Top PDF Access to children and young people’s mental health services: 2018

Access to children and young people’s mental health services: 2018

Access to children and young people’s mental health services: 2018

Our data shows that between one fifth and one quarter of children referred to specialist services are deemed inappropriate for specialist treatment. The proportion of rejected referrals was rising until 2015, and due to low response rates in areas with previously high rates of rejection we cannot be sure that there has been any real improvement in 2018. A conservative estimate of the number of rejected referrals in the latest year is 55,800, but the true number will be higher than this due to providers that did not respond. There is also wide variation between providers, with some rejecting approximately half of all referrals and some reporting that they rejected fewer than one per cent of young people referred this year. There is no consistent measure of how many young people are not accepted into treatment making it difficult to compare across providers. Some may only offer certain tiers of services, include a wider category of young people in their response or filter referrals to other services in ways that result in them not being recorded as ‘rejected.’
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Access and waiting times in children and young people’s mental health services

Access and waiting times in children and young people’s mental health services

when problems can be explained as a normal reaction to a life event; where problem is entirely school-related; service request passed back to referrer. Where information about individual providers’ thresholds for accepting referrals or waiting times are included in this report, it is important to highlight that a straightforward comparison between different providers is difficult. There are no standardised eligibility criteria across CAMHS and each provider collects data about access and waiting times in a different way. Providers with the highest percentage of children who are not accepted may not be the worst performers, as other providers may be measuring this in a different way. Similarly, it is difficult to compare performance across providers on maximum waiting times because of the risk that these are outliers. We have included the average of these maximum waiting times to demonstrate that there are many young people waiting a lot longer than the median waiting times demonstrate. A similar methodology has been employed by NHS Benchmarking. 5 The wide variation between providers indicates that much more could be done to share best practice in increasing access across local areas.
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

• Rates of low wellbeing and dissatisfaction with aspects of life, especially in girls (The Childrens’ Society, 2018). None of these increases necessarily mean that children now have worse mental health than they did before. Diagnosis and treatment rates can reflect changes in help- seeking behaviour, access to mental health professionals, and diagnostic criteria and practice. Parents’ perceptions, and their resulting responses, can be shaped by changes in awareness, knowledge, stigma, and understanding of what constitutes mental disorder (Rüsch et al., 2017). And while low wellbeing and dissatisfaction indicators are closely associated with mental health, they are not the same as mental disorder (Weich et al., 2012). Any approach to the assessment of mental health or wellbeing is subject to the strengths and limitations of the classification system used (Clark et al., 2017).
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Improving children and young people’s mental health services

Improving children and young people’s mental health services

and accountability for spending and outcomes. Key findings Planning for transformation 5 The government faces significant challenges in transforming children and young people’s mental health services, as part of its commitment to parity of esteem between physical and mental health services. The government acknowledges that historically mental health services have been seen as of secondary importance to physical health services. Its periodic survey of the prevalence of mental health conditions among young people allows it to estimate overall need, but historically it has treated far fewer young people than this. In 2015, the most up-to-date estimate indicated that only around one-quarter of children and young people who needed support from mental health services could access those services. The government has endorsed a vision for improving support for children and young people’s mental health, set out in Future in Mind. Delivering this vision will require coordinated action across different parts of government – for example, health, education, local government and justice – and between national and local bodies. Each of these has its own priorities, funding challenges and accountability arrangements. Experience in other sectors also suggests that raising the profile of mental health support and services and reducing the stigma of mental illness may uncover previously unidentified further demand (paragraphs 1.3, 1.7, 1.10 to 1.12, 2.28, 3.18, 3.22 to 3.24 and Figures 4 and 18).
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Mental Health of Children and Young People in England, 2017: Trends and characteristics

Mental Health of Children and Young People in England, 2017: Trends and characteristics

• Rates of low wellbeing and dissatisfaction with aspects of life, especially in girls (The Childrens’ Society, 2018). None of these increases necessarily mean that children now have worse mental health than they did before. Diagnosis and treatment rates can reflect changes in help- seeking behaviour, access to mental health professionals, and diagnostic criteria and practice. Parents’ perceptions, and their resulting responses, can be shaped by changes in awareness, knowledge, stigma, and understanding of what constitutes mental disorder (Rüsch et al., 2017). And while low wellbeing and dissatisfaction indicators are closely associated with mental health, they are not the same as mental disorder (Weich et al., 2012). Any approach to the assessment of mental health or wellbeing is subject to the strengths and limitations of the classification system used (Clark et al., 2017).
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Transformation of mental health services for children and young people in England

Transformation of mental health services for children and young people in England

