table 6). However, whilst population data is important in determining the requirement for services, further information in this Refresh regarding prevalence of risk factors for mental health disorders in these areas must be taken into account in conjunction with population data when planning service provision.

0 2000 4000 6000 8000 10000 12000 Esti m ate d n u m b e r o f c h ild re n p e r b or ou gh /d istr ict

Boroughs and districts

2015 2025 0 2000 4000 6000 8000 10000 12000 Esti m ate d n u m b e r o f c h ild re n p e r b or ou gh /d istr ict

Boroughs and districts

2015 2025

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4.1.2 Black and minority ethnic (BME) communities

Evidence provided in the 2009 CAMHS HNA showed that the prevalence and presentation of child and adolescent mental health disorders varies between ethnic groups and there was no consistent pattern across subgroups. The 2009 CAMHS HNA also provided evidence that:

 Children of Asian origin have a comparable or slightly lower rate of psychiatric disorder than

Caucasian children

 There is a ‘statistically significant bias in relation to the referral route to CAMHS and ethnicity of

children’. This results in lower referral rates from black and ethnic minorities compared with white peers

The 2009 CAMHS HNA suggested that specialist training of interpreters and other staff is required for those dealing with families and young people whose first language is not English when

delivering psychological treatments.

The 2011 Census provides the most up to date data of percentage of children aged 0 – 15 years in ethnic groups at both national, county and borough and district level. It is not possible to compare the current data with the data in the 2009 CAMHS HNA as the groups differ. In the 2011 Census data, Woking and Epsom and Ewell have the highest percentage of children from minority ethnic groups in Surrey and Woking has a higher percentage of children from these groups that England, the South East and Surrey.

Figure 8- Percentage of children aged 0 – 15 years in ethnic groups, 2011

Source: Census 2011, ONS accessed from Surrey-i 29.12.13

0.00 20.00 40.00 60.00 80.00 100.00 120.00

England South East Surrey Elmbridge Epsom and Ewell Guildford Mole Valley Reigate and Banstead Runnymede Spelthorne Surrey Heath Tandridge Waverley Woking Percentage White British All other white groups Multiple ethnic groups Indian

Pakistani

All other Asian groups Black/African/Caribbean/ Black British

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Figure 9 - Percentage of children aged 0 – 15 years in ethnic groups excluding White British group, 2011

Source: Census 2011, ONS accessed from Surrey-i 29.12.13

0.00 10.00 20.00 30.00 40.00 England

South East Surrey Elmbridge Epsom and Ewell Guildford Mole Valley Reigate and Banstead Runnymede Spelthorne Surrey Heath Tandridge Waverley Woking Percentage

All other white groups Multiple ethnic groups Indian

Pakistani

All other Asian groups Black/ African/ Caribbean/ Black British

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4.2

Education

4.2.1 Schools in Surrey

The School Census 2013 gives an estimate of 184,250 children and young people in Surrey schools. This a rise of almost 45,000 compared with the figure of 140,364 in the 2009 CAMHS HNA. However the 2009 figures do not include independent schools. In 2013, 38,127 children are being educated in independent schools, if this number is subtracted from the total the number of children a figure of 146,123 is achieved which represents an increase of almost 6,000 pupils. 20.7% of Surrey children attend independent schools.

The 2013 data provides information on the number of children attending a wider range of schools including academies and independent schools. There are currently six primary schools that are academies and 23 out of 53 secondary schools are academies

Data for children at the primary stage is recorded differently than in 2009, there is no division for infant, junior, primary. The total number of schools at the primary stage has decreased from 308 to 300 but the number of children has shown a notable increase from 45,871 to 83,940. The number of children attending special schools has also increased from 1,860 to 2,341 and there are seven more special schools since 2009.

According to the data available from the School Census, 2013 on Surrey-i the number of children attending pupil referral units is 56, which is considerably lower than the 2009 figure of 256.

Concern has been expressed that the 2013 figure is incorrect. There has been a large decrease in number of children attending pupil referral units from 256 to 56.

