Good mental health and wellbeing is crucial for the healthy development of children and young people (CYP), helping them to develop resilience, face the challenges of adolescence and adulthood, and fulfil their role in society. Mental wellbeing can be influenced by a range of individual, familial, social and environmental factors that can impact on Children and Young People throughout their development. Whilst good emotional and social wellbeing is associated with good physical health, academic engagement and economical independence, poor mental health can have significant long lasting and far-reaching impacts on Children and Young People.

The WHO constitution states [WHO Health and Well-Being]:

• Mental health is more than the absence of mental disorders.
• Mental health is an integral part of health; indeed, there is no health without mental health.
• Mental health is determined by a range of socioeconomic, biological and environmental factors.
• Cost-effective public health and intersectoral strategies and interventions exist to promote, protect and restore mental health.

Mental health is an integral and essential component of health. "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." An important implication of this definition is that mental health is more than just the absence of mental disorders or disabilities.

Mental health is a state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and is able to contribute to his or her community.

Mental health is fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living, and enjoy life. On this basis, the promotion, protection, and restoration of mental health can be regarded as a vital concern of individuals, communities, and societies throughout the world.

Half of all long-term adult mental health disorders are established by age 14 and three quarters by the age of 24 (NHS Mental Health of Children and Young People in England, 2017): The impacts of poor mental health can be seen on social relationships, educational attainment, physical health, crime, homelessness, and employment prospects.

Children are at a higher risk of developing mental illness if they experience adverse events in childhood, are looked after by the local authority, if they have a long-term illness or disability, if they are a young carer or if they have a parent with a substance misuse problem. Children with stable home lives, who attend school regularly and who have positive relationships with their peers and adults have a reduced risk for mental illness.

South Tyneside has developed strong, evidence-based strategies to support Children and Young People, particularly through improving access to mental health services, including the introduction of the Health Minds Teams, the Avoidant Restrictive Food Intake Disorder (ARFID) service, and working in partnership to develop family hubs and offer training for professionals and school staff.

There has also been significant investment in the workforce; not only in health, but across a wide range of public sector roles; in addition to this, schools have made a concerted effort to build resilience.

During the COVID-19 lockdown period between March and June 2020, there was a significant reduction in referrals to mental health services, partly due to school closures and restrictions on GP services, but also related to face-to-face work ceasing for all but the most vulnerable. Referrals have increased since then, but there is further work being undertaken to understand the impact of the reduction of referrals on CYP's mental health and the impact of the reduction in face-to-face services.

National policy (Long term Plan, 2019) recognises the need to improve the experience young people have with their mental health and that changes need to be made to improve transitions and support for young children and young adults.

NICE Guidelines state that Health and Wellbeing Boards should ensure the social and emotional wellbeing of vulnerable children features in the Health and Wellbeing Strategy, as one of the most effective ways of addressing health inequalities. The resulting plan should include outcomes to ensure healthy child development and 'readiness for school' and to prevent mental health and behavioural problems. 

Health and Wellbeing Strategy Vision:

South Tyneside's vision statement within the Joint Health and Wellbeing Strategy is to:

"Work in partnership to improve the health, wellbeing and quality of life for children, adults and families and reduce health inequalities, to help people live longer and healthier lives."

South Tyneside uses the Thrive approach to supporting young people. The Thrive Framework is an integrated, person centred, and needs led approach to delivering mental health services for children, young people and their families. It conceptualises need in five categories: Thriving, Getting Advice and Signposting, Getting Help, Getting More Help and Getting Risk Support.  One of the important factors is the common use of language and understanding across the partnership, however, the most important shift in using the Thrive Model is the emphasis on a needs-led approach and ensuring there is shared decision making with the young person and their family, along with person-led goals, which are reviewed to measure outcomes achieved. 

South Tyneside remains one of the top ICB areas, with the highest spend per child.

National prevalence of mental health problems in children and young people

In 2017 ONS carried out the third Mental Health of Children and Young People in England survey (MHCYP survey) of 9,117 children and young people aged 2-19 years old living in England and registered with a GP. The survey combines reports from children, their parents, and teachers to identify if the child or young person met the International Classification of Disease (ICD-10) diagnostic criteria (WHO, 2016) [The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines (who.int)] for a range of different types of disorder. Those who took part in the survey are contacted to repeat the survey annually.  

The most recently published survey - 2022 [Mental Health of Children and Young People in England 2022 - wave 3 follow up to the 2017 survey - NHS England Digital] shows that there are now 1 in 6 CYP aged between 7-16, in England at risk of poor mental health.  This is an increase from 1 in 9 in the 2017 survey, however, has remained stable since 2020. In the age group 17-19, there has been an increase in rates of probable mental health need at each survey point; the 2017 rate was 1 in 10, this remained stable until 2021 when it increased to 1 in 6, then increased to 1 in 4 in 2022.

Other findings in the 2022 survey show that 1 in 8 11-16-year-olds who use social media have been bullied online; 1 in 5 (over 19%) of 7-16-year-olds lived in households that experienced a reduction in household income in the previous year.

As can been seen from the graph within the weblink attached, trends in the MHCYP survey show a gradual rise in mental disorders overall, largely accounted for by a proportionally large increase in emotional disorders since 2004 (the chart does not include ages over 16, where prevalence is much higher for emotional disorders. [Mental Health of Children and Young People in England, 2017]

There are approximately 4,000 children and young people seeking formal help and support through a range of commissioned children and young people's emotional wellbeing and mental health services (locally accepted referrals data).  However, many more may in fact seek support through use of informal networks and charity/voluntary services.

Population

South Tyneside is around 25 square miles (64 square kilometres) wide, with a population of around 148,000 of which 21.9% are aged 0-18.  According to the most recent census data, there has been an overall decline in the population of around 400 since the 2011 census.

The table below shows the number of families who are supported through children's social care (numbers and rates per 10k children); the data has been taken from 2017 to 2022 year-end figures and shows an overall increase in demand on the social care system.  Whilst the number at the year-end fluctuates, this shows an increase in 2021 and current in-year data indicates that last year's year end figure has already been exceeded to date (over 1500).

Since 2020, there has been a significant increase in the number of children and young people who are elected home schooled, and there are currently 257 children and young people in South Tyneside who are electively home educated.

Deprivation and Poverty

There are socioeconomic factors that attribute to the health and wellbeing of children and young people, such as the links to long term health conditions, mental health conditions, employment prospects and healthy standards of living. South Tyneside has worse health outcomes than other, less deprived Authorities as well as worse health outcomes in its most deprived neighbourhoods.  In 2021, South Tyneside was one of the most deprived areas in England (ranking 12th of 316 English Local Authorities) [Exploring local income deprivation (ons.gov.uk).  

