1. Think Good, Feel Good Project TaMHS The Shropshire Model Supporting emotional health and well being in schools Jo Robins Locum Consultant in Public Health Kay Smallbone Programme Lead 5-19 Renee Lee Project Support Officer Shropshire council

2. The facts… In 2004, 22.8% of the total burden of disease in the UK was attributed to mental disorder, compared with 16.2% for cardio vascular disease and 15.9% for cancer Mental illness is the single largest cost to the National Health Service (NHS), being £10.4 billion, that’s 10.8% of the NHS budget The wider costs amount to £105 billion a year Royal College of Psychiatrists, ‘No health without public mental health’, October 2010 and February 2011

3. Local Context Health and Well-Being Strategy - Outcome 3: Better Emotional and mental health and wellbeing for all –Priority – (i) Improve the emotional wellbeing and mental health of children and young people, by focussing on prevention and early support. –Priority – (ii) Making Shropshire a dementia friendly county to enable earlier diagnosis and improved outlook for people with dementia Priority (i) listed above is to be delivered by the Children’s Trust and reported through to the Health and Well-Being Board. In Shropshire, it is estimated that between 26% and 32% of the population have a mental health condition with the main illnesses being depression and anxiety, alcohol related mental health problems, and personality disorders. In addition to this, over 4000 people in Shropshire are known to suffer from dementia. The ageing nature of our population means that this number is increasing, and problems with diagnosis mean that this figure is already likely to be much higher.

6. What are the risk factors? Factors that increase the probability of a child developing an emotional health problem

7. If a child has one risk factor their chance of developing an emotional health problem is 1-2% Three risk factors is 8% Four or more, increases to 20%

8. The benefits of school engagement “… warm, caring and supportive relationships in school are a crucial factor: not only in maintaining good mental health; but to achieve high levels of performance; greater enjoyment of school; more motivation; better learning; higher attainments; improved attendance levels…” (Weare and Gray, 2002)

9. The Shropshire Model Shropshire Children’s Trust Health and Well Being Board Safeguarding Board CAMHS Commissioners CCG Public Health TaMHS Steering Group Project Team Project Manager School leads TaMHS Administrator Lifelines practitioners Wider Team Children and Young People (3052 pupils) Whole school CAMHS Voluntary Sector partners Statutory partners Families & Community Stakeholders Group

10. National Model: A Whole School Approach

11. Key Deliverables of TaMHS underpinned by Outcomes Increase in staff confidence and skills in working with children and young people experiencing emotional and mental health problems Increase in staff knowledge and awareness of children’s emotional and mental health needs Programme has reached all schools Results from the pilot showed promising results around attendance and attainment improvement in pupil attitudes, anxiety, and feelings

12. Knowledge and skills training Target Group Knowledge and skills based training DescriptionImpact/Outcomes KS1- KS4 Tier 1Sociograms Project Manager and Learning & Skills Team Assessment and tracking toolTo identify need and track progress of pupils KS1- KS4 Tier 1 SUMO (Stop, Understand Move On) SUMO national team or Project Manager Whole school resources creating common language to positive thinking Emotionally healthy whole school culture KS1- KS4 Tier 1 Loss and Bereavement Hope House HospiceTheory/ models of grief, Raise awareness and confidence in supporting pupils following grief. KS1- KS4 Tier 1Re ThinkTime to Change Mental ill- health awareness rising. Service user stories Raise awareness of the differences between mental health and mental ill- health and the long term impact their childhood traumas such as bullying and abuse can have on young people into adult life. KS1- KS4 Tier 1 Self Harm & Introduction to STORM Project manager and Educational Psychology service or CaMHS Understanding and managing self- injury. Introduction to suicide prevention. Raise awareness of prevalence, dispel myths, how to identify early signs, how to respond and support following a disclosure StaffTier 1Stress managementProject managerManaging staff and pupil stress, in including relaxation techniques Ensure staff are in an emotionally sound place before supporting pupils emotional needs

13. Skills based intervention training Target Group Tier of support Intervention trainingTraining delivered byProgramme DescriptionImpact/Outcomes KS1- KS4 Tier 1 & 2Anger Management Project Manager and Learning & Skills Team 8 week peer support (anger) Pupils to understand triggers of anger, defuse and manage more effectively KS1- KS2 Tier 1 & 2Reach for the TopProject Manager6 week 1-1, (attachment) Provide time and space for pupils to talk, to build trust, to feel valued, safe and belong within the school KS1, KS2, KS3 Tier 2 FRIENDS for LIFE (Spence anxiety score measure) Educational Psychology Service 8 week peer support (Anxiety) Using CBT to reduce and mange anxiety KS3, KS4, KS5 Tier 2 STAR Windmills and STAR champions (eg.PM, EWO, TYS, 15-19 teams) 6 week peer support for pre NEETs pupils or those at risk of not reaching their full potential To increase aspiration, motivation and confidence KS1- KS4 Tier 1 & 2Seasons for GrowthBereavement UK 8 week peer support, using Wordens model of grief. To help pupils manage loss and significant change (e.g. bereavement or, divorce) KS1-KS3Tier 1 & 2Lifelines TaMHS team 1-1 support with grief work Enable young people to move forward following grief KS1, KS2, KS3 Tier 2 Nurture Group (Boxall profile measure) Priorslee campus Classic and adapted nurture groups Curriculum based sessions for small groups of vulnerable pupils KS1-3Tier 1Relax Kids and Chill Skils ZJT consultancyRelaxation skills that can be delivered to small groups or whole class To raise awareness of the importance of relaxation and learning strategies of how to relax.

14. Classic nurture groups ‘The school's own nurture group provides pupils with excellent opportunities to work and play in a calm, relaxing atmosphere’

15. Outdoor Nurture Group “using the outdoor environment to stimulate pupils' interests, especially those of boys, is having a positive impact on motivating pupils to learn and raising achievement” Outdoor nurture groups

16. Relaxation garden “The excellent attention paid to children's welfare and to their personal, social and emotional development very successfully builds their confidence and self-esteem. Children are enthusiastic learners” Relaxation garden

17. Year 7 boys self esteem group Positive relationships exist between staff and the students and behaviour is managed well

18. Moving Forward – Think Good Feel Good Self harm identified as a problem in 2013 Self harm pathway developed in consultation with parents & young people Risk assessment policy developed for schools Information for children, young people, parents and practitioners Targeted intervention programme (10 weeks) Signature Strengths Train the trainer pilot in 3 secondary schools PHSE curriculum resource developed Extending the offer to under 5’s and over 16’s