Emotional wellbeing from the start of life
Achieving this Higher Ambition will mean that:
Everyone in Suffolk and North East Essex has good mental health and resilience from the start of life and as they grow and develop.
As an Integrated Care System we will ensure that;
- All children and young people and their families have the right support to be mentally health and resilient
- Children and young people who need specialist support receive services tailored to their needs
- Young people have the best possible mental health in their transition to adulthood
What’s the current picture?
Since 2016, we have asked 26,000 children and young people aged between 11 to 19, across 29 Suffolk schools and colleges, to provide insight into how they felt about their wellbeing. Key findings include:
- More than a third of boys and a half of girls had experienced poor mental health in the past 12 months and over half did not ask for help or support during this time.
- 80% of Year 11s said they felt stressed about exams and homework.
- One in every five boys and two in every five girls suffer from low self-esteem. One in every two young people agreed with the statement: “At times I think that I am no good at all”.
- 50% of those who don’t identify as male or female, and 50% of those who are bi-sexual have self-harmed.
- One in three Year 9s had drunk alcohol in the last month. These reports have been incredibly influential in helping to shape wellbeing support across the county.
Our findings led to us being invited to give evidence to the Women and Equalities Select Committee exploring the wellbeing of young people who identify as LGBTQ+.
Forty percent of adult mental health disorders develop before the age of 14-years, but only 25-40% of young people receive input to support their mental health. Outside of the home, school is often the hub of a young person’s life and therefore offers a prime environment to provide high quality psychological services to promote resilience and wellbeing.
Health and education rarely work collaboratively as equal partners on a shared goal. This project at Thurston Community College involved embedding a Clinical Psychologist into the school to collaboratively develop an early intervention mental health service to meet the unique school community’s needs (staff, students and parents). It was integrated into the whole school system allowing for systemic change and flexibility/accessibility of service provision.
This ‘whole school’ approach focused on co-producing a service to support emotional wellbeing of the school community. It involved: (i) working with the school leadership team to support organisational wellbeing, (ii) bespoke mental health training and supervision to school staff, and (iii) evidence-based interventions given to identified students. Feedback suggests that children, parents and teachers highly value an approach which allows them to (i) learn how to take care of their own wellbeing, (ii) have easy access to high quality mental health guidance and assessment within a non-pathologising community setting, and (iii) feel that the care is co-ordinated around them as an individual in a context they feel comfortable. This approach led to significant improvements in staff wellbeing and significant reductions in anxiety/depression symptoms in children who received a school-based intervention.
- Fewer school pupils with social, emotional and mental health needs
- More children ready for school, achieving a good level of development at the end of reception
- Fewer children providing unpaid care (aged 0-15)
- Fewer children in need due to abuse or neglect
- Fewer children in need due to family stress, dysfunction or absent parenting
- Fewer admissions of children and young people in CAMHS Tier 4 wards: rate (quarterly) per 100,000 population aged 0-17
- Fewer bed days for children and young people in CAMHS Tier 4: rate (quarterly) per 100,000 population aged 0-17
- Increased numbers of children and young people under 18 receiving NHS funded community mental health services
HOW we plan to make a difference
1.1 Children and young people are supported earlier, to prevent serious mental health issues. We will enable this by;
- Developing upstream preventative support, including better information sharing and the use of digital interventions. The NHS, schools, local councils and parents will work together to develop prevention measures to avoid the need for specialist CAMHS services.
- Professionals exploring children and young people’s health and wellbeing with them, listening and agreeing their needs together. Early identification of mental health issues can prevent deterioration and enable early access to support.
- Professionals understanding the triggers and root causes of mental health issues and working with children and families to tackle them. Causes of poor mental health can include experiences of discrimination and bullying; child poverty, hunger and poor housing; trauma and abuse; drugs and alcohol; offending; and radicalisation.
- Supporting children and young people to be aware of the positives and potential dangers of social media. Awareness should include the impact of social media on resilience and the importance of positive communications.
- Using social media and other ways that young people access information, to positively to share information and sources of help. This helps ensures maximum reach, especially in rural areas
1.2 More children and young people have the mental health support they need from their schools and communities.
- Build on Suffolk and North East Essex ICS being a trailblazer for developing mental health support teams in our schools. By January 2020 67 schools will be supported providing mental health support to over 22,000 children and young people. Teams will be trained to support groups more likely to face mental health issues e.g. LGBTQ+, and Looked After Children. This will be rolled out further over the next four years as well as supporting children and young people outside of educational settings.