There are additional pressures on families such as the cost-of-living crisis, which is pushing families further into poverty.  Data from the rising cost of living and its impact on individuals in Great Britain analysis shows that around 1 in 3 of those who reported an increase in their cost of living, also reported spending less on food shopping, or shopping around more. [The rising cost of living and its impact on individuals in Great Britain - Office for National Statistics (ons.gov.uk)].

Statistics from the Anti-Poverty Strategy show that:

• 39% of children were living in poverty in 2020 / 21.
• 45% of South Tyneside neighbourhoods are in the most deprived 20% nationally.
• A quarter of our population live in the 10% most deprived areas in England.
• 13.9% of households in South Tyneside are in fuel poverty.
• There is a prevalence of low paid jobs in South Tyneside with 1 in 5 below the living wage.
• Around 3,790 children in South Tyneside are impacted by the "two-child limit" in relation to Universal Credit and Child Tax Credit.

From research that has been undertaken by Loughborough University, we know that:

• Regionally, the north east has seen the sharpest increase in child poverty levels at 38% - up 7 percentage points from 2010/11.
• Around one in 8 children of a class of 30 are now living in poverty.
• In 202/21 655 of children in poverty lived in a working house (where at least 1 adult is in work).
• 40% of children in lone parent households were in poverty (compared to 24% of those in couple parent households).
• Children from black and minority ethnic groups are more likely to be in poverty, at 46%, compared with 26% of children in white British families.

There has been an increase in the number of children and young people who are eligible for free school meals - in 2022 this was around 2 million pupils nationally. [BBC: Rising number of children on free school meals] In 2022, the north east had around 30% children and young people who were eligible for free school meals, which is a high eligibility rate in comparison to other areas. These children and young people tend to not achieve a good level of development as those who are not eligible for free school meals.

Obesity prevalence is highest among the most deprived groups in society. Children who reside in the most deprived parts of the country are more than twice as likely to be living with obesity than those in the least deprived areas.  Those who are living with obesity will have a high risk of associated health conditions such as; type 2 diabetes, cardiovascular disease, live and respiratory disease and cancer.  Obesity can also impact on mental health.  As of November 2023 (when data was collected), there were around 1 in 5 children and young people living with obesity in England. ^[Obesity Profile - OHID (phe.org.uk)]

In addition, those families with children who have special educational needs are more likely to be more adversely affected by poverty than those who do not. 

Young People Not in Education, Employment or Training (NEET)

The term NEET is used to identify young people usually aged 16-18 (but also up to the age of 24 if they have special educational needs or disabilities), who are not in education, employment or training.

South Tyneside's latest available data (full data up to March 2024 with comparisons to neighbours and North East and England) shows that, whilst we have been above the regional and England average, this is now slightly lower - please see table below:

Percentage of Young People Recorded as NEET and Not Known - (Years 12 and 13 combined) Compared with South Tyneside's Closest (statistical) Neighbours

Research has shown that family income affects children's lives and development in a variety of ways. Children who have lived in persistent poverty during their first seven years have cognitive development scores on average 20% below those of children who have never experienced poverty.

The Child Poverty Action Group (GPAG), have summarised the impact of poverty on children and young people as:

Maternal and Infant Health

Perinatal mental health is a term used to describe a woman's mental health during pregnancy and in the year following birth. It encompasses a range of mental health conditions such as antenatal and postnatal depression, anxiety, perinatal obsessive-compulsive disorder (OCD), postpartum psychosis, and post-traumatic stress disorder (PTSD) following childbirth.  For those who may be diagnosed and require treatment, this typically involves psychological therapies, medication, or a combination of both. 

Perinatal mental health problems affect between 10 to 20% of women during pregnancy and the first year after having a baby. [4. Perinatal mental health - GOV.UK (www.gov.uk)].

Across England, smoking at time of delivery has reduced significantly in recent years and continues to fall, however, South Tyneside remains higher than the England average at 12.1% compared to England score of 9.1% (2021/22).

Health inequalities data tells us that, males living in the most deprived areas were living around 10 years less than those living in more affluent areas; the gap being around 8 years for females. 

Children in Need

Children in the most deprived 10% of small neighbourhoods in the UK are over 10 times more likely to be in foster or residential care or on protection plans than children in the least deprived 10% a study by the Child Welfare Inequalities Project Team has found in South Tyneside a quarter of the population live in the 10% most deprived areas in England.  The Child Welfare Inequalities Project concludes deprivation is the largest single factor in families becoming involved in child protection.

Although each child or young person will have a unique journey into care, the most common reason for becoming looked after was abuse or neglect. These are considered to be major adverse childhood events (ACEs). These can cause trauma and can lead to long-term damaging effects on children and young people's physical and mental health. Other adverse childhood events experienced by looked-after children and young people include physical abuse, emotional abuse, and sexual abuse. Trauma can also include domestic abuse, serious harm, exposure in the home or community to alcohol, drug misuse or violence. All looked-after children and young people will have experienced trauma in some way.

In 2023, there was an increase of 2% in children looked after on the previous year (number of children looked after totalled 83,840 across England). [GOV.UK: Children looked after in England including adoptions, Reporting year 2023]

There was a 6% increase on 2022 in the number of children who began to be looked after (33,000), of which there was a 29% increase in unaccompanied asylum-seeking children (UASC).

In South Tyneside there have been 6,707 contacts and 1,067 to Children's Social Care in the period September 2023-February 2024 in the last six months.  Of those, 21% were children with previous referrals (within the last 12 months).

Locally collected data (September 23-February 24) tells us in South Tyneside there are 106.1 (per 10,000) 315 children looked after, with 70 cases beginning in the last 6 months.  There are currently 823 children open to the Early Help Service.

Access to Mental Health Services

Performance data from local statutory mental health services, and the digital offer with Kooth, to the end of the fiscal year 2022/23 show the number of children and young people accessing those services as:

The number of referrals to statutory services in 2023/24 has slightly decreased from 2022, (2,977 referrals received via the Single Point of Access), however, access to digital support via Kooth has slightly increased from 2021/22 when there were 510 new registrations and 3,498 logins.

Schools are consistently the highest referrers into services, and the main point from which young people hear about Kooth.

Children and Young People with Special Education Needs and Disabilities

Data taken from the School Census 2022/23 tells us that; nationally, there are 1,183,384 pupils in schools who have identified SEN needs without an Education Health Care Plan (EHCP) - this is an increase of 4.7% from 2022.  There are 389,171 pupils who do have an Education Health Care Plan (EHCP) - increase of 9.5% from 2022.

