and Extended Hope
Hope and Extended Hope
Supporting Children and Young People in Crisis
Emma Mapes – Hope Team Manager Christine Gee – Extended Hope Team Manager Hope Service
• A unique multi agency service for 11-18 year olds in Surrey, with complex mental health, emotional and social needs.
• Jointly funded - CCG’s and Surrey County Council, working in partnership by Surrey and Borders Partnership Trust
• 3 sites – Epsom, Guildford and Extended Hope
Building Futures Transforming Lives Referrals
Referrals to Hope can be made via a Social Worker or a CAMHS Consultant Psychiatrist
• Social Worker referral criteria: • To prevent out of county fostering, community home or residential placements for young people • To prevent family breakdown, where a young person is likely to be placed out of county
• CAMHS Consultant referral criteria: • To prevent or shorten Tier 4 inpatient hospital admissions for young people with mental health difficulties.
• Extended Hope referral criteria: • To support Surrey young people in mental health / emotional crisis out of hours
Building Futures Transforming Lives Risk profile of Hope young people
• Hope young people are considered to pose a significant level of risk to themselves, to others or be at significant risk from others.
• Risks: significant risk of previous suicide attempts, engaging in significant self harm, complex mental health disorders, significant risk to others (in terms of aggressive behaviour or involvement with drugs/alcohol) and significant levels of risk of CSE/extremism.
Building Futures Transforming Lives Risk management
• Increase the intensity of the work we are carrying out, via day programme or outreach
• Hold weekly case reviews with the MDT/Supervision
• Zone (RAG) all young people every week
• Twice daily discussions with day programme team regarding each young person
• Work more intensively with parents/carers
Building Futures Transforming Lives Risk management
• Frequent attenders plans with general hospitals • Review risk assessments, crisis plan & care plan
• Post-crisis meetings to discuss ongoing care plan, review safety plans with parents/carers and young people
• Learning from significant and serious incidents
• Attending Suicide Prevention Forums within Public Health England
• Attending Suicide Prevention Group (for CYPS) within SABP
• Offer respite (Hope House) and/or out of hours support
Building Futures Transforming Lives Supporting staff
• Group and individual supervision • Case reviews • Case tracking • Clinical support group in disciplines • Management open door policy, involvement in the day programme • Access to SABP and SCC support services • Multi disciplinary students, good learning environment • Employed students into permanent positions
Building Futures Transforming Lives Crisis Care
• Work together to prevent or shorten psychiatric inpatient hospital admissions. (working closely with inpatient units)
• Support young people so that they can stay with their families or in a fostering or residential placements in Surrey.
• Prevent young people being unnecessarily placed on S136 suites, pediatric wards, police custody and inpatient units.
• Manage significant levels risks to self and others, whilst supporting the young people and family in the community.
• Enable family work coordinated by a family therapist.
Building Futures Transforming Lives Crisis Care
• Run a parents and carers group & FLASH • Support transitions to school, training, work, or adult services. • Provide intensive community outreach service for young people and their carers. • Regular home visits by mental health nurses, social workers, activity workers. • Provide a Therapeutic Day Programme in an Ofsted registered Pupil Referral unit using a DBT model. • Extended Hope - Out of hours support / 7 day respite
Building Futures Transforming Lives Partnership working
Young People / Parents / Carers
Paediatric Wards Education
Drug and Alcohol Services CAMHS Community Teams
Police GP HOPE / EXTENDED HOPE Emergency Duty Team Adult Services SERVICE Tier 4 Hospitals CAMHS Community Crisis Team Children’s Services
CYP Havens Children’s homes / placements Criminal Justice Liaison & Diversion Service CAMHS Specialist Teams
Building Futures Transforming Lives Case Study - Kate
• Became a Child Looked After at age 2 ½, along with her sister • Adopted at age 4, with her sister (aged 6) • Complex presentation – suicidality, self harm, missing, CSE concerns • Became known to CAMHS in April 2017 • Psychiatric admissions – June 17-April 18 / June 18-Jan19 • Placement in a Surrey children’s home following last admission • Placement breaking down due to level of self harm
Building Futures Transforming Lives Case Study
Wrap around mental health support with Hope / Extended Hope Admission to Hope House
Assessment of current mental state Ongoing support to children’s home Medication Review
Frequent attenders plan with Kate new local general hospital Risk assessment/care plan/crisis plan
Supported with transition Support to manage recent allegation to a new placement against peer
Training to children’s home to help Advice and support to children’s services around placement options understand and manage mental Extension to respite at health needs and self harm Hope House
Building Futures Transforming Lives