Mental Health Innovation for Children in

Esther Schmidt- Children’s Commissioning Lead Swindon CCG

Amy Smith- Children and Young People’s Programme Manager Swindon CCG “Climbing a mountain is hard, just like achieving our dreams, but we shouldn’t let things stand in our way and in the end it is worth it”

Advice from Falcon Class, Uplands School. Green Paper Trailblazer Bid

Background In July 2018, the Trailblazer Bid was released following the Government’s Green Paper Consultation on ‘Transforming children and young people’s mental health provision: a green paper’ Three core Green Paper proposals: 1. To incentivise and support all schools and colleges to identify and train a Designated Senior Lead for mental health. 2. To fund new Mental Health Support Teams, which will be supervised by children and young people’s mental health staff. 3. To pilot a four week waiting time for access to specialist NHS children and young people’s mental health services.

Our Mission: To Optimise the Health and Wellbeing of the People of Swindon and Shrivenham Mental Health Support Teams (MHSTs) Overview

• First wave operational by December 2019- rollout to a fifth of the country by end of 2022/23. • £215m funding 2018-21 to rollout MHSTs and 4WW Pilots. • Swindon successful in securing £2.3m to implement three MHSTs.

Mental Health Support Teams will:

• Deliver evidence-based interventions in or close to schools and colleges for those with mild to moderate mental health issues, e.g. mild anxiety. • Help children and young people with more severe needs to access the right support. • Work with and within schools and colleges, providing a link to specialist NHS services. • Build on and increase support already in place, not replace it.

Our Mission: To Optimise the Health and Wellbeing of the People of Swindon and Shrivenham School Cluster Areas

Cluster 1 Cluster 2 Cluster 3 Abbey Park Great Western Nova Hreod Dorcan Academy Academy Commonweal St Lukes Warneford Moredon New College Tregoze Primary Rodbourne Cheney Robert Le Kyng Peatmoor Swindon Academy East Wichel Oakhurst Sevenfields Drove Primary Tadpole Beechcroft Infants Mountford Manor Red Oaks Ruskin Junior Lainesmead Orchid Vale Ferndale Oaktree Haydon Wick Even Swindon Goddard Park Abbey Meads Gorse Hill Eldene Grange Junior Liden

Total of 41 5982 pupils 6852 pupils 8266 pupils schools Our Mission: To Optimise the Health and Wellbeing of the People of Swindon and Shrivenham The Swindon Vision

• Voluntary Sector Led - Barnardo's is the lead provider • ‘Step up - Step Down’ model – ‘graduated response’ • ‘No wrong Front Door Model’ - accepting self referrals and linking closely with Early Help Hubs • Children and Young People seen outside of school lessons – can be seen before and after school and on weekends • Outreach model - seen in schools or off- site, holiday provision • Follow-up of all non-attendance via phone call, apps and text within 24 hours • Establishment of the Anna Freud ‘Thrive • Anna Freud THRIVE model Model’

Our Mission: To Optimise the Health and Wellbeing of the People of Swindon and Shrivenham Our Mission: To Optimise the Health and Wellbeing of the People of Swindon and Shrivenham Survey Feedback with Children & Young People/Parents & Carer’s

Co-production

Throughout the planning and delivery stage, co-production with children, young people and families is essential.

Consultation/Survey in collaboration with STEP & Swindon SEND Families Voice

• 100 parents/carers • 436 children/young people • 93 children disabled • 16 ethnicities represented • 62 primary, special, secondary schools and colleges and Educated Other Than at School

Our Mission: To Optimise the Health and Wellbeing of the People of Swindon and Shrivenham Main issues that impact on young people’s mental health

Identity or sexuality 90

Anti social behaviour or crime 102

Relationships 116

Disability 116

Drugs or Alcohol 133

Pressure from friends 142

Social media 162

Home or family life 173

School or exam pressures 213

Bullying 304

0 50 100 150 200 250 300 350 Support currently received

Zomos 1 Social Worker 1 Rainbows Group 1 Lift Psychology 1 Butterflies Children's Centre 1 Pastoral Care 2 GoZone 2 Dr / GP 2 College 2 T Zone 4 School Counsellor 6 STEP 14 Counselling 22 CAMHS 24 TaMHS 25 Teacher 27 Family and friends 61

0 10203040506070 What was helpful with accessing services

• Non-judgemental staff • Staff listening to young people • Trust built with staff • Confidentiality explored with staff • A safe environment to speak • Opportunity for young people to understand feelings and express self • Tools to resolve situations • Good relationships, experienced and accessible staff (for example, a mentor, pastoral care) and a whole school approach What was unhelpful

• Staff inability to build and establish good relationships with children/young people • Quick staff turnover • Long waiting lists • Inconsistent and infrequent support • No change after intervention • Lack of understanding, awareness, knowledge, skills and expertise amongst school staff • Communication Place of Support and Type of Support

Somewhere else (please 32 tell us where?) Online support (such as 25 Kooth)

Drop in centre 31

In a community / youth Group work 114 building (e.g. cafe or youth 55 centre)

In a building on the grounds of your school / 81 college, place of education (not main building) One to one support 207

In the main building of your school / college, place 146 of education

Family support 214 In my home 236

0 50 100 150 200 250 0 50 100 150 200 250 Time of Support

During school / college holidays 54

Before school / college (8:00am - 9:00am) 78

In the evening 79

Weekends 101

After School / College (3:00pm - 5:00pm) 117

During school / college (10:00am - 3:00pm) 189

0 20 40 60 80 100 120 140 160 180 200 Recommendations • MHSTs raising mental health awareness • MHSTs providing training • MHSTs build and maintain trusting relationships with young people • MHSTs use outcome measures that inform and improve service delivery • STEP works with young people to develop an information pack on mental health (where to get help, who can I talk to and confidentiality) • STEP consults with young people accessing MHSTs to evaluate the service- evolving through co-production • Children/young people and parents/carers have quicker access to the right support and services • Improved communication between school and parents/carers on mental health Next Steps • Single Point of Access re-design- No Wrong Front Door • Alignment to Early Help Hub • Tell it once- Triage- Assessment

Desired Outcome:

• Right Service Right Time, • No duplication • Reduction of waiting times • Earlier Intervention stopping escalation of complexity, including inpatient stays