This gives the total number of children and young people who have special educational needs (SEN) as 1,572,555.

Using the same data (School Census 22/23) the published South Tyneside Figures are:

• 3,960 - SEN Support/SEN without an EHC Plan
• 1,105 - EHC Plans
• Total SEN = 5,065

The table below demonstrates the South Tyneside picture against statistical neighbours, the north east as a region and England and tells us that South Tyneside currently has a higher rate of children and young people requiring SEN support. This trend has been consistent over the last four years.

Youth Justice

In 22/23 there were 21 First Time Entrants (FTE) in service an increase from the 12 in 2021/22.

From Ministry of Justice data return (unpublished), in 22/23 there were 21 First Time Entrants (FTE) in service, an increase from the 12 in 2021/22. However, these numbers are comparably low which is reflective of the continued use of Outcome 22s [Deferred prosecution - Outcome 22 (yjlc.uk)], joint working work between YJS and Northumbria Police, and an indication that data for 2020/2021/2022 was anomalous due to the Covid 19 pandemic. South Tyneside's FTE figures are substantially less than the region and national comparators.

Custody rates remain at 0 for young people, as they have done since 2019. This reflects positive working relationships between YJS and the court in identifying and using bail support, ISS and Intensive Referral Orders as an alternative to custody.

Strength based assessments are undertaken with all young people which includes a mental health needs assessment. Where there are indicators of neurodiversity, staff are also able to complete the Do-It Profiler [Neurodiversity in Youth Justice - Do-IT Profiler (doitprofiler.com)]

with input from young people. A partnership approach is key to ensuring the needs of young people is considered and addressed with monthly peer support from colleagues in Lifecycle and CYPS for consultation.

Substance Misuse

Data from the Matrix (young people's drug and alcohol service) tells us there were 107 young people (60 boys and 45 girls) in treatment over 2022/23. 2022/23 also saw an increase in young people presenting with anxiety and mental health needs, this is consistent with the increase in need following the Covid pandemic and the impact on young people.

The main source of referrals received were from Children's Social Care at 30% higher than the National average of 21%. There were 27% of referrals were received from young people themselves, or friends and family on their behalf. This is higher than the national average of 18%. Referrals from the Youth Justice Service is lower than the national average at 4%, however this has resulted in the development of a more suitable screening tool to further identify young people's substance related need and more collaborative working. 

In 2021/22 there was an increase across all age groups accessing the Matrix Drug & Alcohol Service.  The average age of young people referred to the service is 13-14 years. Cannabis is the primary substance used by young people, with a constant rise since 2019/20.  Alcohol consumption in young people, whilst always slightly higher than England, has decreased to 48% in 2022/23 from 55% in 2021/22. [Alcohol and drug misuse and treatment statistics - GOV.UK (www.gov.uk)]

Domestic Abuse

Domestic abuse is defined as, any incident or pattern of incidents of controlling, coercive or threatening behaviour,  violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass but is not limited to the following types of abuse:

• Psychological
• physical
• sexual
• financial
• emotional
• online or digital abuse

Controlling behaviour is: a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.

Coercive behaviour is: an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim."

This definition, which is not a legal definition, includes 'honour' based violence, female genital mutilation (FGM) and forced marriage, and is clear that victims are not confined to one gender or ethnic group.

Long-term effects of domestic abuse on children and young people can include; mental health problems, such as becoming anxious or depressed. Low mental health can also lead to impact on physical health, including self-harm, developing an eating disorder, having a lowered sense of self-worth, using alcohol and other drugs as unhealthy coping mechanisms, repeating behaviours seen in their domestic setting

Since the Domestic Abuse Act 2021, children that have been exposed to domestic abuse are now recognised as victims of domestic abuse in their own right, rather than just witnesses.

The police recorded 1,500,369 domestic abuse-related incidents and crimes in England and Wales in the year ending March 2022 [https://www.ncdv.org.uk/domestic-abuse-statistics-uk/]. In 2020/21 the number of domestic abuse-related crimes increased to almost 8% compared to the previous year [https://www.nspcc.org.uk/about-us/news-opinion/2022/record-number-children-affected-domestic-abuse/. 

An estimated 1.4 million women and 751,000 men aged 16 years and over experienced domestic abuse in the last year (2022); a prevalence rate of approximately 5.7% of women and 3.2% of men. [Domestic abuse victim characteristics, England and Wales - Office for National Statistics (ons.gov.uk)]

Young Carers

The standard definition of a carer is "anyone who cares for a friend or family member who, due to illness, disability, a mental health problem or an addiction, cannot cope without their support. The care they provide is unpaid".

The 2021 Census tells us that there are approximately 15,000 carers in South Tyneside, with 8% in the 5-24-year-old category; approximately 1,200 young and young adult carers who are likely to be juggling their caring role alongside education and other interests. This can make it hugely challenging for young carers to enjoy the same opportunities as their peers.

Young Carers have been identified as a priority within the South Tyneside Carer's Strategy 2022-2027 [CARERS_STRATEGY_2022-2027.pdf (southtyneside.gov.uk), to support young carers to achieve their full potential.

Self Harm

Self harm amongst pre and early teens has increased in recent years, and appears to following an upward trajectory following the COVID-19 pandemic, please refer to Health Related Behaviour Questionnaire below, which contains some data from children and young people on this topic.

In 2022/23 [Public health profiles - OHID (phe.org.uk) the rate of hospital admissions as a result of self harm in 10-24 years was 319/100,000.  A breakdown of the age groups are as follows:

Eating Disorders

Service providers are reporting that they are seeing younger children (pre-teen/upper primary age) through their service.  They report that social media is an influence on body image and how they perceive themselves. 

Data from the service provider (Cumbria, Northumberland, Tyne and Wear - CNTW) reflects that the number of acute admissions were as follows:

• 2021 - 2022 - 11 admissions into SRH
• 2022 - 2023 - 11 admission into SRH
• 2023 - non at present

The community team have reported an vast increase in referrals to the team between 2019 and 2023 (performance data indicates that referral numbers have almost quadropuled, however, this data is not accessible for publishing).

Health Related Behaviour Questionnaire

The Health-Related Behaviour Questionnaire (HRBQ) is a digital survey which collects self-reported data from children and young people in academic years 4, 5 and 6 in primary school (ages 8-11yrs) and academic years 8 and 10 in secondary schools (ages 12-15yrs) about various health topics. 

