The need to bring mental health support within school & college provision

Future in Mind- Children and Young People’s Mental Wellbeing 2015 Future in Mind, an NHS England report with recommendations which highlights the difficulties children, young people and their families have in accessing mental health support . The report highlights that for 75 per cent of adults with mental health problems these start before the age of 18. Yet we may be reaching as few as one-in-four children and young people with problems that could be helped. The report articulates how we need to set about tackling the problems to create a system that brings together the potential of the web, schools, social care, the NHS, the voluntary sector, parents and children and young people themselves.

Local Transformation Plan In response partners in Brighton and Hove came together to develop a vision to improve children and young people’s mental health support, interventions, services and outcomes. This resulted in our Children and Young People’s Mental Health Local Transformation Plan.   The overarching aim was to build resilience, intervene early, and improve access to mental health services and outcomes to improve the mental health and wellbeing of our children, especially those who are most vulnerable.

Five big themes: Promoting resilience, prevention and early intervention Improving access to effective support – a system without tiers Care for the most vulnerable Accountability and transparency Developing the workforce

Some key words and phrases captured below, demonstrate the `voice` of children and young people in Brighton & Hove A service in an appropriate environment, away from the clinic where possible Flexibility and choice offering outreach and support by phone, email and other means I would like to have help and support if I miss an appointment  

Child and Adolescent Mental Health Services and Schools Link Pilot Scheme NHS England and the Department for Education invited proposals to apply to become a pilot to improve joint working between school settings and child and adolescent mental health services. Brighton & Hove CAMHS and Schools Link Scheme undertook a Whole-School Emotional Health and Well-Being Pilot 2015-2016 in three secondary schools and called the project Community CAMHs.

School based Primary Mental Health Workers Provision to include; Targeted appointment based service for young people within school. Upskilling school staff with reflective practice, bespoke training/workshops, consultation and co-delivering interventions and building on existing expertise. Consultation, workshops and information sharing with parents/carers. Support to develop student voices and parents/carers packages. Each school to provide a named mental health lead to make links with the Primary Mental Health Worker, champion, coordinate and influence change, and ensure the right professionals are involved.  

Preliminary evaluation of our pilot Opportunities for schools to reflect on the learning from the PMHWs being in schools at a variety of levels Opportunities to think about the implementation and the wider role of mental health and behaviour in the wider school context (e.g., exclusions) Opportunities to reflect on the graduated approach to mental health, consistency in support for students and staff in each school, and links with other professionals. Areas that we’re now including: Broader multi-agency professional group at each school on a half-termly basis to discuss whole school issues in relation to social, emotional, and mental health difficulties One to one reflection/consultation for the mental health lead in each school by the school EP on a monthly basis Regular analysis of exclusion data and links between these and emotionally resilient schools Consultation with all agencies regarding transition needs and support for Y6 pupils/parents.

Working together CCG commissioning including ; Direct referral link to specialist CAMHS and an identified specialist CAMHs schools link. CCG commissioning including ; The #IAMWHOLE campaign, aiming to encourage young people to challenge harmful language and negative stigma surrounding mental health and encourage others to speak out and seek help. Resourcing schools to develop culture change and curriculum development. https://www.youtube.com/watch?v=FZ4TlCx3eHA 2016 https://www.youtube.com/watch?v=97gZiaApTq8 2017 Primary age story launch ‘Flo and the Funny Feelings’ 2018 https://www.youtube.com/watch?v=f05UqEh4AAo Find Get Give website for 11- 25s to connect them up with mental health support wherever they re https://www.findgetgive.com/

Public Health Schools projects 2016/17 Healthy Eating Workshops / Family Cookery Demos Change for Life Clubs Sugar/teeth workshop Asthma Project Healthy Choice Award Sustrans Project – Bike It Ben Online Safety AITC Zip Zap after school club Sun Safety 5 Ways to Smile

Community Wellbeing A new All Age Community Wellbeing Service was launched on 1 June 2017 in Brighton & Hove. From 1 June all referrals for counselling will go through a centralised triage hub staffed by all the partners.  People working with children and young people can complete a simple form to refer into the service. Young people can also self-refer. The partners will triage every day to speed up referral processes and ensure that people get into the system as quickly as possible.