- The health and care system will support schools and colleges to embed emotional resilience into the curriculum. Emotional resilience helps children and young people manage life challenges and improve their wellbeing.
- The health and care system will support schools to help their pupils achieve positive health and wellbeing, in partnership with parents. Teachers can spot mental health issues early, and to signpost children and parents to appropriate support.
- Support will help build capacity and confidence within schools in this area.
2.1 Children and young people in mental health crisis have the right support.
- We will develop and expand integrated community-based 24/7 crisis support services for children and young people by April 2021.
2.2 Children and young people can access specialist community-based mental health services when they need them. We will enable this by;
- Expanding access to community-based mental health services for children and young people, including outreach to people’s homes where needed by April 2021. In the next 10 years all children and young people needing specialist care will be able to access it.
- Meeting current and forthcoming waiting time standards for specialist mental health services.
- Providing specialist support promptly helps achieve recovery sooner.
- Using evidence-based models to guide service delivery, by March 2021. Models such as iThrive guide referral to the right service for the child’s needs.
- Personalised care for children and young people. This enables them to exercise choice and control, with co-ordinated and responsive care that also supports their family to care for their needs.
- Integrated local health and care services that support children and young people’s mental and physical health. This includes primary care, secondary healthcare, social care hubs and school-based health services. Place-based support encourages whole family and whole-community approaches, and a kinder, more supportive community.
- Giving families with complex needs living chaotic lifestyles community-based targeted support, including parenting, domestic abuse, mental health, and drugs and alcohol. Resilient families, with positive lifestyles and good parenting, help children maintain good mental health.
- Giving targeted support to vulnerable young people aged 18-26 with complex needs and chaotic lifestyles (Project in Ipswich). Support can include health, social care, education/training/employment, debt, housing and relationships. These measures can help achieve and maintain good mental and physical health.
- Prompt access to Early Intervention in Psychosis services, which is a proven effective treatment.
- Developing new services for children and young people who have complex needs that are not currently being met, including those who have been sexual assaulted but do not receive Sexual Assault Referral Services. These new services will provide consultation, advice, assessment, treatment and transition into integrated services for highly vulnerable children with complex trauma, including those who have had Adverse Childhood Experiences.
2.3 Children and young people have the best specialist inpatient care.
- We will implement the findings of the CAMHS service review by March 2021, to ensure the right types of bed are available where needed, and provides high quality care and support. Safe and effective inpatient care, with enough capacity to meet demand, ensures people get the right service when they need it, and support their families too.
2.4 Young people with eating disorders have specialist support when they need it.
- We will deliver new waiting time standards for eating disorders by March 2021. Further investment will enable the standards to start urgent treatment in one week, and non-urgent treatment in four weeks, to be met.
- We will ensure criteria for accessing eating disorders services are open and inclusive by March 2021. Eligibility criteria should not in effect restrict access to support for those who need it.
2.5 Young carers have the support they need.
2.6. Children and young people who self-harm or are at risk of self-harming are supported. We will enable this by:
- Evidence-based schools awareness programmes on the risks of self-harm, high risk groups and sources of support. Improving awareness supports people to help themselves if they are at risk, and to help others. Campaigns include social media and other ways to reach people.
- Training people working in health, care and education to recognise self-harm and support. Staff and volunteers trained in self-harm can be alert to high risk groups, recognise signs, have difficult conversations, and provide high quality support throughout their organisation and community.
- Improving access for children and young people who self-harm to evidence-based treatments, delivered in a personalised way.
- Sharing information between health, care and education services on self-harm to help prevent self-harm continuing and escalating.
- Focusing support on the underlying causes of self-harm, not solely self-harming behaviours. Tackling the causes of self-harm helps recovery and building resilience.
3.1 Young people have the mental health support they need to manage change in their transition to adulthood. We will enable this by
- A comprehensive integrated approach across health, social care, education and the voluntary sector for young people to the age of 25, and their families. Young people aged 16-18 are more susceptible to mental illness, undergoing physiological change and making important transitions in their lives. Evidence based models can support transition: ‘iThrive’ covers 47% of the 0-18 population and can be expanded to 25- year olds.
- Building the capability and capacity of universities to improve student welfare services and improve access to mental health services for their student population. The Mental Health in Higher Education programme focuses on suicide reduction, improving access to psychological therapies and groups of students with particular vulnerabilities.
- Supporting the survivors of complex trauma, abuse and exploitation. The effects can continue into adulthood, so support should be seamless between adult and children’s services