Areas of interest include age-appropriate questions about citizenship, healthy eating, physical activity, dental care, drugs, alcohol & tobacco, emotional health & wellbeing, safety, puberty & growing up, school & career and relationships & sexual health.  The questions are age-appropriate and ask children and young people about their experience in the days and weeks before the survey. 

The 2022 data is heavily COVID-19 affected, and considerable fewer participants completed the survey, for this reason, results have been compared to the previous South Tyneside survey in 2017, rather than the wider area data which was not available.  The outcomes from the survey are not publicly accessible, however, if required, can be requested by contacting: public.health@southtyneside.gov.uk

Key headline results from the questionnaire in relation to mental health and emotional wellbeing are as follows:

Primary

1. Self-esteem* is lower in children this year than in 2017, with 26% of pupils rating their self-esteem as high this year compared to 31% in the last survey.  33% of boys said their self-esteem was high, compared to only 20% of girls.

*This measurement is derived from the responses to a set of ten statements taken from a standard self-esteem enquiry method developed by Denis Lawrence (Lawrence, 1981) [The development of a self-esteem questionnaire. (apa.org)]. The scale is based on social confidence and relationships with friends.

2. Overall, children are more worried about things than they were in the previous survey.  80% of children said they were worried about at least one of the items listed in the questionnaire this year, compared to 75% in 2017. 

Top worries for our children include:

• 37% (40%) SATS/tests
• 33% (27%) problems with friends
• 32% (30%) family problems
• 30% (21%) how they look - girls were more worried about this (39% of those questioned) than the boys (21%)
• 30% (31%) crime - this figure is lower than the previous survey
•  27% worried about COVID-19
• 18% (17%) body changes while growing up

3. Most children have one, or a group of, close friends. This figure of 84% has not changed.

4. Resilience in year 6 children has given mixed results, with 65% pupils responding that when something goes wrong, they 'usually' or 'always' learn from it for next time, compared to 63% in 2017.  In contrast, this year 30% said they get upset and feel bad for ages when something goes wrong, compared to only 20% in the previous survey.

Secondary

5. Student's self-esteem* is falling.  Only 25% of students reported high self-esteem, compared to 37% in the previous survey.  Only half (50%) of young people said they were happy with their life at the moment, compared to 65% in 2017.

*This measurement is derived from the responses to a set of ten statements taken from a standard self-esteem enquiry method developed by Denis Lawrence (Lawrence, 1981).  The scale is based on social confidence and relationships with friends.

6. Students are slightly more worried about things this year, with 86% (83%) of young people reporting they were worried about at least one thing listed in the survey.  Girls are significantly more worried about the listed topics than the students in the previous survey, particularly around the way they look.

Top worries for boys:

• 44% the future (44%)
• 40% exams and tests (41%)
• 35% mental health of a family member (25%)
• 31% the way they look (24%)
• 26% family problems (25%)

Top worries for girls

• 70% the way they look (54%)
• 70% exams and tests (51%)
• 61% the future (45%)
• 54% their own mental health (33%)
• 52% schoolwork (27%)

42% of pupils reported that they think they have been picked on or bullied because of the way they look, compared to 32% in 2017. 

7. 36% of pupils responded that they feel afraid of going to school because of bullying at least 'sometimes', an increase from 27% in the previous survey. 44% of pupils responded that they think their school takes bullying seriously, fewer than the 54% in the previous survey, despite more students (25%) reporting bullying, compared to only 17% in 2017.

8. Self-harm has risen significantly in secondary-aged boys, and slightly in girls.  13% of boys this year said they had self-harmed, compared to 7% in the last survey.  19%, around a fifth, of girls said the same this year, compared to 17% in the last survey.  8% (5%) of boys and 16% (11%) of girls did not want to say if they had self-harmed.   49% of boys and 64% of girls who self-harmed did not receive any support, compared to 38% and 44% in 2017, however only 15% of those who reported to have self-harmed had shared this information with someone else, the most common being a friend at 10%.

9. Our young people have good coping strategies when feeling worried or stressed, with listening to music, socialising with friends and thinking carefully about how to problem solve themselves being the top 3 activities for both boys and girls.

Top activities to combat stress for boys:

• 72% listening to music (73%)
• 69% going out to socialise with friends (71%)
•  69% thinking carefully about the problem themselves (71%)

Top activities to combat stress for girls:

• 92% listening to music (85%)
• 75% going out to socialise with friends (77%)
• 72% thinking carefully about the problem themselves (72%)

50% of boys, and 57% of girls will do nothing when they are feeling stressed or worried, compared to 34% and 40% respectively in the last survey.

Various sessions have been offered to children and young people for them to tell us about their experiences on the commissioned mental health services.  From those sessions, there are themes emerging such as, communication; several children and young people have told us that they are not aware of what the mental health offer is and how they access support.  More work is being undertaken to understand this in more detail and how we can work with young people to improve communication. 

The Health-Related Behaviour Questionnaire responses in section 2 outline what young people have told us about their experiences, such as what the top worries are - how this differs from girls and boys, however, listening to music is the top coping strategy across both sexes. 

In 2018/19, the place based ICB commissioned a specific LGBT+ Support Service.  This was in response to conversations with young people who told us that they were referred to mental health services when they were confused about their identity, however, did not feel that there was enough understanding with the practitioners they spoke to, equally did not feel it was the right place for them to receive advice and support. 

Other feedback includes not all fully understanding the differences in services, eg, South Tyneside and Sunderland Foundation Trust (STSFT) Lifecycle Service, and Cumbria, Northumberland, Tyne and Wear (CNTW) CYPS Service and how this affects them.  They feel it would be better if this was more streamlined.  Those who were awaiting, or had a neurodevelopmental assessment had a better understanding of the services.

Some young people (and families) have told us that being able to see the Mental Health Support Team (known locally as the Healthy Minds Team which our young people named) instead of going out of schools has been better for them and reduces some level of anxiety.

Following feedback from young people, it is apparent that there are inconsistencies across educational settings, which includes an understanding of emotional/mental health, and how to support someone who may be experiencing difficulties.  Some young people advised that there are assemblies with information, people in and around school who they are aware of and have been signposted to, but some advised that they when they have spoken to staff, they have not had the knowledge, or skills to know how to support them to seek help.

From speaking to parents and carers, they have told us from their perspective they are left feeling frustrated when their children's needs cannot be met by one service, and they are transferred to another but receive little or no communication as to when they may be seen.  They also would benefit from an understand of what the process is to receiving support and what support can be offered during the period of time until the young person is seen by the service. 

Following feedback from families that they felt practitioners who work with their children were not able to articulate the mental health offer available, the Children and Young People's Mental Health & Wellbeing Alliance hosted an event for those practitioners who work directly with children and young people in the borough to attend and learn more about the offer.  This included an overview of the sections of the thrive model; hearing from services how they fit into that and interacting with service representatives to have opportunities to ask questions and to meet the providers directly.

