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Children and Families Networking Event Tuesday 26 th March 2019

Children and Families Networking Event Tuesday 26 th March 2019. Working Together to Improve the Mental Health of our Children & Young People. Welcome & Housekeeping. Chris Baird Director Children and Families. Programme 1. What we know 2. Early Help and Prevention

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Children and Families Networking Event Tuesday 26 th March 2019

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  1. Children and Families Networking Event Tuesday 26th March 2019 Working Together to Improve the Mental Health of our Children & Young People

  2. Welcome & Housekeeping Chris Baird Director Children and Families

  3. Programme 1. What we know 2. Early Help and Prevention 3. The NHS Long Term Plan

  4. What we know

  5. One in eight 5 to 19 year olds had a mental health diagnosis in 2017 One in eight (12.8%) 5 to 19 year olds had at least one mental health diagnosis when assessed in 2017 That would be approximately 3,500 children and young people in Herefordshire.

  6. One in twenty One in twenty (5.0%) 5 to 19 year olds met the criteria for two or more individual mental health disorders at the time of interview.

  7. 4 Broad Types

  8. Through the ages

  9. What do we know? • Services oversubscribed • Varying levels of awareness amongst young people, but a lot of interest • Multiple and complex needs • Lack of opportunity for young people to engage early • Context is important – support for families • When young people get help the outcomes are good

  10. The facts • We have lost 20,000+ opportunities for young people to engage early with a professional and get signposted to help • The CLD Trust get 1200 referrals from health professionals for therapy every year + 300 for Strong Young Minds • The CLD Trust have trained 350 mental health champions through Strong Young Minds

  11. What more do we know? • Still too many professionals making judgments on initial presentations • More young people coming forward with LGBTQ+ issues – support from NWD • MHNA stated there are around 8500 young people in the county needing some level of mental health and emotional wellbeing support in Herefordshire at any one time.

  12. The Voice of Children and Young People How do we know? • Participation – the Wellbeing Ambassadors • Strong Young Minds Champions • Feedback from service users of The CLD Trust including that from our work in schools • Monitoring and evaluation

  13. The Voice of Children and Young People What do we know? • Still a lack of awareness of how to get help and how to keep well • Still young people not getting help when they need it and at early stages • Desire to self-refer • Dislike of clinical jargon • Therapeutic intervention works

  14. Sometimes I would feel my anger building at school. Now, after counselling, I can control and recognise my feelings more easily. I have become more confident, more sociable and more content with myself I’ve had my Dad come in and talked to him about how I felt so that helped a lot

  15. Prevalence - presentations

  16. Prevalence – actual issues

  17. Questions? For more on the work of The CLD Trust, including the Strong Young Minds project…. Alex Fitzpatrick alex@thecldtrust.org

  18. Young People’s View https://www.stitcher.com/podcast/this-is-distorted/health-uncovered-with-cel-spellman/e/52293238

  19. Children & Young People’s Mental Health WorkshopPlease take 35 minutes on your tables to discuss andrecord your views What do we know about children and young people’s mental health and emotional wellbeing in Herefordshire?

  20. Early Help and Prevention

  21. What is Early Help? • Early Help means providing help for children and families as soon as problems start to emerge or when there is a strong likelihood that problems will emerge in the future. Herefordshire’s Early Help is about providing services at the right time to meet family’s needs and to keep them in control of resolving their issues and problems, to reinforce and develop the families’ own skills to determine their future, reducing poor outcomes and inequalities.

  22. Level 4 Immediate intervention or Assessment required from MASH Herefordshire Levels of Need HOW PROFESSIONALS RESPOND CHILD OR FAMILY’S SITUATION Level 3 Multiple Agency Intervention Required …IN NEED OF SERIOUS HELP Children or young people with very complex needs or I am extremely concerned for their safety based on evidence of abuse or neglect or disclosure by the child. Referral to MASH. REALLY CONCERNED, AND NEED TO TALK TO THE MASH TEAM Level 2 Relevant Agency Intervention Required Children or young people with identified vulnerabilities and needs that require a multi- agency co-ordinated approach. Undertake the Early Help Assessment. …COMPLEX NEEDS – WILL NEED FURTHER HELP NEED TO WORK WITH OTHER AGENCIES Level 1 No Intervention or Support Required. NEED TO OFFER SUPPORT, CAN DO THIS WITHIN OUR AGENCY …ADDITIONAL NEEDS - MAY NEED SOME EXTRA HELP Children and young people with emerging vulnerabilities whose needs require targeted support. Consider EHA. NO EXTRA SUPPORT REQUIRED …THRIVING Children making good overall progress in all areas of their development, broadly receiving appropriate universal services such as health care and education. They may also use leisure and play facilities, housing or voluntary sector services.