(6) Facilitative administration is key to any effective service-improvement implementation and is central to the success of disseminating EBPs. Facilitative administration provides leadership and makes use of a range of data inputs to inform decision-making, support the overall processes, and keep staff organized and focused on the desired intervention outcomes. Policies, procedures, structures, culture, and climate are given careful attention to ensure they are aligned with the needs of practitioners learning and implementing EBPs. To this end, the training of service managers/clinical leads is an integral component of the project. This comprises approximately 12 days of training which aims to develop competency in leading service change to deliver evidence-based, quality-driven, outcomes-informed services. Additional aims are: (a) to have critical knowledge of the theoretical, research and implementation literature that underpins service change and (b) to enable service leaders to make the necessary changes in their services during the training course. The course typically involves producing a 4-5,000-word report on a local project, conducted as part of the training that initiates and evaluates a local service change consistent with the principles and ethos of the national project.
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Services for Children and Young People with Mental Health Needs. Lancashire s Local Offer. Lancashire s Health Services

Services for Children and Young People with Mental Health Needs. Lancashire s Local Offer. Lancashire s Health Services

1. Name of the service and what the service provides Lancashire Care NHS Foundation Trust - Child & Adolescent Mental Health Service (CAMHS) – Community Services Lancashire Care Foundation Trust Child and Adolescent Mental Health Services (CAMHS) Tier 3 provide a service for children and young people aged 5-16 who have a range of emotional and behavioural difficulties. The service supports and promotes emotional health and wellbeing.

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Children and Young People s Mental Health Services Workforce Report for Local Authorities

Children and Young People s Mental Health Services Workforce Report for Local Authorities

Background • This bespoke report for Local Authorities outlines details of the second comprehensive national stocktake of the CYP MH workforce, which builds on a previous data collection performed by the NHS Benchmarking Network in 2016. Children and Young People’s mental health services are a high profile service area that has been identified for investment and development in a number of recent national strategies including the NHS Five Year Forward View (2014) and NHS Long Term Plan (2019). CYP MH was also discussed in a recent Government green paper “Transforming Children and Young People’s Mental Health” (2017) which outlined aspirations for an inclusive multi-agency portfolio of CYP MH services that would form the backbone of an expanded delivery model in future years. Much of this vision is articulated in the NHS Long Term Plan with workforce growth central to plans to expand CYP MH services in future.
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The effectiveness of interventions aimed at improving access to health and mental health services for looked after children and young people: a systematic review

The effectiveness of interventions aimed at improving access to health and mental health services for looked after children and young people: a systematic review

the child or young person being moved from one local authority to another (Callaghan 2003; McAuley & Young 2006; Richardson 2002; Street & Davies 2002). The emotional and mental health of children and young people who may have already experienced trauma, loss and separation prior to entry into care together with insufficient support or training for professional carers may contribute to a placement breakdown and requests for the child to be moved (Oosterman 2007; Sallnas, Vinnerljung & Westermark 2004). It is acknowledged that lack of timely and appropriate interventions from specialist mental health services can compound or create a circle of LACYP with emotional and behavioural problems unable to receive appropriate treatment or help from services due to placement instability but continuing to experience placement disruption because of their unresolved or untreated emotional distress and behavioural difficulties. The current review identified one study examining placement stability, which found a positive impact of placing mental health clinicians onsite at foster care agencies on placement stability, although further robust research with baseline data and a control sample is warranted to corroborate this finding and inform commissioning and provision of services.
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

They can occur when the young person thinks about going out, or travelling as well as in the actual situation. Panic disorder Characterised by recurrent attacks of severe anxiety or panic which are not restricted to a particular situation and often ‘come out of the blue’. Symptoms of anxiety in this condition are intense. They start suddenly, peak in a few minutes and include the sudden onset of palpitations, chest pain, choking sensations and dizziness . Post-traumatic stress disorder (PTSD)

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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

Certain groups of children are more likely than others to have a behavioural disorder. Boys remain more likely than girls, and rates peaked in 11 to 16 year olds and were lowest in those aged 17 to 19. Caution, however, is needed with interpretation of the tail off in rates in this older age group. A diagnosis of behavioural disorder ideally needs evidence of impairment in different settings: and valid reports of this are easier to achieve with parent and/or teacher reports. Teacher reports were not obtained for any 17 to 19 year olds on the survey, and about half of 17 to 19 year olds did not have a responding parent. Given non-compliance is an aspect of behavioural disorder, it is likely that survey non-response will also be higher in this group. Another feature of this analysis also impacts on the ability to compare 5 to 16 year old participants with those aged 17 to 19: prevalence in the younger group was uprated with a small adjustment factor (1.06) that took account of the fact that some in this age group did not have a teacher report. Adjustment factors – their rationale, calculation, and impact – are discussed more fully in the Survey Design and Methods Report.
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