There is a requirement of the Children and Young People Mental Health & Wellbeing Alliance (see governance section), that the Local Transformation Plan (also known as the Place-Based Children and Young People Strategic Plan) is refreshed annually.  The Alliance agreed the following priorities which have been shared across the ICB and align with those of the Health & Wellbeing Strategy. 

1.    Reduce Health Inequalities; ensure we align mental health plans with SEND; autism; health; youth justice and unaccompanied migrants and looked after children.

2.    Develop the workforce - to include progression; diversity and retention.

3.    Define 0-25 mental health offer and embed All Age Neighbourhood model - to include meeting NHS wait time directives.

4.    Improve communication, including the use of technology.

5.    Transparency - use of digital data tools to measure impact and drive service improvement and interdependencies.

Core20PLUS5 is a national NHS England and NHS Improvement approach to support the reduction of health inequalities. The approach defines a target population cohort - the 'Core20PLUS' - and identifies '5' focus clinical areas requiring accelerated improvement to reduce health inequalities.

The 5 clinical areas are:

• Asthma
• Diabetes
• Epilepsy
• Oral health
• Mental health

When speaking to young people and their families, it is apparent that there was not always an understanding of what services were available, how they can be accessed and what to expect.

Further exploration would be required to understand how inconsistencies across education settings can be reduced to ensure children and young people receive the same messages when accessing support.

A study forecasting (data source: North East North Cumbria Integrated Care Board) the effects of COVID-19 and lockdown on children and young people's mental health from 2021 are as follows (these figures are specific to South Tyneside):

The forecasting above is not indicative of the number of referrals which have come through the mental health services (final year-end figures for 2023 are not yet known, however, previous years are set out within this document), and the impact on pre-school children who did not have the opportunity to attend pre-school groups to develop social skills, which would need to be considered.

There are opportunities in future planning, to explore how mental health services are aligned and where these could be streamlined to ensure accessibility.

South Tyneside is an outlier in terms of Autism as a primary need for Education Health Care Plan (South Tyneside Joint Strategic Needs and Assets Assessment 2021) and currently the assessments are carried out via Cumbria Northumberland Tyne & Wear (CNTW) Children and Young People's Service (CYPS).  There may be opportunities to consider how these assessments are carried out in the future.

What already exists?  

Maternal Mental Health

The Perinatal Community Mental Health Team which is part of Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW), a provider of mental health and disability services, is a community service which provides secondary care for women who are experiencing mental health problems within the perinatal period and offers care and support for women with a range of moderate to severe common mental health problems such as depression, anxiety, bipolar disorder, schizophrenia and psychosis.  Referrals can be made via a midwife, obstetrician, health visitor, GP or by the Specialist Mental Health Service

Women who may be having difficulty with their mental wellbeing during pregnancy may also be referred to the Obstetric Mental Health Clinic - provided by South Tyneside and Sunderland Foundation Trust (STSFT) - and seen by one of the specialist teams within the antenatal clinics.  In the first instance, any difficulties should be raised with the midwife, GP, or health visitor.

It is also possible to self-refer to the Maternal Mental Health Service (provided by South Tyneside and Sunderland Foundation Trust).  They can provide support for issues including traumatic births, pregnancy, or newborn loss, fear/anxiety around pregnancy or childbirth. 

Talking Therapies can also provide psychological support to women during pregnancy, and the wider family.  Self-referrals can be made through the Single Point of Access on 0191 283 2937.

Children and Young People's Offer

Healthy Minds Team (Mental Health Support Team) is a "getting advice and getting help" service (based on the i-Thrive model) and currently work with schools in developing a "whole school approach" to good mental wellbeing, by providing consultation and training and to build resilience in children, providing group or 1-1 interventions.    

Lifecycle is a 'Getting Help' service (based on the Thrive model) and supports young people who have difficulties with attachment, behaviour, development, emerging OCD, anxiety and depression. It provides whole-person therapeutic and non-therapeutic services to young people of any age and their families.

Children and Young People's Service (provided by Cumbria, Northumberland, Tyne and Wear Trust), support young people with more complex needs, which can range from attachment, eating disorders, psychosis, mange medication, risk and more.  They also provide a diagnostic service for neurodevelopmental assessment (this is under the Getting More Help in the Thrive Model).  Under 'Risk Support' in the Thrive Model, Cumbria, Northumberland, Tyne and Wear Trust also provide access to inpatient care, where this is deemed necessary.

Kooth is a digital online tool which is anonymous and in South Tyneside is available for children and young people aged 10-25.  They offer online community support with peers, access to articles which have been developed by young people (this part sits under the "Getting Advice" part of the Thrive Model). 

Kooth also provides a digital counselling service via chat and can be accessed 365 days a year and has counsellors available 12-10pm Monday to Friday and 6-10pm Saturday and Sunday.  Kooth's counterpart Qwell is available for those aged 25+.

Humankind provide support for young carers and can help with:

• support to identify future goals and aspirations.
• advocacy (speaking on behalf of a young carer).
• information, advice, and guidance.
• activities to give them a break from their caring role.
• meeting people in a similar situation.
• support to access other services.

Humankind also provides an LGBT+ Support Service across South Tyneside for those between the age of 11-25.  All reasonable adjustments are based on a young person's needs and on a case-by-case basis. All staff are fully trained in speech, language, and communication needs.

The service can help with:

• one-to-one sessions.
• sexual health guidance.
• support to access clinical gender identity services.
• the opportunity to meet other young people to share experiences.
• support for your family, either one to one or together.
• hate crime reporting.
• fun activities and sessions such as sailing, meals, climbing, etc. in a safe space.

The National Trust provide activities for children, young people and adults with SEND, Learning Disabilities and/or Autism, including young people with mental health needs - particularly those young people who are more vulnerable (including care leavers) or who are engaging in emotional-based school avoidance behaviours.  Activities may vary, as some activities are seasonal due to being weather permitted.  Referrals can be made from various professionals. 

0-19 Service (up to 25 for those with Special Educational Needs or Disabilities)

Health visitors

South Tyneside Council commission a Health Visiting Service which is provided by Sunderland and South Tyneside NHS Trust. Health Visitors lead the Healthy Child Programme (0-5 years) and are fundamental in ensuring every child has the best start in life.

These specialist Public Health nurses work with families with a new baby from late in the antenatal period up to five years of age. During this period, all families receive at least 5 comprehensive contacts with their Hv where the physical and mental health of both mum and infant (and the family situation) are reviewed and needs and risks are determined to identify any support or referral required.