Table 7 - Number of children in schools in Surrey by type, January 2009

School type Number of schools Total number on roll % total

Nursery 4 363 0.3 Infant/First 107 16,255 11.6 Junior 51 16,571 11.8 Primary 150 45,871 32.7 Secondary 53 59,188 42.2 Special 23 1,860 1.3

Pupil referral unit 14 256 0.2

Total 402 140,364 100

Source: SCC, January 2009 (2009 CAMHS HNA)

Table 8 – Number of schools in Surrey by school type and number on roll, 2013

School type Number of schools Total number on roll % of children on roll (STATE FUNDED ONLY) % children on roll (ALL SCHOOLS) Nursery 4 346 0.24 0.18 Primary 300 83,940 57.44 45.56 Secondary 53 59,440 40.68 32.26 Special 30 2,341 1.60 1.27 Pupil referral unit 10 56 0.04 0.03 TOTAL STATE FUNDED 397 146,123 100 Independent 109 38,127 20.69 TOTAL ALL SCHOOLS 506 184,250 99.69

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Table 9 - Number of children in schools across Surrey boroughs/districts, January 2009

Local authority Number of schools Total number on roll % total

Elmbridge 34 13,191 9.4

Epsom and Ewell 26 11,239 8.0

Guildford 52 17,208 12.3

Mole Valley 34 10,180 7.3

Reigate and Banstead 44 17,154 12.2

Runnymede 32 9,946 7.1 Spelthorne 32 12,835 9.1 Surrey Heath 34 11,696 8.3 Tandridge 32 10,621 7.6 Waverley 50 14,751 10.5 Woking 32 11,543 8.2 Total 402 140,364 100

Source: SCC, 2009 (2009 CAMHS HNA)

Number of schools in Surrey in 2014 is now 389 as although the number of children is increasing, schools have amalgamated. However, there are a potential number of free schools and new schools to be opened in the next two to three years.

2.2. Fixed Term Exclusions (FTEs)

The impact of FTEs on emotional wellbeing and mental health of children and young people is that it can mask the underlying needs and issues.

Barnardo’s (2010)1 states that for many, bad behaviour in school is a result of real difficulties

outside school, such as bereavement, parental separation, drug misuse, stress of living in a deprived area and suggests that sending pupils home to chaotic families or risky neighbourhoods does nothing to improve their behaviour and exposes them to the risk of getting involved in antisocial behaviour and crime and that children at risk of exclusion need more adult supervision, not less. For some children, school provides routine, boundaries and stability that they do not have at home.

The report also highlights that permanent exclusions have declined in recent years but that

temporary, fixed term exclusions have increased with 1 in 20 secondary pupils being excluded and some missing as much as 9 weeks of school each year.

Statutory guidance identifies a number of groups for whom the exclusion rate is consistently higher than average. This includes pupils with special educational needs (SEN), pupils eligible for free school meals, looked after children and pupils from certain ethnic groups. The groups with the highest national rates of exclusion are Gypsy Roma, Travellers (GRT) of Irish Heritage and Black Caribbeans.

National picture

Across all schools in England there were 363,280 FTEs in 2008/09 with 307,840 FTEs in secondary schools affecting 1 in 20 of the secondary school population.

Persistent disruptive behaviour is the most prevalent official reason for school exclusion and the Barnardo's report asks how behaviour is allowed to become ‘persistently disruptive’ without effective interventions at an earlier stage to help resolve problems.

The reduction in permanent exclusions is partly as a result of a change in culture and practice within education with zero exclusions and managed moves alongside the recognition of the need for adequate, resourced alternative provision.

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The report focuses on four models of intervention to restore at-risk young people to learning and work to improve behaviour, each costing less than a Pupil Referral Unit (PRU) place:

 The Shropshire Project – unpicking the issues

 Palmersville Training – choosing vocational alternatives

 The Late Intervention Service – tracking down the hardest to reach

 Leeds Reach – respite and reintegration

The Shropshire Project approach focused on early interventions and preventive services for 5 – 18 year olds centred on family support work with primary objective to prevent school exclusions. There was a focus on emotional management as they found those most frequently referred had low self-esteem expressed through poor behaviour.

The projects demonstrated that with the right intervention, understanding of the consequences of choices can have a positive impact on behaviour. Managing anger and understanding the

consequences of actions are important skills for school and life in general.

