Slides by Peter Fonagy, Kathryn Pugh, Anne O’Herlihy, Robin Barker CAMHS Transformation Programme – CYP IAPT Dr Jacqueline Cornish NCD CYP & Transition Slides by Peter Fonagy, Kathryn Pugh, Anne O’Herlihy, Robin Barker CYP – IAPT Programme

Could the profile of children and young people’s mental health get any higher? Health Select Committee Report Ministerial Children and Young People’s Mental Health and Wellbeing Taskforce Collaborative Commissioning Pilots Department for Education Guidance UK Youth Parliament national campaign for 2015 Young Minds Vs campaign ….. NHS England Tier 4 Review Five Year Forward View and Achieving Better Access to Mental Health Services by 2020 07/12/201807/12/2018

Where are we going? ‘golden threads’ running through legislation and policy Parity of Esteem between physical and mental health Whole life course Evidence based treatment Prevention and early intervention Timely access and waiting times No decision about me without me Choice Personalisation Outcomes that matter to children, young people and their families Recent publications: Tier 2/3 Specification for CAMHS and Transition and transfer to and discharge from care seehttp://www.england.nhs.uk/resources/resources-for-ccgs/

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

Mental illness during childhood and adolescence in the UK: £11,030 to £59,130 annually per child Lifetime cost of a 1-year cohort of children with Conduct Disorder: £5.2 billion Costs of adult crime with history of CD £60 billion in England and Wales £22.5billion attributable to CD £37.5 billion to subthreshold CD Including costs of various agencies Health Social services Education Justice Evidence-based practice has substantial clinical & cost benefits Little & Edovald, 2012; Suhrcke, Puillas & Selai, 2008 Only 6% of current spending on mental health goes to services aimed at children and young people Kennedy, 2010 With permission P Fonagy 5

CAMHS fit for the future – CYP IAPT Began in April 2011 with specific remit (and limited budget) to work with existing CAMH services to: Improve collaborative practice with children, young people and families Deliver a workforce to offer evidence based practice (EBP) as recommended by NICE in CBT for anxiety disorders and depression Parenting training for conduct disorder (age 3-10) Systemic Family Practice for conduct disorder (over 10s), depression and self-harm, and eating disorders Interpersonal Psychotherapy for adolescents (IPT-A) for depression Competency based curriculum using Roth and Pilling CAMHS competencies Training for supervisors and service leads Outreach and enhanced supervision workshops for other staff not attending training courses within the CYP IAPT Programme.

CAMHS fit for the future Using ROMs (routine outcomes monitoring) To guide therapist and supervisor To help client monitor and understand how treatment is progressing Across ALL Professions Empowering service users to take control of their care, establish treatment goals, choose treatment approaches and take opportunities to improve their own health Improving access to evidence-based therapies Introducing evidence-based organisation of care

Map In 2015 CYP IAPT is working with CAMHS & partner agencies that cover 68% of 0-19 population.

Therapist trainee numbers by modality across 4 years of CYP IAPT (n=749)

Trained supervisor numbers by modality across 4 years of CYP IAPT (n=249)

Trained service transformational leads across 4 years of CYP IAPT (n=178)

Responding iteratively to service needs In 2014-15, 184 CAMHS staff are to complete a New Enhanced Evidence Based Practice curriculum – brief short course at certificate level for Band 5-6 to create a CAMHS workforce that can work effectively Parenting offered as PG Dip and PG Cert Collaboratives take on a greater level of local support and challenge

Quality assurance Accreditation council - CYP IAPT principles embedded in established accreditation processes for individual therapists, modality courses, services to support demonstration of and commitment to quality assurance BABCP assuring CBT, Parenting AFT will assure Systemic Family Practice BPS will assure IPT-A with IPT-UK assuring relevant courses

Moving forwards - how to get to 100% by 2018 Who does what – 65% of CYP IAPT is workforce development Offering courses at a more local level Replacement training More use of remote learning e.g. Northumbria Greater level of responsiveness to service needs and where CAMHS is now Continued support for added value improvements to practice Filling the gaps for the CAMHS workforce LD, ASD Tier 4 New curricula e.g. NICE approved combination treatment, use of practice based evidence Modifying curricula to widen workforce of therapists

Coming on stream…… Taskforce Report – March 2015 Building on CYP IAPT, service standards Delivering With Delivering Well now embedded in established accreditation processes System Dynamic Model for health, social care and education New resources for evidence based community eating disorder teams For new commissioners – MindEd training modules

Contacts: Kathryn.pugh1@nhs.net anne.oherlihy@nhs.net www.cypiapt.org