‘No Wrong Door’ June 2011

1. ‘No Wrong Door’June 2011 ELSA (Emotional Literacy Support Assistants) The TaMHS Project(Targeted Mental Health in Schools)

2. The TaMHS Project(Targeted Mental Health in Schools) • DCSF funded project. In York it provided £222,500 for 1 year April 2010 –2011 • Aims to improve emotional wellbeing and mental health of children and young people, working preventatively • Joint working with CAMHS • The Educational Psychology (EP) Service seconded a Senior EP and maingrade EP to lead the project.

3. Aims of TaMHS To offer a preventative approach to emotional health and wellbeing by: • Increasing staff confidence and competence in recognising and managing mental heath needs • Providing evidence-based interventions which are sustainable and can build future capacity in schools. Creating enhanced and appropriate pastoral care to children and families. • Reducing inappropriate referrals to specialist CAMHS • Reducing levels of fixed term and permanent exclusions.

4. York High Hob Moor Primary Woodthorpe Primary Canon Lee Burton Green Primary Clifton Green Primary Lakeside Primary Clifton With Rawcliffe Primary York TaMHS Schools:8 schools: 2 high schools and 6 feeders Additionally training was accessed by staff from Danesgate Community (EOTAS)

5. York TaMHS • ELSA 5-day training programme (Emotional Literacy Support Assistants) Delivered by Educational Psychology Service and Behaviour Support Service

6. What are ELSAs? ELSAs help children with social and emotional difficulties to recognise, understand and manage their emotions, to increase their wellbeing and success in school. ELSAs plan and deliver individual (and small group) support programmes. ELSAs receive training and supervision from Educational Psychologists.

7. ELSA Training Programme: Day 1: Emotional literacy in schools Self-esteem Day 2: Loss and Bereavement Writing therapeutic stories Day 3: Anger management Attachment Day 4: Active listening and communication skills Autistic spectrum difficulties/social stories Day 5: Social skills and Friendship skills Circle Time and Silver SEAL

8. Psychology Service Commitment • Deliver training to develop ELSA skills. • Follow-up advice on planning programmes of support and on useful published resources. • Provide group supervision and problem-solving to ELSAs

9. School Commitment • Release ELSA for training and supervision sessions. • Designate time and space for planning and delivery of ELSA support to pupils. • Allocate funds to develop bank of resources over time. • Maintain ELSA role within school.

10. Benefits to School • Positive changes in managing pupils with behavioural, emotional or social difficulties. • New skills/ideas cascaded to staff. Capacity building within school. • Increased confidence in managing mental health issues and less need to ‘refer on’.

11. Measuring impact • Questionnaires to evaluate ELSAs confidence and competence over time. • Pre and post questionnaires completed by parents, teachers and pupils using York SEB Competencies and Goodman's Strengths and Difficulties Questionnaire (SDQ). • Cost effectiveness case studies • Impact on referrals to CAMHS

12. Confidence and Competence Questionnaires

13. Confidence and Competence Questionnaires • Overall there was a significant positive increase from the initial induction of ELSAs to the end of the first year of TaMHS. • The top three items showing the biggest overall gains: • ’I know where to seek information, advice and support on EHWB issues’ • ’I have the skills to run effective groups to develop EHWB’ • ’I have the skills to work with individual pupils experiencing difficulties relating to EHWB’

14. Group level: Friendships Social Skills Transition Behaviour for Learning Self-esteem Emotional Literacy Anger Management. Individual level: Anger Management Social Skills Self-esteem Self-awareness Anxiety Solution-focused Conversations. Range of interventions

15. Range of interventions Experiences of working as an ELSA: Karen Reynolds and Lesley Purcell from Lakeside Primary Jackie Fox and Angela Scarr from Clifton with Rawcliffe Primary

16. SEB Competencies – group work

17. SEB Competencies – individual work

18. SDQs - – individual work

19. Secondary 1 - £170 Secondary 2 - £157 Primary 1 - £371 Primary 2 - £345 Primary 3 - £324 Primary 4 - £193 Primary 5 - £183 Primary 6 - £182 Cost effectiveness case studies:costs with TaMHS interventions

20. Cost effectiveness case studies:costs without TaMHS interventions • Non/poor attendance* £580 per intervention • Fixed term exclusion* £500 per event • Permanent exclusion* £1,500 per month • Referral to PSA (or similar) £50 per case • Referral to Beh. Support £350 per case • Referral to PMHW £234 per case

21. Cost effectiveness case studies:costs without TaMHS interventions Alternative provision: • Danesgate PRU £3,500 per term • Danesgate tuition £4,000 per term • ALPS package £30,000 per year • Country Classroom (BESD non-residential) £28,000 per year • BESD residential school up to £200,000 per year

22. Referrals to CAMHSData comparing April 2009-10 with April 2010-11 • TaMHS schools - referrals increased from 15 to 26 referrals, with an anticipated increase to 31 referrals with February/March data extrapolated, giving an increase of 107%. • Non-TaMHS schools - referrals increased but by a comparatively smaller percentage: approximately 20%.

