Children and Young People s Emotional Wellbeing and Mental Health Transformation Plan 2015-2020
2
Summary The Government is making the mental health and emotional wellbeing of children and young people a priority. Tameside and Glossop Clinical Commissioning Group (CCG) and it s partners are committed to improving children s and young people s mental health and emotional wellbeing information, advice, guidance and support. We know there have been problems in the way support and care is given across all the many organisations involved. Patients tell us that services don t always work together well enough - leading to long waiting times and some confusion. We realise that we need to make big changes. We want to use this opportunity to transform our local services. This summary plan explains how we plan to do this. To obtain or read a full copy of the plan please go to: www.tamesideandglossopccg.org/ corporate/commissioning or www.tameside.gov.uk/ publichealthreports 3
Contents Page Future in mind 5 Listening 6 Our ambition 7 Our local needs 9 Tameside and Glossop facts 11 Where are we now? 13 Our plan with the future in mind 17 For more information 18 4
Future in mind Our Vision We want our services in Tameside and Glossop to work together to support all children and young people to stay well. They should provide the very best care and support for each child and young person when they need it. We will put children, young people and their families and carers at the heart of what we do focussing on doing our best for them. Three guiding principles: Engagement - We will involve young people and their parents as we help to improve people s mental health and emotional wellness. We will work closely with the local authority and other organisations to provide the best services. Transparency - We will be open and keep people up to date with the work we are doing and the decisions we make. Transformation - As we change the services we provide we will keep checking that they are the right services in the right place. 5
Listening We have been listening to what children and young people say they want for a better service. I should be listened to, given time to tell my story and feel like what I say matters. I should be treated equally and as an individual and be able to shape my own goals with my worker. I want my situation to be treated sensitively and I should be respected and not feel judged. I should always be made to feel safe and supported so that I can express myself in a safe environment. I want my friends, family and those close to me to understand the issues so that we can support each other. I want professionals to be kind and understanding. I need to trust them if they are going to help me. I want clear and up to date detailed information about the services that I can access. I want my support to feel consistent and easy to find my way around, especially if I need to see different people and services. I want to get the right type of help when things first start to be a problem, at the right time, in the right place and without having to wait until things get worse. I want to feel that services are shaped around my needs and not the other way round, but I also want to know that I am not alone in how I am feeling. 6
Our Ambition We plan to transform our services so that: All the different services work more closely together to improve the mental health and emotional wellbeing of children and young people in Tameside and Glossop. Any service is able to help you to get the right professional help. Children, young people and families have: The information they need. An easy way to get professional help. A clear understanding of what each service offers. Support that is as close to home as possible. We focus on preventing emotional wellbeing and mental health problems from developing. We prioritise services for children in the first years of life and their families particularly where the child has special needs. We are following the main themes of the Government s plans for 2020 Future in Mind : Helping all young people to be emotionally resilient so that they can cope better with difficulties. Improving the way that people get support. Prioritising the most vulnerable. Being open and accountable for our decisions. Helping our staff to improve in their work. 7
We will move away from a system which is all about the organisations that provide services towards one built around the needs of children, young people and their families. We will increase the use of interventions and treatments that are known to work. We will make mental health support more visible and easily accessible for children and young people. We want to improve care for children and young people in crisis so they are treated in the right place, at the right time and as close to home as possible. With young families we want to strengthen the bonds between parent and child, avoiding trauma in the early years, building resilience and improving behaviour. We are going to improve the way we tell people how we are managing the services. We want to involve people more in decisions because we know that this will improve our care and support. We are going to help our staff to learn and develop more so that they can work better for children and young people. 8
