Developing well Helping families to thrive Health and Wellbeing Board Conference workshop 9 th July 2015 Sally Orr Sasha Monk Maria Nastri Jen Beer/Shelley Taylor

Children’s Centres in Hertfordshire Making Hertfordshire an even better place to live and work Maximising opportunities for all children and young people

Early Years Strategy Achieving the best start for all Hertfordshire children by reducing inequalities in health, attainment and wellbeing Ensuring that young children from diverse backgrounds develop well and are ready for school Meet the needs of all children in a social inclusion approach Supporting parents to have good self-esteem and parenting skills, and high aspirations for their children Enabling families to live healthily and have good mental health and wellbeing Identifying and responding to families with higher needs earlier and offering appropriate and timely targeted support Ensuring sustainable universal and targeted early intervention services which prevent problems escalating and reduce the demand for more specialist services Developing local networks of co-produced family focussed early years services built around identified community needs

Children’s centre programme 82 Sure Start Children’s Centres by 2012 Increasing child population: 2006 – 64, – 78,000 under 5 year olds Fully commissioned programme: Schools, NHS Trust, District Council, Leisure, Private Minimalist model: Services delivered through 300 community venues; small admin hubs Political support for the programme High quality

Strategy for recommissioning Reduce demand on higher cost services through effective, multi-agency, early help, family focussed services from conception to 5 years Develop HWBB Early Years Strategy Retain all 82 centres to build on successful, locality based community model Reduce budget by 13%; group Centres for efficiency Provide further integration with health services – health visiting, midwifery, FNP, health promotion, GPs, CCGs Contribute to the Families First (early help) strategy

Helping families to thrive Howe Dell Children’s Centre Part of the Hatfield Group Lead agency: Birchwood Nursery School Sasha Monks Penny Briggs

Supporting vulnerable adolescents

Supporting vulnerable adolescents & their families – our ethos Empowering young people Holistic approach to need Developing resilience within families Continuum of provision A distinctive adolescent-centred approach is required Adolescents are not simply young adults or old children. Risks and pathways are different. This developmental stage holds distinctive strengths and opportunities

The needs of vulnerable adolescents Often a time of increased risk-taking, emotional highs and lows, and sensitivity to peer influence, all underpinned by interacting social and neurobiological changes Adapted to harms experienced in earlier childhood Unmet needs (emotional / physical) that they seek to meet via risky routes Adolescent choices are part of the problem and part of the solution Misinterpreted as rational informed adult ‘lifestyle choices’

Range of provision available  Youth Offer  Early Help  Youth Connexions Targeted work  Mentoring  Brief Therapy  Counselling in Schools Service  Targeted Youth Support  A-DASH  Thriving Families

Some quotes Adolescents are not monsters. They are just people trying to learn how to make it among the adults in the world, who are probably not so sure themselves. Virginia Satir The toddler must say no in order to find out who she is. The adolescent says no to assert who she is not. - Louise J. Kaplan I think that is a universal adolescent feeling, trying to find your place. The adolescent who is perfectly adjusted to his environment, I've yet to meet. - Roger Bannister

Mental Health in Children and Young People 1 in 10 children aged five to sixteen have a clinically significant mental health problem, with prevalence increasing with age. More than half of all adults with mental health problems were diagnosed in childhood. Less than half were treated appropriately at the time A child’s emotional health and wellbeing influences their cognitive development and learning as well as their physical and social health and their mental wellbeing in adulthood

Hertfordshire intelligence About 23, year olds in Hertfordshire will have a diagnosable mental health problem. While Hertfordshire is a good place to live and enjoys higher than average levels of wellbeing, more than 14% of the county’s children under 16 are living in poverty: a known risk factor for mental ill health 24% of school children in Hertfordshire are from a minority ethnic group. Children from some BME communities face greater risk of poor mental health as adults.

Hertfordshire Intelligence Health Related Behaviour Questionnaire: What our young people worry about Hertfordshire pupils are more likely to worry about money problems, death, exams and tests, and the way they look 25% of primary school pupils, and 38% of secondary school pupils said they worried about the way they look (This is higher than in other areas) Young people in year 8 and 10 identify exams and tests as the main thing that they worry about (55%) Education 31% of pupils said that their school taught them to deal with their feelings positively

Hertfordshire Intelligence Health Related Behaviour Questionnaire: Bullying 43% of primary school pupils and 41% of secondary school pupils said they’d been bullied at school at some point Around 1 in 4 pupils sometimes feel afraid of going to school because they may be bullied. Self Harm 60% of secondary school pupils know someone that has self-harmed How do young people cope with worries? The most common response to this question was ‘listen to music’, followed closely by ‘think carefully about the problem by themselves’ and then ‘talk to a friend or sibling’, ‘talk to an adult’, or ‘don’t tell anyone’.

Promoting Emotional Wellbeing What works Whole systems approach to promoting resilience Challenge stigma/ raise awareness around mental ill health Peer education and support Training and support for professionals Five Ways to Wellbeing A snapshot of what’s already happening in Herts Training e.g. MindEd, CAMHS Referral, My Teen Brain, Self-Harm Pastoral leads groups – enabling coordination/ sharing best practice In planning: Girls Physical Activity & Emotional Wellbeing project Do Something Different pilot: text programme to reduce anxiety How to Thrive – Resilience e.g. Penn Resilience programme CAMHS review (includes focus on prevention and early intervention)

Discussion points What are the key things we need to do under the broad theme ‘Developing Well’ of the Health and Wellbeing strategy? AttachmentMindfulness Mental health and wellbeingResilience Risky behavioursBe active Strong social networksHome learning

Discussion points What challenges could stop us from achieving our objectives and how can we tackle them together? Information sharing Partnerships Whole family working Silos Demography Evidencing impact Resources Thresholds and criteria Community involvement