  23. The Early Help provided will be: • Family focused – and designed to address the issues of the whole household in a holistic way; • Community Focussed – drawing on the strengths and services in each locality • Targeted – to ensure the right level of support at the right time; • Multi-agency – to reflect the complex and multi-faceted issues that families can often face; • Aimed at building resilience in families, to provide them with the tools and skills to help and support themselves in the future. • For further information please visit our Early Help website: • https://www.herefordshire.gov.uk/info/200227/support_for_schools_and_settings/615/behaviour_and_support/2

  24. The Early Help Assessment The Early Help Assessment (EHA) is designed to assist practitioners in a range of settings to assess the needs of families, children and young people.It replaces the Common Assessment Framework (CAF). The EHA can be used by schools, health, housing or prevention and early help services across Herefordshire. It can also be used to coordinate more complex early help provision including intensive family support.

  25. The Early Help Assessment Continued The underlying principles of the Early Help Assessment are: The Early Help Assessment assesses the strengths and needs of each family member. Families will play a big part in developing their support plan for meeting any identified additional needs. The assessment and support plan allows all family members to identify their level of need and measure progress themselves. To enable a holistic assessment of the whole family’s needsand should not focus on the policy or statutory obligations of a single service. It is a transferable document and can be shared between agencies, where family consent has been given. You can download a copy of the EHA here https://www.herefordshire.gov.uk/downloads/file/5589/early_help_assessment_form_and_consent

  26. Family Network Meetings Family Network meetings play a crucial role in the integration of services to provide early intervention and prevent needs escalating. The FNM will have ownership and commitment from key professionals working in each locality. Representatives from the core agencies and organisations whose focus is to support children and families will attend this meeting. Family Network meetings are being held every six weeks in the following areas: •Bromyard •Kington and Weobley •Leominster •Hereford City North •Hereford City South •Kingstone and Golden Valley •Ledbury •Ross-on-Wye

  27. Step-down from social care to Early Help Assessment • When a social worker decides that intervention from social care is no longer required and that the needs of a family can be supported through the Early Help process, the procedure is clearly explained in the guidance 2017, https://www.herefordshire.gov.uk/downloads/file/5593/step-down_to_early_help_guidance. • An Early Help Assessment consent and step-down plan should be used and consent MUST be obtained before a case can step-down to Early Help.

  28. Specialist Early Help Family Support Services • Internal Early Help Family Support Team work with high level complex level 3 cases. • Vennture 4families – commissioned service work with level 3 cases using a professional link worker and volunteer model • Homestart – commissioned service works with low level 3 cases and high level 2 cases using a volunteer model • All work holistically with the whole family to ensure all needs of the family are being identified and have an agreed outcome focused support plan to meet their needs • To access all services an early help assessment / must be completed with the family and securely sent to the early help coordinators team

  29. Herefordshire Young Carers Support Service • Herefordshire Young Carers Support Service (part of the Early Help Family Support Team) • A young carer is a child or young person (aged between 5 and 18) who helps to look after someone in their family who has a disability, an illness or mental health, alcohol or drug problem. • Latest figures show the average age of a young carer is 12 – percentages show 1 in 12 secondary pupils are young carers. • 48% complete general caring, 82% emotional support and 18% personal care. • Tim Williams (01432 383 529) and Donna Smith (01432 383 074)

  30. Other Early Help Support available • Partner agencies provide lots of support to children young people and families within early help • Partner agencies include schools, early years settings, Health visitors, school nurses, Midwives, Women’s Aid, WRASAC, CLD, No Wrong Door, Addaction, DWP For more information: • Refer to the Early Help Directory • Search on WISH • Speak to your Early Help Coordinator

  31. Children Centre Services • Work with families with children aged under 5yrs • Facilitate a universal Let’s Play and/or Baby Let’s Play in each centre that families can be signposted to. • Provide an experienced Early Years worker, who can deliver 1:1 targeted support in the home or in group sessions in the Children’s Centre e.g. baby massage sessions, ‘Let’s talk with your baby’, Bookstart corner, Communication Steps and Solihull • Provide advice and guidance around the Early Years Foundation Stage, key health messages and parenting. • Promote the take up of free Nursery Education Funding for eligible 2yr olds and will support families to access this. All three and four-year-olds are entitled to 15 hours free childcare, while some may be eligible for up to 30 hours childcare see link www.herefordshire.gov.uk/NEF • Professionals working with families and children are able to make a request for support by completing the Early Help Assessment part 1 and parents can request support themselves

  32. Parenting courses Herefordshire Council run a range of courses for parents and guardians who would like to have a little extra support, information and advice when it comes to bringing up children and young people. All are run by family support workers who are trained to deliver courses like the Triple P programmehttp://www.triplep-parenting.uk.net/uk-en/triple-p/, and the Solihullhttps://solihullapproachparenting.com/. For further information about positive parenting see the WISH website. https://www.wisherefordshire.org/children-and-families/support-for- parents-and-families/parenting-courses/

  33. Herefordshire directory of early help services • This is a list of local and nationwide services available to download in the directory of early help services https://www.herefordshire.gov.uk/downloads/file/5600/herefordshire_directory_of_early_help_services_for_families and on the WISH website https://www.wisherefordshire.org/marketplace/api/cms/search/doSearch?q=Early+help&pc=

