Top PDF Improving children and young people’s mental health services

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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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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Future in mind. Promoting, protecting and improving our children and young people s mental health and wellbeing

Future in mind. Promoting, protecting and improving our children and young people s mental health and wellbeing

5. Improving access to effective support – a system without tiers 47 commissioning perspective compatible with the type of model we describe in this chapter. This should address the role of pre-crisis, crisis, and ‘step-down’ services alongside inpatient provision. We return later in the report to the question of how we achieve a planning and commissioning framework, and information systems that can enable the system to make much better decisions about what inpatient capacity is required and to improve outcomes for children and young people for whom inpatient care cannot be avoided. There is strong support for investing in effective targeted and specialist community provision, including admission prevention and ‘step-down’ provision. This can provide clear pathways for young people leaving inpatient care to help avoid unnecessary use of inpatient provision and shorten duration of stay by easing the transition out of inpatient care (13). In line with the NHS 5 Year Forward View, NHS England is exploring a range of options for future commissioning and more collaborative work.
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Care in mind : improving the mental health of children and young people in state care in Scotland

Care in mind : improving the mental health of children and young people in state care in Scotland

accommodated children and young people. The service consists of a psychiatrist, a psycho-therapist, three psychologists, a family therapist and three psychiatric nurses, along with administrative support. This new service has been built upon the foundation of two pilot projects, Open Door and LACES, which ran between 1999 and 2003. The former operated in East Dunbartonshire, a small local authority on the edge of Glasgow city, and the latter which served the ‘East Sector’ of Glasgow city itself. Open Door (Scottish Health Feedback 2003b, van Beinum et al., 2002) mainly worked with children and staff in residential units while LACES worked with children under the age of twelve, the majority of whom were placed with foster carers. In the same period, the Acorn Project was set up in the West Dunbartonshire local authority area under the auspices of Lomond and Argyll NHS Primary Care Trust, part of the Argyll and Clyde Health Board area. The Acorn project consisted of a mental health professional and a social worker and also aimed to serve the needs of children and young people in residential and foster care. Meanwhile in Ayrshire, the LEAP Project had been established with a diverse team of nurses and youth workers to provide an
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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

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

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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Mental Health of Children and Young People in England, 2017

Mental Health of Children and Young People in England, 2017

inappropriate treatment. This information would not be available if other methods of collection were used, such as sampling from lists of patients in contact with mental health services, or patients registered with a general practitioner. This approach has quality implications for other survey aims. For example, a survey of the resident population excludes those who were living in a care home (for example mental health units and young offender institutions). As discussed in this publication, people living in such settings are likely to have worse mental health than those living in private households, which may have an effect on the quality of the prevalence estimates produced by this survey. However, the proportion of the overall population not living in private households is so small that this would have little (or no significant) impact on the prevalence estimates for the disorders examined, as such the decision was made that the improvement in the survey’s ability to provide an estimate of the treatment gap justified this trade-off between these two survey outcomes. Details of the strengths and limitations of the results of this survey are detailed in full in the Survey Design and Methods Report.
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