Children and Young People’s Mental Health and Well-being A Local Perspective

1. Children and Young People’s Mental Health and Well-beingA Local Perspective Alison O’Sullivan Director of Children’s Services, Kirklees Vice President, ADCS Children’s Mental Health | NCASC 2014

2. Facts and Figures…With thanks to NHS England for following slides

3. Age of onset of lifetime mental illness – predates subsequent illness by several decades Impact of mental disorder: Most lifetime mental disorder arises early adulthood Source: Kim-Cohen et al, 2003; Kessler et al, 2005; Kessler et al, 2007

4. Mental health problems are the greatest health problem faced by children and young people

5. 76% 80% Percentage unknown to any service 70% 60% 50% 35% 40% 30% 20% Adults with depression 5-15 year olds % With anxiety or diagnosable depression not in contact with mental health services Source: Ford et al. (2005) Child & Adol Ment Health, 10:2-9 Dean et al., (2004) DoH; McCrone et al., (2008) King’s Fund

6. Number of under 20 young people per 11Pspecialist in child mental health 30,000 30,000 No of under 20 year olds per CAMHS medical specialist 25,000 20,000 15,000 7,500 NUMBER OF UNDER 20 YEAR OLDS 10,000 6,000 5,300 5,000 0 SWITZERLAND FINLAND FRANCE UK Source PEDRINI ET AL., (2012) ; LEVAY ET AL., (2004); WHO MENTAL HEALTH ATLAS (2005) With permission P Fonagy

7. Biggest Barriers • Commissioning fragmentation – ‘shared’ responsibility • Professional preciousness – commissioners and providers • Low status – low priority – stigma • Disinvestment – overall funding level • Inconsistent use of best practice • Child perspective and voice not heard Only 6% of current spending on mental health goes to services aimed at children and young people Kennedy, 2010 Children’s Mental Health | NCASC 2014

8. Children’s Mental Health | NCASC 2014

9. Solutions – what? • National leadership across the system • Policy and some National design • Standards and clear measurement of outcomes • Coherent collaborative commissioning • Voice of the child Children’s Mental Health | NCASC 2014

10. Solutions – how? • Make visible and own poor starting point • Really cut through silos • Face the ‘demons’ • Recognise it’s a journey • Create and apply leadership Evidence-based practice has substantial clinical & cost benefits Little & Edovald, 2012; Suhrcke, Puillas & Selai, 2008 Children’s Mental Health | NCASC 2014