23. Referrals to CAMHSData comparing April 2009-10 with April 2010-11 Possible explanations: • improved identification of need • swifter/more efficient referral procedures through consultation processes with PMHWs • ELSAs confident and empowered to refer NB The consultation process enables ‘filtering out’ of inappropriate referrals, leading to more appropriate referrals going through to CAMHS.

24. OFSTED • ‘Pastoral care is good … A team of well-trained teachers and support staff provide particularly effective care for the most vulnerable pupils. The 'Targeted, Adolescent and Mental Health' (TaMHS) support programme is a real asset in developing pupils' social and emotional skills, consequently enabling them to be successful learners. One parent described how her child's participation in this programme has 'made a massive difference to (her) child's approach to school and home life' (Dec 2010)

25. Quotes from steering group • “It has given the more vulnerable children more confidence and has built up their resilience in dealing with situations, which would otherwise have caused them unhappiness. It is lovely to see the children using the coping strategies they have been taught.”(Headteacher) • “Children have been very well supported both on a formal and informal basis. They themselves recognise an improvement in their emotional state/behaviour and have a more positive view of school, they are as a result making good academic progress.” (Deputy Head)

26. Quotes from staff • “The programme has added an extra dimension to the school’s pastoral system, and has enabled staff to get a real handle upon children in their care.” (primary school teacher) • “An extremely effective and excellent use of money.” (Y6 teacher) • “The liaison with parents is effective…..it is good to see the pupils applying skills they have learnt when they return to class.” (Y3 teacher)

27. Quotes from staff • “X has improved considerably since the one-to-one sessions. She really appreciates the attention…and feels special … In tutor time she is usually polite and friendly and just seems generally a lot happier with life. She still has big issues with punctuality although her attendance has improved significantly. More importantly, X feels pleased with this herself and she is making good efforts to get herself to school. X seems to have a lot more self control and appreciates the need for respectful behaviour and attitude even though she does still need to work on this at times!” (Y9 teacher)

28. Quotes from parents • “X is getting better at accepting helpful criticism. He used to have tantrums if you tried to offer help or guidance.” • “I have noticed a change in X as he seems to be applying himself in school better.” • “We have seen a big difference in his mood swings. I am very happy with his attitude to life now.” • “X has really enjoyed the sessions and talked positively about them. He seems to be able to accept praise more readily and is more aware of his and other people’s emotions.”

29. Quotes from pupils “I started getting worried about things about 1 year ago but ever since Mrs X started helping me it’s been a lot better. I’ve done lots of strategies to help me calm down like the firework method where I think about a firework, so there is the trigger which gets me worried then the fuse when I get even more worried then BANG! in which I sort of break down but I’ve managed to stop it every time on the trigger. I have also done a method where there is a bag with six or seven marbles which represent my worries and every time I take out a marble it means 1 worry gone away.” (primary pupil)

30. Quotes from pupils • “I have found the sessions helpful and have enjoyed speaking to someone about H. The memory book has been helpful as I can store all my memories of time with H and will give me something to share and discuss with my mum. I am going to continue with the memory book.” (secondary pupil with terminally ill sister, H) • “I am better at: making friends … listening and being sensible … calming down … joining in more and being confident enough to answer questions.” (primary pupils)

31. Mainstreaming Strategy:TaMHS at a strategic level • Funding from the Early Intervention Grant has been provided to sustain ELSA activities. • Key themes are embedded in the Children and Young People's Plan (2010-2012) and CAMHS Strategy (2011)

32. Mainstreaming Strategy • Danesgate Community Outreach – autumn term 2010 • Danesgate Centre TAs – spring term 2011 • Westfield ELSA – summer term 2011 • Hob Moor ELSA – autumn term 2011

33. With thanks to: THE ELSAs “It is great knowing that you’ve made a difference to children’s emotional wellbeing.”