Health visitors are often the first to recognise whether a child is not progressing well, mum is struggling with her physical and or mental health - or the family is struggling and therefore work closely with other health and social care partners to ensure the safety and wellbeing of the family. A vulnerable parent pathway is in operation for young parents and/or those with extra needs.

School Nurses

South Tyneside Council also commission a school nursing service again delivered by Sunderland and South Tyneside NHS Trust.

They lead on delivering the five to 19 elements of the Healthy Child Programme and are also specialist community public health nurses (SCPHN - SN).

In South Tyneside they are supported by skilled, mixed teams of staff, including community staff nurses and health care assistants.

They work alongside other members of the children's workforce, including GPs, health visitors and voluntary services. They partner closely with schools, providing training for staff, deliver mandated programmes such as the National Child Measurement Programme, carry out vision screening and delivering specific public health sessions at a population based on need in each school. Individual support is also provided to children and young people in need around mental health, sexual health, healthy weight, or risk-taking behaviour.

Our School Nurses run a confidential text messaging service for young people called CHAT health, where they can get confidential help and advice on a range of health topics, with mental health often being the number one topic of conversation.

Young Adults

Community Treatment Team provides an assessment and treatment service for people who are experiencing difficulties with their mental health.  The team is made up of several health care professionals. Appointments with the team are arranged at a number of different sites.  The service is available for those aged over the age of 18. 

Youth Justice

South Tyneside Youth Justice Service coordinates the provision and delivery of interventions and partnership working that are underpinned by the principle aim of the youth justice system. The aim of the Youth Justice system is to prevent offending by children and young people and prevent re-offending (Crime and disorder act 1998).

South Tyneside YJS works in partnership to achieve the national youth justice strategic objectives, which are to:

• reduce the number of children in the youth justice system
• reduce re-offending by children in the youth justice system
• improve the safety and wellbeing of children in the youth justice system
• improve outcomes for children in the youth justice system

The Youth Justice service provides a range of programmes with the aim to prevent re-offending, supporting, and promoting the welfare of young people, improving the life chances of young people, and protecting the public. The services including educational support, mentoring support, skills training, group work, and ensuring that the young people have the right provision for physical, sexual, emotional, and mental health.

Outdoor Education and Youth Services

The Youth Service gives young people the opportunity to be involved in social action/community projects across the borough,access creative activities, and develop personal, social, and emotional skills. The service offers sessions tailored to young people with SEND.

Youth Service

2022/23 saw an increase in the participation for children and young people from 2021/22. The service hosted an inaugural 'Youth Festival' in-line with the National Youth Agency's annual youth work week as well as other themed / topical events reflected in the data of open access.

Additional activities were funded through the Office of the Police Crime Commissioner (OPCC) Violence Reduction Unit (VRU) to reduce seasonal violence during the summer and winter months. This increased participation through a range of targeted diversionary positive activities, as identified below:

2022-23 has seen an increase in targeted delivery with additional activities funded by the Violence Reduction Unit OPCC and Ministry of Justice Street Games.

Connexions

Connexions provides independent and impartial advice and guidance for post-16 careers, employment, and educational options. Young people with multiple vulnerabilities in year 11, NEET young people aged 16-18, and those with SEND are offered Personalised support to help remove any barriers in accessing future Education, Employment or Training opportunities. The benefits of education, employment and training are well documented to improving mental health and wellbeing. The overall aim is to support young people around career choice, post 16 options and ensuring a smooth, supported transition into their post 16/18 destination.

Holiday Activity and Food Programme

The Holiday Activity and Food (HAF) programme is a national scheme for children and young people aged 5-16 years in receipt of free school meals (FSM), and for young people up to the age of 18 years with SEND also in receipt of FSM.  Funded by the Department for Education (DfE) the programme delivers accessible enrichment activities and meals during Easter, Summer, and Winter school holidays. Due to South Tyneside being a highly deprived area, there are a number of children who are eligible for the Holiday Activity and Food Programme and service level data (unpublished) indicates there was an increase in the number of children and young people who accessed the programme.

Matrix Young People's Service

The service delivers specialist drug treatment, advice and information for young people requiring care-planned multi-disciplinary responses and interventions to support them and their families with drug or alcohol related needs. Matrix can be accessed through multiple referral points and offers both outreach and centre-based appointments.

The design and delivery of the Matrix Service reflects the intrinsic differences of children and adults and is flexible to the needs of young people offering both outreach and centre-based appointments. Many young people who use substances have multiple psychological, social and educational issues with a wide range of complexities, predicaments and vulnerabilities. Matrix acknowledges that some young people have been exposed to adverse childhood experiences requiring a support system which is responsive in meeting their holistic needs.

Children and Families Social Care

South Tyneside's Children in Care Council is called MAGIC (Making a Great Important Change). The MAGIC Umbrella includes several groups and activities that bring together cared for children in fun and creative ways to share their experiences, and voice opinions, that help to change and improve Children's Services in South Tyneside.

The Children with Disabilities (CWD) Social Work Team, who provide access to specialist social work support to families of disabled children aged 0-18. The team works with children and young people who have a permanent and substantial impairment, typically needing input from agencies on a lifelong basis. Needs assessments identify what services are best placed to support the child and their family.

Impact Family Services - This service provides a range of programmes for both children and adults who are experiencing a difficult time due to separation, divorce, or domestic abuse.

Leaving Care

Young people have access to a dedicated Health and Wellbeing Counsellor providing one to one therapeutic support as well as group support and therapeutic activities.

One to one talking therapy is offered to help young people change how they think and feel. Through one-to-one support young people can explore issues such as anxiety, stress, loss, loneliness, anger and relationship difficulties.

Activities and opportunities are offered to build resilience, tackle social isolation and loneliness and promote wellbeing.

The service is confidential, easily accessible, flexible and designed to meet the needs of young people.

For complex mental health needs young people are signposted to appropriate specialist intervention. The dedicated health and well-being Counsellor can help guide and navigate this journey in accessing these services.

Early Help

Early/Family Help in South Tyneside is not a single service or programme but rather an approach which allows for collaboration and coordination between communities, families, and services. The Early/Family Help system aims to draw on a family's strengths, local universal services, and, where necessary, targeted services.