Local picture

Department of Education (DfE) statutory guidance stresses the importance of early intervention in addressing the underlying causes of all disruptive behaviour. For students with SEN or disabilities, any intervention should include an assessment of whether appropriate provision is in place. Head teachers are advised to consider use of a multi agency approach for all students who demonstrate persistent disruptive behaviour and what extra support is needed e.g. support of Traveller

Education services. Schools should avoid permanent exclusion of looked after children.

Table 10 – Number of Fixed Period Exclusions (FPE) and percentage of school population for schools in Surrey, 2009 to 2012 Year State-funded primary (1)(2) State-funded secondary (1)(3) Special (4) State-funded primary, state-funded secondary and special schools (1)(2)(3)(4) Number of FPE % school population (5) Number of FPE % school population (5) Number of FPE % school population (5) Number of FPE (6) % school population (5) 2009/10 551 0.69 5,552 9.32 390 16.93 6,490 4.59 2010/11 656 0.82 4,451 7.45 343 14.77 5,450 3.83 2011/12 778 0.95 3,896 6.56 489 21.17 5,160 3.60

Source: Schools Census, 2009/10, 2010/11, 2011/12

The above table shows an increase of 2.6% in the number of FTE in state funded primary schools (1 & 2) in Surrey from 551 in 2009/10 to 778 in 2011/12. With state funded secondary schools (1 & 3) there was a reduction of 2.56% FTE from 2009/10 to 2011/12. However, for special schools (4) the number of FTE increased by 4.24% from 2009/10 to 2011/12.

The overall number of FTE in state funded primary, secondary and special schools in Surrey reduced by 0.99% from 2009/10 to 2011/12.

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Figure 10 – Fixed Term Exclusions 2009/10, 2010/11, 2011/12

Source: Schools Census, 2009/10, 2010/11, 2011/12

Figure 11 – Percentage of children with the highest percentage Fixed Term Exclusions in Surrey by ethnic group

Source: School Census, 2009/10 and 2011/12

There are a wide range of ethnic groups in Surrey in the FTE data, but the numbers appear to be extremely low. The table above shows that the highest percentage of children with Fixed Term Exclusions by ethnic group is from the Irish Traveller and Gypsy Roma communities although this has reduced from 2009/10. There has been a small increase in the number of Fixed Term Exclusions from the other ethnic groups

0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 2009/10 2010/11 2011/12 % of school population Years

Fixed Term Exclusions 2009/2012

0 5 10 15 20 25 30 % of school population

FTE by ethnic group

2009/10 2011/12 2011/2012

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Table 11- Reasons for Fixed Term Exclusions in state-funded primary, secondary and special schools in Surrey in 2009/10 and 2011/12

State funded schools

FTE reason Secondary

2009/10 Secondary 2011/12 Primary, secondary and special schools 2009/10 Primary, secondary and special schools 2011/12 Physical assault against a pupil 897 635 1,090 915 Physical assault against an adult 62 54 323 312 Verbal abuse/ threatening behaviour against a pupil 257 193 280 239 Verbal abuse/ threatening behaviour against an adult 1,361 956 1,439 1,072 Bullying * 74 42 88 60 Racist abuse 68 59 73 71 Sexual misconduct 32 43 35 49

Drug & alcohol related 169 94 186 109

Damage 89 76 126 106 Theft 115 101 118 106 Persistent disruptive behaviour 1,427 870 1,686 1,288 Other 1,008 773 1,052 836 Total 5,550 3,900 6,490 5,160

Source: School Census, 2009/10 and 2011/12

The above table shows an overall decrease in the total number of FTE in all Surrey state-funded schools from 6,490 in 2009/10 to 5,160 in 2011/12 (-1,330). The only reason category showing an increase is ‘sexual misconduct’ from 35 in 2009/10 to 49 in 2011/12, an increase of 14 FTEs, with 11 in state-funded secondary schools. The remaining three are in primary and/or special schools. The highest numbers of exclusions are for ‘verbal abuse/threatening behaviour’ against an adult 1,439 in 2009/10 reducing to 1,072 in 2011/12. In 2009/10, ‘physical assault against a pupil’ 1,090 in 2009/10 reducing to 915 in 2011/12 and for ‘persistent disruptive behaviour’ at 1,686 in 2009/10 reducing to 1,288 in 2011/12. The Persistent disruptive behaviour category is very broad and will encompass a range of issues but a crude analysis of the data suggests a need for further

emotional management support, reflecting the Barnardo’s report findings.