More recent follow-up studies of children with ADHD attending child mental health services found higher persistence rates into adulthood (van Lieshout et al., 2016). This topic report splits hyperactivity disorders into two categories: • Hyperkinetic disorder - Symptoms of inattention, hyperactivity and impulsivity are present and lead to impairment in several settings such as school or work, home life and leisure activities. Symptoms are evident by seven years old, and can be identified retrospectively

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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

While the rate of ASD appeared to be higher in younger age groups, this was not statistically significant. If the sample had been larger, it is possible that a difference in rates by age group might have been significant. Although developmental problems are often more common among younger children, research suggests that most adults with an ASD diagnosed in childhood struggle with significant impairment (Howlin et al., 2004). Because few parent reports and no teacher reports were obtained for those in the oldest age group, it had been expected that some cases of ASD might have been missed in this group. Other methodological factors, described in detail in the Survey Design and Methods Report, may also have affected the reliability of age group comparisons.
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

Rowland, Adam White, Alexandra Pop, Salah Merad and Dean Fletcher. We are also indebted to the team of ONS and NatCen interviewers who spent countless hours interviewing participants who took part in this survey. Clinical raters undertook the enormous task of reviewing information on all the children and young people who took part. From the University of Exeter College of Medicine and Health these included Carmen Apostu, Pamela Bowman, Tamsin Newlove- Delgado, Oana Mitrofan and Eva Wooding. From Kings College London: Sophie Epstein, Andrew McWilliams, Helena Hamilton, Christine Kuhn. Thanks to Bruce Clark and the Body Dysmorphic Disorder team from South London and Maudsley Hospital for independently rating the BDD diagnoses.
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

Measuring recognition of difficulties with emotions, concentration, behaviour or getting along with people The perception of a problem is one of the key requirements to accessing support, so the extent to which poor mental health is recognised as such is an important factor to consider when thinking about access to services (Wolpert and Ford, 2015). Children, particularly those of primary school age, rarely access services on their own behalf, which means the perception of important adults is crucial to their access to services in relation to their mental health. The extent to which parents or young people recognise mental health difficulties can be inferred from response to the first question on the impact supplement of the Strengths and Difficulties Questionnaire. This asks the parent or young person whether they consider that the child or they have a problem with emotions, concentration, behaviour or getting along with people. A report of definite or severe difficulties was considered to indicate the recognition of poor mental health and a report of no or minor problems to suggest that the parent or young
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

38 Discussion The effects of new technology and social media on overall health and wellbeing are still relatively unknown. Sampasa-Kanyinga and Lewis (2015) found an independent association between using social media sites for more than two hours per day and self-reported poor mental health, increased levels of psychological distress and suicidal ideation. This prevalence survey also found an association between mental disorders and spending more than four hours on social media per day, whether it was a school or non-school day. Young people with a disorder were also more likely to agree that they spend longer online than they intend to.
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

We are also indebted to the team of ONS and NatCen interviewers who spent countless hours interviewing participants who took part in this survey. Clinical raters undertook the enormous task of reviewing information on all the children and young people who took part. From the University of Exeter College of Medicine and Health these included Carmen Apostu, Pamela Bowman, Tamsin Newlove- Delgado and Oana Mitrofan. From Kings College London: Sophie Epstein, Andrew McWilliams, Helena Hamilton, Christine Kuhn. Thanks to Bruce Clark and the Body Dysmorphic Disorder team from South London and Maudsley Hospital for
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

We are also indebted to team of ONS and NatCen interviewers who spent countless hours interviewing participants who took part in this this survey. Clinical raters undertook the enormous task of reviewing information on all the children and young people who took part. From the University of Exeter College of Medicine and Health these included Carmen Apostu, Pamela Bowman, Tamsin Newlove- Delgado, Oana Mitrofan and Eva Wooding. From Kings College London: Sophie Epstein, Andrew McWilliams, Helena Hamilton, Christine Kuhn. Thanks to Bruce Clark and the Body Dysmorphic Disorder team from South London and Maudsley Hospital for independently rating BDD diagnoses.
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

Around one in sixteen (6.4%) of 17 to 19 year olds experienced more than one mental disorder at the same time. The Mental Health of Children and Young People (MHCYP) surveywas previously conducted with 5 to 15 year olds in 1999 and 5 to 16 year olds in 2004, who were living in Britain and sampled from Child Benefit records. For the 2017 survey, a stratified multistage random probability sample of children was drawn from the NHS Patient Register in October 2016. Children and young people were eligible to take part if they were aged 2 to 19, lived in England, and were registered with a GP.
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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

Many children and young people have some rituals or superstitions, e.g. not stepping on the cracks in the pavement, having to go through a special goodnight ritual, having to wear lucky clothes for exams, or needing a lucky mascot for school sports matches. It is also common for young people to go through phases when they seem obsessed by one particular subject or activity, e.g. cars, a pop group, a football team. But what we want to know is whether the child has any rituals or obsessions that go beyond this.

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