Our Local Needs In this section we look at the current mental health and wellbeing needs of Tameside and Glossop s children and young people. Child Poverty There are high levels of child poverty in Tameside with just over a third of people living in some of the most deprived areas of Britain. Children growing up in poverty have a greater likelihood of having health problems from birth and of continuing with physical and mental health problems throughout their life. Poverty and inequality mean that someone has a higher chance of developing a disability or life limiting illness and ultimately a decreased life expectancy. Though poverty can affect anyone, a number of groups are more at risk than others. Ethnicity Children and young people from black and ethnic minority groups may be more likely to suffer from mental health and emotional problems because a greater proportion are excluded from school, looked after, in local authority accommodation or homeless. There may be barriers to accessing services in some ethnic communities due to limited knowledge of English. Youth Offending Levels of mental health problems among young people involved in any part of the criminal justice system are higher than in the general population. Mental health problems can be around three times higher for those involved in the criminal justice system as for the rest of society. 9
Looked After Children The number of Tameside and Glossop children who are looked after is higher than the England average. Looked after children are more likely to have mental health problems than other people. Among children aged 5 to 17 years who are looked after by local authorities in England, 45% have a mental health disorder, 37% have clinically significant conduct disorders, 12% have emotional disorders, such as anxiety or depression, and 7% are hyperkinetic. Domestic Abuse Domestic Abuse often remains hidden. Abuse is not disclosed for a variety of reasons: shame and stigma, fear of not being believed, and also confidence in services and amongst victims themselves in dealing effectively with abuse and the relationships where it occurs. Tameside is ranked fourth highest out of ten Greater Manchester Authorities in terms of rate of domestic abuse per 1,000 population. There is a long lasting impact on children and young people s emotional well-being due to being exposed to the trauma of witnessing domestic abuse. Children and young people who witness domestic abuse can suffer from: Anxiety or depression Difficulty in sleeping or nightmares Experience of physical pain Temper tantrums Low self-esteem Use of drugs or alcohol Eating disorders Self-Harm There are more young people aged between 10 and 24 who are being admitted into hospital because they have been harming themselves compared to 5 years ago. More young people harm themselves in Tameside than the average for England. 10
Tameside and Glossop Facts Almost a quarter of our population is under 19 years of age. 18.6% of school children are from a minority ethnic group. Tameside secondary schools exclusions rate in 2012/13 was higher than the England average and the highest in the North West. The health and wellbeing of children in Tameside and Glossop is generally worse than the England average. The level of child poverty is worse than the England average with 22.7% of children aged under 16 living in poverty. The number of Tameside and Glossop children in a looked after care setting is higher than the England average. Over half the young people involved with the Youth Offending Team needed help with emotional and mental health problems. 11
The admission rate for self-harm among 10 to 24 years in the last three years is higher than the England average; 79% of those admitted for selfharm were female. We think 12,375 children and young people could need help from the Child and Adolescent Mental Health Services (CAMHS) of which 1,035 would require specialist input. 41,785 5-19 year olds would benefit from awareness and prevention programmes in over 100 schools across Tameside and Glossop. Referrals to our CAMHS service are higher than estimated expected demand, with 62% of all referrals in 2014-15 accepted. The average waiting list for unseen clients is 113 days from referral to assessment. Tameside and Glossop has a higher than expected demand for inpatient eating disorder services. Within our Adult Mental Health provision just under 9% of accepted referrals are for under 18 s, whilst under 18 s makes up 16.2% of the open case load. 12
Where are we now? In 2015, we started transforming the Child and Adolescent Mental Health Services. We have focused on helping workers within services, GP s and other children s services to develop skills to support children s emotional health within communities. We wanted to support staff in children s services e.g. Youth Offending Teams, secondary care health services and children s social care, as well as GP s and schools to develop the skills they needed. We provided consultation, liaison and training. These are some of the services that are available in Tameside and Glossop: Children and Adolescent Mental Health Service (CAMHS) Tameside & Glossop Children and Adolescent Mental Health Service (CAMHS) supports families and professionals who are concerned about children and young people who may be experiencing mental health difficulties. Trauma, including Post-Traumatic Stress Disorder (PTSD) Psychosis Bi-Polar disorder The service is made up of a team of mental health professionals, staffed by child and adolescent psychiatrists, clinical nurse specialists, psychologists, family therapists and mental health practitioners. There are staff who specialise in working with young people with a learning disability. School Nursing Service Children who are happy and healthy achieve more at school. The School Nursing Service aims to promote optimal health, well-being and opportunities for all children and their families within Tameside and Glossop. The service works closely with children and their families and carers, schools and other agencies to provide a child focused, flexible, accessible service to meet their health needs. They see young people at all levels of ability. Some of the difficulties this team can help with include: Depression Self- Harm Anxiety Disorders (including phobias) Obsession/Compulsive disorders Attention Deficit Hyperactivity Disorder (ADHD) Eating Disorders 13