*The ‘bullying’ category in the above table indicates a decrease in FTE incidents relating to this from 88 in 2009/10 to 60 in 2011/12. However, this does not include cyber bullying which is on the increase although a relatively recent phenomenon.

In extreme cases, cyber bullying has driven teenagers to suicide & research2 from the Anti-Bullying

Alliance suggests it is part of everyday life for more than half (55.2%) of all children and young people.

The key themes of 2013 Anti-Bullying week include equipping young people to recognise cyber bullying, supporting professionals to develop youth-led anti-bullying initiatives and promoting positive use of technology. Caring professions need digital skills to be able to support young people effectively. Many experts highlight the need to build social skills, such as resilience, self-esteem and empathy.

The Bullying Intervention Group runs an annual research called Cybersurvey3. The findings

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 Particularly vulnerable groups identified included young carers, looked after young people, those with mental health issues or special educational needs.

 Young people in care may miss out on e-safety lessons, possibly joining a class mid way

through the year or seeking intimacy in online relationships.

 Young carers are more likely to depend on the internet for their social life, while SEN pupils

may need tailored e-safety training. Young people who self harm are especially high risk.

 Children are using technology at an increasingly younger age so support needs to start in

primary school

 Research shows that 15 year olds are least likely to follow e-safety advice (with only 30%

saying they do so) so they need extra support. Targeted Mental Health in Schools (TaMHS)

Since April 2011, the TaMHS approach has been rolled out across Surrey. Of the 365 schools in Surrey, 209 (57%) schools engaged with the TaMHS approach from November 2011 to November 2013. Approximately 3000 staff across 146 Surrey schools have received or booked in to receive Mental Health Awareness training so far, delivered by primary mental health workers and CAMHS community nurses for schools. Groups of 10 - 36 school staff were trained with a mean of 21 participants in each school.

Evaluation is being undertaken by the Royal Holloway University of London. Interim evaluation has found that school staff were consistently satisfied with the mental health training they received. School staff felt significantly more competent across all areas of mental health awareness following their training.

The most improved areas related to staff were:

 Understanding of their role in supporting children with emotional and behavioural difficulties

 Knowledge about the services that are in place in school to support young people’s emotional

health

 Understanding of the structure of CAMHS, feeling more able to make appropriate referrals to

CAMHS

Four main themes emerged from focus groups with schools engaged in the TaMHS approach including:

 Positive experience of the TaMHS training package

 Positive impact of TaMHS training on the understanding, confidence and skills of individual

school staff

 Positive impact of TaMHS training on school functioning and the development of networks of

support

 Positive impact of TaMHS training on outcomes for children.

Future plans for TaMHS in 2014-2015 include support to specific schools following a detailed analysis of unengaged schools, as the next phase of TaMHS. Some schools clearly have

embedded systems in place and therefore do not need to prioritise TaMHS at this stage. Training continues to be delivered to schools and there are plans to deliver more attachment training to schools and ensure full implementation of the TaMHS approach by encouraging uptake of the consultation lines and primary mental health worker consultation sessions in schools.

An Emotional Literacy Support Assistants (ELSA) Programme has been piloted in south east Surrey and has been successfully evaluated. Educational psychologists train teaching assistants to provide emotional literacy support programmes to help children to recognise, understand and manage their emotions and equips ELSAs to identify children needing extra support and plan and deliver individual and small group programmes. 82 ELSAs have been trained with a further

programme being delivered in SE Surrey to develop the capacity in recognition of the impact of the pilot. The next area to receive the training will be SW Surrey in February - April 2014, followed by

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NW and NE areas. The programme is delivered by trained educational psychologists who offer supervision to the ELSA network.