Early/Family Help in South Tyneside, and the basis for decision making on basis of need, is centred on the principle of: "Right Conversations, Right Help, Right Time." Needs for children/young people/families are categorised into 4 levels which informs the services that are best placed to address the needs. The South Tyneside Framework for Decision Making explains the different levels outlined below with examples of the needs, risks, and impacts at each level but are briefly outlined here:

• Universal: Families have the capacity to support themselves, or their needs can be met by universal services
• Additional: Children, young people or families are experiencing additional needs which need some support to reduce the likelihood of the situation becoming worse.
• Complex: Children, Young People and families with complex needs which are having an impact on their expected outcomes
• Acute: Children and young people where their need is having a major impact on their expected outcomes and there are serious concerns about their safety.

Family Help Services

The South Tyneside Council Early/Family Help Team - provides tailored support to children, young people and families meeting the Supporting Families Programme thresholds for intervention for Local Authority provided Early Help support.

Family Hubs - provide a joined-up, place-based provision of family services. They bring services together to improve access, strengthen links between families, professionals, services, and providers, and centralise relationships. Consequently, a wide range of services can be delivered through the Family Hubs network.

South Tyneside's Family Hub network provides a range of Early/Family Help prevention and intervention programmes for those 0-19/25. These programmes include:

• Learning with Play and Learning with Play (SEND) 0-4 years,
• Baby Explorers, Little Explorers and Language Explorers which focus on bonding, communication, development milestones, and health and wellbeing,
• HENRY Antenatal-10 years which provides support to parents and children in developing healthy lifestyle habits and a happier home environment.
• Triple P Parenting Programmes 0-19 years which provides support for families to build healthy relationships and manage children's behaviour.

The Family Hubs Programme Guide will change in response to demand and need and be tailored as feedback from service users is received.

STANLEY's Daycare within South Tyneside - based with Family Hubs but operates independently from the Family Hubs core offer and provides Early Years Foundation Stage education for children up to 4 years.

Asylum, Refugee and Migrant Community Integration Team - Supports individuals and families experiencing crisis due to their migration status. Manage complex welfare and legal systems to support Asylum seekers, refugees, or migrants to integrate into their community.

Education Psychology

The service can provide a range of support including assessment and identification of need.  Schools, however, before an educational psychologist becomes involved, the child or young person will have already received additional support in school, where the school will have adapted their teaching in relation to a child's strengths and areas for improvement in accessing the curriculum.

They can also provide advice and support relating to emotional based school avoidance and have a specialist Emotional Resilience Team (below) who deliver support to schools through a service level agreement.

Emotional Resilience Team

The Team provide support to targeted children and young people from ages 7 to 16, who have been identified as requiring support in particular areas that may create barriers to their learning and/or mental health.  The team also works with targeted Year 6 children and helps to support them with their transition to Year 7 (secondary education).

In addition, intensive support is provided to children and young people who are presenting as school refusers, helping to reintegrate them into an education setting.

The team can also offer bereavement support to children who are struggling with the death or loss of someone close to them.

South Tyneside Council

On license from the National Autistic Society offers the Early Bird (under five), Early Bird Plus (four-nine) and Teen Life (10-16-year-olds) support programmes for parents and carers.  The programmes, which are delivered by staff from Educational Psychology and Portage and Pre-school Service, offer advice and guidance on strategies to help support young autistic children, such as developing good behaviours and social skills. Staff offer termly coffee mornings for parents who have attended the programmes which offer further advice and support.

South Tyneside Council is an Autism Education Trust (AET) partner. As licenced trainers they provide a range of courses to education settings in early years, primary/secondary schools, and post-16 providers.

The courses offer staff working within education settings a range of training option, practical strategies, and free resources to enable them to support autistic children and young people in both mainstream and specialist settings.

The National Autistic Society supports children in mainstream schools into further and higher education. It has a diagnostic service and offers specialist support via its helpline. Help is available at home or in residential settings. 

The North East Autism Society offers services across the North East; including Education, Childcare, Adult Care, Short Breaks, assistance to families and employment services.

Inclusion Service

To support mainstream settings to effectively meet the needs of autistic children and young people, South Tyneside Council have created an Inclusion Service, which is delivered by highly skilled teachers and Higher-Level Teaching Assistants (HLTAs).  These staff have a range of expertise and experience working with children and young people who have Special Educational Needs (SEN). The Inclusion Service focuses on two areas of need which have been identified as a priority: Communication and Interaction - Autism and Social, Emotional & Mental Health.

Support from the Service is available to all Early Years, Primary and Secondary settings and aims to ensure that staff within mainstream settings have the skills, training and knowledge they need to meet the needs of our children.  This is achieved through a robust system of observations, recommendations, implementation and review.

The Service will:

• Provide advice and support to settings regarding individual children and young people.
• Provide advice and guidance regarding whole school approaches to inclusive practice.
• Deliver training to schools/settings and partners.

Emotional Based School Avoidance & Transition Project 

 The Emotional Based School Avoidance (EBSA) & Transitions Project is being led by our Emotional Resilience Team Manager, who will engage with settings, children and young people, parents and carers as well as other Education, Health & Care Services to understand the challenges that children and young people can face during times of transition and when experiencing Emotional Based School Avoidance. The project aims to:  

• Obtain a baseline of current occurrences of EBSA across the Local Area  
• Develop a training offer for stakeholders in Transitions & EBSA. 
• Develop an intense programme of support for children and young people with Emotionally Based School Avoidance, to understand better how to support them as we work to enhance our Alternative Provision offer. 
• Establish an EBSA Panel/Focus group to enable better multi-agency approaches to supporting young people experiencing EBSA. 
• Develop a new model for how to best support children and young people experiencing EBSA that promotes reintegration into settings, with new a EBSA Policy & Guidance for schools/settings. 
• Develop a Transition Protocol that parents/carers and settings are confident produces positive outcomes, preventing applications for EHCP's at perceived 'critical' points. 

Mental Health Champions Network

The Mental Health Champions Network is an opportunity for professionals working in schools, the voluntary sector and health services to come together to share good practice around mental health for children and young people.  As well as face-to-face network meetings, information and updates are sent to the network regularly via email to be shared with any professional that works with children and young people.  Work is currently underway to ensure that every school in South Tyneside has a named Mental Health Champion. 

Senior Mental Health Lead in Schools

Following consultation, proposals set out within the 'Transforming children and young people's mental health provision: a green paper', encourages all schools and colleges to appoint a designated lead for mental health [Senior mental health lead training - GOV.UK (www.gov.uk)].

Whilst there were already several Mental Health Champions (as above), this is specific Department for Education approved training, which will upskill staff to recognise signs that a child or young person may require additional support. South Tyneside now has more than a third of its education establishments who have completed the Department for Education's approved training and appointed designed Senior Mental Health Lead.

Healthy Schools Award/Healthy Schools Network

The Healthy Schools Award refreshes its accreditation annually based on local priority and need, and national guidance and evidence. 