Health Visiting The service works to keep parents and children healthy and provides advice and support to parents and carers until children reach school age. Integrated Service for Children with Additional Needs (ISCAN) This multi-disciplinary team comprises of Occupational Therapy, Physiotherapy, Speech and Language Therapy, Learning Disability Nursing, Complex Needs Nursing, Social Workers and Nursery Nurses. The Integrated Service provides nurses and therapists that work as lead professionals for parents with children with identified disabilities. Paediatrics Services The children s ward comprises of a 21 bedded inpatient unit and an 8 bedded day case unit. They provide nursing care for children aged between 0 to 16 years of age (in secondary education) with a variety of medical, surgical, orthopaedic, ENT, dental and gynaecological problems. Tameside Council Tameside Council provides: Behaviour for Learning and Inclusion Service Communication Language and Autistic Spectrum Support Service Children s Social Care Tameside Youth Offending Team Service for Children with Disabilities and their Families 14
42nd Street This regional charity provides services to young people under stress. They work with young people between the ages of 11-25 living in parts of Greater Manchester, providing a range of services including one to one counselling, therapy and psychosocial support. Off the Record (OTR) A person centred counselling service based in Hyde and at other young person friendly venues that delivers emotional wellbeing services in Tameside for young people aged 10 to 25. Tameside Oldham and Glossop Mind Mind is a mental health charity covering Tameside and Glossop (and Oldham), providing counselling and therapeutic group work and activities. Lifeline This national charity works in Tameside with young people up to the age of 25 who suffer from substance abuse. They include family support and interventions. Papyrus Papyrus is a national suicide prevention charity focussing on young people and young adults. Making a Difference Tameside Fully trained workers in mental health and coaching skills provide individually tailored practical support to people in their own homes including household management, cooking and budgeting. Home-Start Home-Start is a family support charity that works with families who are suffering from stress and who have at least one child under the age of five. Crossroads - Harmony Home Harmony Home is a refuge for women aged 16-24 that provides transitional housing for women who are in the process of recovery. It provides a number of programmes of support from substance abuse treatment, to psychological assistance, domestic abuse. It runs a support group for children aged 5 15 who have experienced domestic abuse. 15
Our plan with the future in mind These are some of the key parts of our plan. September 2015 to March 2017 Getting Help We will be making it easier for children and young people to get help from any part of the mental health system through one place. Community Eating Disorders Service Tameside and Glossop Clinical Commissioning Group (CCG) is working with other CCGs in Greater Manchester to develop and deliver a community based eating disorder service. We want to provide a comprehensive locally based service to young people who have an eating disorder. The service will be structured on a hub and spoke model. The South Hub will be based in Stockport with satellite bases in Trafford and Tameside and Glossop. The North Hub will be based in Oldham with satellite bases in Rochdale and Bury. The Hub will be a vibrant, child oriented, community facility, located centrally. It will be staffed 7 days a week and will be the main base offering drop ins, groups, assessments and treatments. We want it to be a thriving community resource including a library of self-help resources, a café and a centre for training events, groups and meetings/talks. 16
Staff at the hub will be able to see people at the hubs. They will also be able to travel to carry out emergency visits where needed. Routine and specialist services will be available including family based treatment. October 2015 to October 2016 Transition to Adulthood we will continue to work on making it easier for young people to move from children s to adult services. September 2015 to December 2016 Parental Mental Health We will continue our focus on Parent Infant Mental Health and expand this to include parents of children of all ages. October 2015 to May 2016 We will work with all partners across health, children s social care and education to ensure there is a better way for children and young people to get help if they are suffering from problems with attention, concentration, impulsivity and hyperactivity (ADHD and ASD). September 2015 to June 2016 Develop the Workforce. We will develop training programmes that lead to a better skilled workforce across the whole system. September 2015 to June 2016 Coping. We will make sure people can get a range of information about the services that are available to them. We want children, young people and those who care for them to have a choice over their care and to have the option to manage their own care through direct payments. 17
For more information Contact: NHS Tameside and Glossop Clinical Commissioning Group New Century House Progress Way Windmill Lane Denton Manchester M34 2GP 0161 304 5300 www.tamesideandglossopccg.org To obtain or read a copy of the full plan please go to: www.tamesideandglossopccg.org/corporate/commissioning or www.tameside.gov.uk/publichealthreports Text and layout by easy-read-online.co.uk 18