4.2.3 English as a Second Language (EASL)

National picture

The UK population is increasingly diverse, with a wide range of languages spoken. In some areas

the number ranges from a handful to over 100 languages in some boroughs e.g. Ealing4. This can

be a particular challenge for schools.

Overcoming language barriers in order to access relevant services is challenging. Language and communication difficulties can cause individuals to experience inequalities e.g. accessing services. Those in minority ethnic communities are often the most disadvantaged and also in greater need of health, education and social welfare services but often least able to access readily due to

communication difficulties. Early research by National Association for Language Development in the Curriculum (NALDIC) found that refugee children and young people are at risk of developing psychological problems and language remains a significant barrier to accessing mental health

support services5.

Language barriers can also impact on the quality and experience of services e.g. between patients and doctors, potentially leading to wrong diagnosis and inappropriate or ineffective prescribing and treatment.

Barriers to integration, lack of knowledge about education systems & methods may impact on refugees and asylum seeking children and families experience affecting parental interactions with school and support with homework.

Joseph Rowntree Foundation looked at requests for interpreting as within a mental health context it is argued that individuals need to express themselves in their mother tongue.

Funding for EASL was previously through a ring-fenced Ethnic Minority Achievement Grant but from April 2011 is through the Pupil Premium to enable schools to allocate extra funding to interventions aimed at boosting attainment of pupils from deprived backgrounds.

There is now a greater emphasis on the voice of local communities in determining types of

services needed e.g. Healthwatch6

Local picture

Surrey census data shows an upward trend in the percentage and number of minority ethnic

pupils. There are nearly 190 languages spoken in Surrey maintained schools in 20137.

In 2009 there were 12670 (9.1%) children in Surrey schools with EASL. Woking had the highest percentage (18.5%); Mole Valley (4%) and Tandridge the lowest at (4%).

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Table 12 - Comparison of percentage of pupils with EASL in Surrey by borough/district, 2008 - 2012

Local authority % EASL

2012

% EASL 2008

Epsom and Ewell 12.4 10.2

Elmbridge 9.3 8.0

Guildford 7.9 6.3

Mole Valley 5.0 4.1

Reigate and Banstead 9.8 7.5

Runnymede 12.2 8.2 Surrey Heath 9.5 8.6 Spelthorne 12.0 8.3 Tandridge 3.3 2.8 Waverley 4.8 3.8 Woking 22.1 19.1 Grand Total 9.7 7.8

Source: School Census, January 2008 and January 2012

The above table shows that in 2012, the boroughs with the highest percentage of EASL pupils are Woking (22%), Epsom and Ewell (12.4%), Runnymede (12.2%) and Spelthorne (12.0%). There is an overall increase of 1.9% in the percentage of pupils with EASL from 2008 to 2012, with the greatest increase in Runnymede at 5%, followed by Spelthorne (3.7%) and Woking (2.9%). These boroughs have some of the highest numbers of minority ethnic communities in Surrey. The lowest percentage increase of EASL pupils was in Tandridge (0.5%) followed by Surrey Heath (0.8%) and Mole Valley (0.8%).

The table below shows the difference in the range of languages spoken expressed as a percentage.

Figure 12 – Difference in the range of languages spoken in Surrey expressed as a percentage, variance 2008 to 2012

Source: School Census, January 2008 and January 2012

-150% -100% -50% 0% 50% 100% 150% Arab ic Be n gali Chin es e En gli sh Fre n ch H in d u Gu ja ra ti It alia n Ma lay N ep ali Pa n ja b i Po lis h Po rtu gu es e Sp an is h Taga log/Fili p in o Tamil Urd u Ot h er lan gu age Re fu se d , u n kn o w n o r …

Variance 2008 to 2012

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* Hindu, Gujarati, Malay, Tagalog/Filipino and Tamil only appear in one year hence recorded as

100% change.Only languages with at least 200 pupils have been listed separately. The highest

increase is in Polish.