  34. Early Help Coordinators contact details For questions and support, please contact the Early Help Coordinator Team: Leominster & Wigmore, Kington & Weobley & Bromyard: Diane Woodbridge diane.woodbridge@herefordshire.gov.uk South City, Ledbury, Ross and Golden Valley: Wendy Drew wendy.drew@herefordshire.gov.uk North City: Lizi Birrell lizi.birrell@herefordshire.gov.uk MASH: Katie Spencerkatie.spencer@herefordshire.gov.uk

  35. Solid Roots Programme Lindsay MacHardy Public Health Specialist

  36. The Solid Roots Programme is essentially 3 work streams that will deliver training across the 0-5 workforce, enhancing skills and ability to support young children and families in relation to: • Solid Roots: early speech and language difficulties (Elklan) • Solid Roots: EY Training - maths, literacy, learning and development • Solid Roots: Solihull - parenting, attachment and infant mental health • Project start 1st September 2018 • Project end 31st August 2020

  37. The Solihull Approach • The Solihull Approach is a UK evidence based training programme, developed with professionals and parents to support infant/parent mental health 0-5 years. • Herefordshire is rolling out this approach in three stages: • Training professionals working with families & children 0-5 years to support improved emotional health, attachment and well-being. • Establish a network of Solihull champions and Trainers to cascade beyond the project end. • The purchase of a licence to cascade FREE online training for parents, carers, grandparents etc

  38. Features of the approach include: • Workforce development to increase skills and consistency • Early intervention and prevention in the early years• Used by everyone in a multiagency team – consistent approach• Parenting programmes from conception through to adolescence.• Emphasis on including fathers.• Increases the accessibility of parenting programmes through online courses• Framework for working with emotional and behaviour difficulties• Strong and growing evidence base

  39. Evidence Based Programme • The Solihull Approach is all about relationships! It is based on: Containment, Reciprocity and Behaviour Management. Early experience determines which parts of the brain grow and which parts dwindle. • Parenting/ carers’ behaviours are crucial in stimulating certain brain areas to develop in optimal ways. • This “healthy” brain development facilitates the child’s ability to regulate their own emotions and behaviour. • The 3 most prolific phases of brain development across the lifespan are: • Antenatal • 0-3 years • Teenage

  40. Free Online Parenting Courses for all Herefordshire Residents Free online course widely advertised using the following postcard:

  41. Face to Face Training for Professionals Training Courses:1. Solihull Foundation course – 200 professionals trained locally – more details on next page.2. Train the trainer – 100 selected to complete course to equip them to deliver further foundation courses as part of a sustainable model. Training targeted at any practitioner working with children 0-5 years. In Herefordshire we will be targeting early years professionals, family support workers, social workers, head teachers, midwives, professionals working with children 0-5 years, children centre staff, reception class teachers, hospital staff

  42. Foundation Course • Course covers; impact of trauma, impact of relationships on health and wellbeing • Recourse packs include; sleeping, weaning, toileting, playing, emotional and physical development, applying the model to school aged children (including adolescents), information on issues such as depression, phobias, eating disorders

  43. Making Every Contact Count

  44. Time for a short break Networking and refreshments

  45. The NHS Long-Term PlanWhat does it mean for children’s mental health?

  46. NHS Long Term Plan The NHS made a new commitment that funding for children and young people’s mental health services will grow faster than both overall NHS funding and total mental health spending. This will support, among other things: Increasing access to services • Significantly more children and young people to access timely and appropriate mental health care. NHS-funded school and college-based Mental Health Support Teams will be available in at least one fifth of the country by 2023. That’s at least an additional 345,000 children and young people aged 0-25. • Extend current service models to create a comprehensive offer for 0-25 year olds that reaches across mental health services for children, young people and adults. • New services for children who have complex needs - 6,000 highly vulnerable children with complex trauma, this will provide consultation, advice, assessment, treatment and transition into integrated services.

  47. NHS Long Term Plan • Boost investment in children and young people’s eating disorder services as the need continues to rise. • Over the next three years, test and implement the most effective ways to reduce waiting times for specialist services, such as autism. Increasing support for those in a mental health crisis • Single-point of access and timely, age-appropriate 24/7 mental health crisis care for everyone, accessible via NHS 111 by 2023/24. • Roll out of post-crisis support for families (and staff) who are bereaved by suicide, who are likely to have experienced extreme trauma and are at risk of crisis themselves.

  48. NHS Long Term Plan Herefordshire & Worcestershire Engagement Work • 152 Local Healthwatch across England are all carrying out engagement work on local priorities in the NHS long term plan • March – May 2019: Healthwatch Herefordshire and Worcestershire, and NHS organisations will undertake public engagement face to face at groups and events across both counties. • March – May 2019: Online survey for Herefordshire & Worcestershire • June - Joint summary report produced across Herefordshire & Worcestershire This feedback report will inform how NHS organisations implement the NHS Long Term Plan locallyproducing implementation plans in Autumn 2019

  49. Long Term Plan Local Priorities Engagement topics Local Care Out Of Hospital Emergency Services Specialist Services Prevention and Self-Care Health Inequalities Mental health Care for Children & Young People Mental Health Care for Adults Learning Disability & Autism Services

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