Educational settings in Early Years, Primary, and Secondary and Special, are assessed in 4 main criteria areas: Healthy Eating, Physical Activity, Personal, Social and Health Education (including Relationships, Sex and Health Education), and Emotional Wellbeing.  Settings must re-accredit every 3 years to ensure they are evidencing best practice, and every school in South Tyneside is either up-to-date or working towards re-accreditation.  We are proud to say that 100% of South Tyneside schools are engaged with the programme.

We have recently welcomed South Tyneside College to the Healthy Schools Network.  A new set of criteria questions were developed in partnership with college staff and students, and in June 2023 they successfully achieved the first Healthy Schools Award for Further Education settings in the borough.

Every school in South Tyneside has a named Healthy Schools Lead within their school.  As part of the network, schools are provided with regular bulletins which include continuing professional development (CPD) and training, funding opportunities, information and updates on key public health topics, and upcoming campaigns.  Healthy Schools Network meetings are held termly, with a focus on a particular health topic, to ensure schools are promoting the best possible health outcomes for their pupils.

RSHE

The Department for Education 'Relationships, Sex and Health Education (RSHE)' guidelines became mandatory for all schools in 2019.  Also referred to as 'RSE', the document sets out details of what children and young people need to know to be safe and healthy, and how schools should deliver high qu

ality, evidence-based and age-appropriate teaching of these subjects to help prepare pupils for the future.  Direct support for teaching staff is available to all South Tyneside schools, and schools are offered termly network meetings and training around RSHE topics to ensure key messages are being delivered to students equitably across the borough.

South Tyneside Young Health Ambassadors

As part of the Young Health Ambassador programme, supported by 'a better u', young people in South Tyneside schools and colleges in year 9 and above complete a 6-8-week training course in key public health topic areas and behaviour change, to take information back to their schools and act as peer support for students and the community.

The young health ambassadors are supported to design and run their own health campaign, based on what they have learned about the level of need in South Tyneside, and what is important to them.  The young people are trained to inspect health services and offer guidance on how they can be 'young person friendly'.

The 2023 cohort includes young people from the majority of South Tyneside secondary schools and South Tyneside College.  Their health campaign for the next academic year centres around 'mental health' as their topic area, focussing on access to mental health services and opening up conversations around self-care, referral pathways and mental health management with service users and service provider professionals by creating their own podcast.

South Tyneside Young People's Parliament

South Tyneside Young People's Parliament (STYPP) represent youth voice across South Tyneside and the focus of their campaign last year was 'Health and Wellbeing'. 

The young people held engagement events and conducted research in local secondary schools around services available to them. They found that young people were unaware of what services were available to them.  In response, they developed a list of services on their campaign website, and designed an illustrated map of the borough showing what is available.  The map is proudly displayed in many settings where young people may visit, including all secondary schools. See the STYPP's campaign page.

Stronger Schools

Is a website which professionals and school staff have access to which aims to provide good quality information and advice on how best to support students in the classroom on a range of topics, such as anxiety.  It aims to support children from 5 -11 in Key Stage 1 and Key Stage 2, but some of the guidance is applicable to young people in year 7.

Autism Hub

The Toby Henderson Trust (THT) provides post-diagnostic support and early intervention with autistic children and young people. They also offer a wide range of services including webinars on topics such as sensory, masking etc, professionals (including school staff).  They also offer similar training to parents/carers of autistic children. 

Autism In Mind (AIM)

Autism in Mind (AIM) supports individuals and families living with autism in South Tyneside.   Support is provided to anyone with a diagnosis of autism age 16+.  The organisation works with both individuals and families to empower autistic adults to live as independently as possible.

Escape Interventions

Escape is a third sector charity which exists to promote the emotional, social, educational, and vocational competence of children and young people, by offering a range of therapeutic interventions, including counselling, advice, guidance, and support, to enable them to reach their potential and remove the barriers to personal success. They provide support to 4-25-year-olds and their parents/carers to alleviate mental health issues such as anxiety, depression, stress, anger, domestic/sexual abuse, bereavement/loss etc. They deliver resilience programmes to improve young people's ability to cope with adverse childhood experiences. They also provide free outdoor and creative activities to promote good mental health for 11-18year olds. Referrals can be made by parents, young people themselves or professionals involved, over the telephone or via a simple referral form.

Carer Support

South Tyneside Young Carers service is delivered by TEN North East. They work with young carers under the age of 18 and offer the following support:

• Advice, support and signposting
• Peer support and opportunities to meet other young carers
• School support
• Personal development, workshops and qualifications

Further information can be found at: Young carers - South Tyneside Council

Connected Caring, a partnership between Age Concern Tyneside South (ACTS), Vision and Hearing Support, and Your Voice Counts provides support to adult carers in South Tyneside. This includes:

• Advice and support based around the needs of the carer to enable them to continue their caring role.
• Access to emotional and wellbeing support.
• Peer support groups.
• Skills development, such as supporting with employment and training opportunities, as well as digital connection support.
• Working with Young Carers to support transition.

Further information can be found at: Carers - South Tyneside Council

The Local Transformation Plan (CYP Strategic Plan) identifies the priorities which require to be met annually. Some of the priority areas are dictated through Key Lines of Enquiry (KLOE's) through the NHS; others are developed through data which has been collated and from feedback through our coproduction work with children, young people and their families.

The oversight for meeting these priorities is through the Children and Young People Mental Health and Wellbeing Alliance, which is a strategic meeting and consists of partners from across various areas, including Health, Local Authority, Education, and the Voluntary Sector.  

The Alliance escalates, where required, issues to the Health and Wellbeing Board, as well as providing regular updates to the Integrated Care Board (ICB) and, when required, the Integrated Care System (ICS).

The Children in need of help and protection (health and wellbeing needs in South Tyneside) JSNAA is out of date and requires a refresh.

• Health and Wellbeing Strategy
• Health and Wellbeing Strategy Vision
• Local Transformation Plan
• The Children in need of help and protection (health and wellbeing needs in South Tyneside) JSNAA (requires refreshed)
• Children and young people with Special Educational Needs (health and wellbeing needs in South Tyneside)
• SEND Local Offer 
• Early Help JSNAA (pending publication)
• Carer's Strategy 
• Carer's JSNAA (pending publication)
• All Age Autism Strategy 
• Learning Disabilities Strategy 
• Mental Health Strategy

The following details will be published on the JSNAA website.  They should refer to a named contact (rather than an organisation or generic email/phone number). Topic Leads and Authors should decide between them who is best placed to respond to queries.