The table below shows the comparison of percentage of pupils with EASL in Surrey 2008-2012

Table 13 – Comparison of percentage of pupils with EASL in Surrey by school type, 2008 – 2012

% pupils with EASL % pupils with EASL School phase 2008 2012 Nursery 12 -

Infant and first 8 9

Junior 6 7

Primary 10 13

Secondary age 11-16 7 10

Secondary age 11-18 7 9

Special 5 7

Source: School Census January 2008 and 2012

The table shows an increase of EASL across all school phases with the largest increase in primary and secondary age 11-16.

4.2.4 Young people not in education, employment or training (NEET)

Young people who are not in work, education or training are increasingly likely to face a lifetime of

poorer health and lower happiness8. The Prince’s Trust Macqaurie Youth Index report from

2008-2010 highlights how being NEET can impact on a young person’s happiness and mental health. Almost half of young people (48%) claimed that unemployment had cause problems of self harm, panic attacks and insomnia. For a significant number, being out of work caused feelings of self-loathing and inferiority. Young people are twice as likely to self harm or suffer from panic attacks a year into unemployment.

Local Picture

Table 14 - Young people aged 16-18 years who are NEET in Surrey, 2008 to 2013

Local authority October 2008 October 2009 October 2010 October 2011 October 2012 October 2013 Elmbridge 80 103 76 79 84 37 Epsom and Ewell 61 52 46 49 48 16 Guildford 114 126 129 93 104 44 Mole Valley 77 98 67 63 44 15 Reigate and Banstead 173 198 129 115 86 55 Runnymede 97 90 83 79 64 25 Spelthorne 140 147 155 157 119 45 Surrey Heath 90 97 75 89 59 21 Tandridge 89 65 62 65 59 18 Waverley 75 97 75 61 50 33 Woking 114 127 82 64 65 35 Grand Total 1110 1200 979 914 782 344 Source: SCC, 2013

NB: Services for Young People now typically report NEET for young people (roughly those aged 19) following a DfE change in 2011/12. To make the historical comparison to 2008/09, the 16-18 year old data has been used in this table.

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There was a reduction in overall numbers of young people who are NEET in Surrey of 518 from 1,200 in 2009 to 782 in 2012. The largest change is in Reigate and Banstead with a reduction of 54 from 98 to 44 and Woking with a reduction of 47, from 97 to 50.

The ten most deprived areas in Surrey are in the following wards: Maybury and Sheerwater, and Goldsworth East in Woking; Merstham and Horley West in Reigate and Banstead; Westborough and Stoke in Guildford; Stanwell North in Spelthorne; Godalming and Central Ockford in Waverley; Court in Epsom and Ewell; and Walton Ambleside in Elmbridge. Young people living in deprived neighbourhoods are more likely to become NEET.

Home tuition

There are 678 pupils on the Elective Home Education roll across Surrey although home educated children do not have to register with the Local Authority. National trends indicate that there will be double this amount in Surrey. Parents who home educate take full responsibility for their child’s emotional wellbeing and mental health and education fund where necessary. Where the Elective Home Education team is consulted and any needs are identified, the family will be signposted to the appropriate service/agency. Where a child has a statement of SEN and is home educated, Local Authority support is discretionary.

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4.3

Health

4.3.1 Children with mental disorders in England, Surrey and in Surrey borough and districts

In the 2009 CAMHS HNA national prevalence rates for specific conditions were applied to local population data on children and young people to provide Surrey estimated prevalence rates. In the 2009 report it was acknowledged that these estimates should be used with caution as prevalence rates vary widely across the country due to variation in the prevalence of risk factors and this is the case with the estimated prevalence rates for 2012; the 2012 data is based on the same national

prevalence rates as used in 2009 i.e. those found in the Mental Health of Children and Young

people in Great Britain, 2004 report9.These national rates have been used as this study has not been updated and there is no source of up to date data.