Schools Wellbeing-Where are we now? We now have a PMHW embedded in each of the 10 secondary schools in Brighton & Hove for 2 days per week. Schools have an option of buying in additional time.   We have 54 Primary Schools and these are divided into 7 clusters, each school has a minimum time allocation and we work with schools to balance working at an individual school level and a cluster based level where schools can pool their time. The framework evaluation enables us to assess individual school and cross cluster need where themes and priorities can then be identified.

Response to the Children and Young People’s Mental Health Green Paper from Brighton & Hove Inclusion Support Service (BHISS) We welcome:- • Incentivising schools to designate a lead member of staff for mental health. • Research into the impact on mental health of social media with the suggestion that this should include how many hours parents are spending on social media and therefore less available to their children. • Faster responses by the NHS to those showing signs of psychosis and eating disorders as well as improved services for women suffering with post–natal depression. • The anticipated changes to teacher training so that teachers are more likely to recognise behaviours such as insecure attachment or trauma.

Response to the Children and Young People’s Mental Health Green Paper from BHISS Concerns; • That the emphasis is still on fast response and waiting times rather than the quality and the effectiveness of the intervention offered. • That data collected on waiting times takes precedence over outcomes or client satisfaction. • If the Mental Health Support Teams are not better qualified or trained than school staff they will increase referrals to the specialist services not reduce them. [All our PMHWs have an accredited MH qualification and extensive experience]. • Learning from B&H secondary school pilot demonstrated embedding PMHWs in school systems is most effective in responding to needs. • That there needs to be more focus on improved outcomes than diagnosis. • That the reduction in Early Years-family centres and Youth workers is likely to have been detrimental to the mental health outcomes for families. • That Mental Health may still be regarded as a second class issue in schools compared to the narrow academic curriculum.

• That the government could reduce the stress on the education system by having a more supportive and less punitive style of inspecting schools. This would create a climate in schools that is much more conducive to mental health. • There are some wonderful examples of BHISS and Amaze running parent groups using a evidence based programmes and interventions such as VIG developed by B&H Educational Psychologists with very positive outcomes. In some areas they have run the parents’ group at the same time a group has been running in the primary school, so that the whole family have understanding and using techniques to reduce anxieties. • The B&H EPs have developed staff training in Attachment Aware and now developing Emotion Coaching programmes. This intervention builds capacity in schools to assist children and young people who have experienced early developmental trauma. Impact measures are in the process of collation. This model can be adapted to support families with complex needs, broadening and linking te interventions across schools, families and communities. • Schools should receive the funding directly so that they can purchase providers they find effectiveshould be considered as joint leads and supervisors within the Mental Health Teams to facilitate system Response to the Children and Young People’s Mental Health Green Paper from BHISS Suggestions 1. • That the government could reduce the stress on the education system by having a more supportive and less punitive style of inspecting schools. This would create a climate in schools that is much more conducive to positive mental health. • That more effective parent groups using evidence based programmes and interventions such as VIG developed by B&H Educational Psychologists and with Amaze, an information, advice and support service for parents of children with SEND. • Support for Eps such as Brighton and Hove’s who have developed staff training in Attachment Aware and now Emotion Coaching programmes. Intervention which builds capacity in schools to assist children and young people who have experienced early developmental trauma and importantly guides attention to children’s vulnerability support needs and away from punitive behavioural intervention.

Response to the Children and Young People’s Mental Health Green Paper from BHISS Suggestions 2. • Schools should receive the funding directly so that they can purchase providers they find effective. • If Designated Leads are to be sufficiently influential and able to challenge systemic practices which may be negatively affecting young people’s mental health, they need to have senior management status. • Adopt the model as in B&H where all teams are within one integrated Inclusion Support Service - Mental Health Teams link in with the Educational Psychology Service, the ASC team SEMH team and can all offer therapeutic support to individuals as well as offering training to the schools and the professionals aimed at building capacity to support the most vulnerable pupils. • Funding directed to ensure that there continues to be a sufficient supply of Educational Psychologists being trained along with Mental Health Practitioners facilitating systemic practice in schools and communities as well as providing joint parent workshops, staff development opportunities, research, group and targeted support.