Table 15 - Estimate of children and young people with specific conditions, comparison of 2009 with 2012 estimates Surrey estimates 2009 Surrey estimates 2012 National percentage aged 5 – 16 years

All All Boys Girls All

Emotional disorder 5,884 6,014 3.1 4.4 3.7 Anxiety disorders 5,248 5,364 2.9 3.8 3.3 Separation anxiety 636 650 0.3 0.5 0.4 Specific phobia 1,272 1,300 0.8 0.8 0.8 Social phobia 477 488 0.3 0.3 0.3 Panic 318 325 0.1 0.3 0.2 Agoraphobia 159 163 0.1 0.2 0.1

Post traumatic stress 318 325 0 0.6 0.2

Obsessive compulsive 318 325 0.2 0.2 0.2

Generalised anxiety 1,272 1,300 0.6 1.0 0.8

Other anxiety 1,431 1,463 0.8 1.1 0.9

Depression 1,431 1,463 0.6 1.1 0.9

Depressive episode (full ICD 10

criteria) 954

975

0.5 0.8 0.6

Other depressive episode 318 325 0.2 0.3 0.2

Conduct disorders 9,224 9,427 7.5 3.9 5.8

Oppositional defiant disorder 4,771 4,876 4.0 2.0 3.0

Unsocialised conduct disorder 1,272 1,300 1.1 0.5 0.8

Socialised conduct disorder 2,068 2,113 1.6 0.9 1.3

Other conduct disorder 954 975 0.8 0.4 0.6

Hyperkinetic disorder 2,386 2,438 2.6 0.4 1.5

Less common disorder 2,068 2,113 1.9 0.8 1.3

Autistic Spectrum disorder 1,431 1,463 1.4 0.3 0.9

Tick disorders 0 0 0.0 0.1 0.0

Eating disorders 477 488 0.5 0.1 0.3

Mutism 159 163 0.0 0.2 0.1

Any disorder 15,268 15,603 11.4 7.8 9.6

Source: Mental Health of Children and Young people in Great Britain 2004, and Surrey population estimates from ONS 2007 and 2012 (2009 data from 2009 CAMHS HNA)

Figure

Updating...

References

  1. https://www.gov.uk/government/publications/special-educational-needs-in-england-january-2012
  2. I www.surreyi.gov.uk
  3. Children
  4. new NICE guideline
  5. Recent NICE guidance
  6. www.theparentcentre.gov.uk
  7. www.teachingnet.gov.uk
  8. http://www.barnardos.org.uk/not_present_and_not_correct.pdf
  9. http://www.anti-bullyingalliance.org.uk/press-centre/executive-summary-of-findings-which-show-parents-and-teachers-struggle-to-keep-kids-safe-online.aspx
  10. http://www.anti-bullyingalliance.org.uk/press-centre/executive-summary-of-findings-which-show-parents-and-teachers-struggle-to-keep-kids-safe-online.aspx
  11. http://www.youthworksconsulting.co.uk/
  12. http://www.childrenengland.org.uk/upload/Language%20Briefing.pdf
  13. http://www.naldic.org.uk/eal-teaching-and-learning/outline-guidance/ealrefugee/refuasc
  14. ch http://www.healthwatch.co.uk/
  15. http://www.cfsurrey.org.uk/sites/default/files/file_attach/Surrey%20Uncovered.pdf
  16. www.princes-trust.org.uk/pdf/Youth_Index_jan2011.pdf
  17. http://atlas.chimat.org.uk/IAS/profiles/profile?profileId=41&geoTypeId=
  18. http://www.fph.org.uk/uploads/Thinking%20Ahead.pdf
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  20. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216870/No-Health-Without-Mental-Health-Implementation-Framework-Report-accessible-version.pdf
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  22. http://www.rcpsych.ac.uk/pdf/No%20Health%20-%20%20the%20evidence_%20revised%20May%2010.pdf
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  24. http://www.rcpsych.ac.uk/healthadvice/parentsandyouthinfo/parentscarers/chronicphysicalillnesses.aspx
  25. http://www.mencap.org.uk/node/7000
  26. http://www.learningdisabilities.org.uk/publications/count-us-in/
  27. http://www.learningdisabilities.org.uk/content/site/our-work/health-and-wellbeing/what-we-are-doing/friends-for-life
  28. http://www.learningdisabilities.org.uk/content/site/our-work/health-and-wellbeing/what-we-are-doing/friends-for-life
  29. http://webarchive.nationalarchives.gov.uk/20130401151715/https://www.education.gov.uk/publications/standard/publicationdetail/page1/cm%208027
  30. http://www.rcpsych.ac.uk/files/pdfversion/cr164.pdf