Children and young people's mental health and emotional wellbeing (health and wellbeing needs in South Tyneside)

There are a range of assets and services available in South Tyneside that seek to prevent, identify, and manage/ treat MHEW issues in South Tyneside. These services extend from those that are universally available to all, through to those that are either targeted at particular populations or groups, or those that are specialist services for children and young people meeting particular criteria. There are a number of PHE Indicators related to protective factors in young people.

Universal

General Standards and Confidentiality

Our Healthy Schools Award has been achieved by all schools in South Tyneside. It also extends to the Early Years with all of our Children Centres, who are also signed up to the award. All of our Children Centre and Daycare settings staff are trained to use Growth Mind-sets with children and their families. The Outreach staff are also trained in Dino-school, Incredible Years and Solihull parenting programmes.

Many of our schools have Emotional Health / Mental Health Champions; this role could be developed to act as a bridge to clinical services.

As part of the Healthy Schools and Change4Life Programme in South Tyneside there has been a further work on confidentiality and the rights of young people when accessing services. This is now promoted though some printed information and a confidentiality statement that is available on the Change4Life website.

Further work is needed on promoting confidentiality in children's services. This should include a structured approach to ensuring local services reach the You're Welcome standards, and that services actively promote confidentiality in all of their materials and websites.

Training for Children and Young People

The Young People's Parliament have taken part in Young Minds training and Mindfulness training. Our Young Peoples Parliament has a Mental Health Subgroup which looks specifically at Mental Health Issues for young people and feeds back into the CAMHS and Emotional Resilience Groups.

Workforce Development and Resources

A Primary School Risk Taking Behaviour / Emotional Resilience resource was launched in September. The impact of this resource is not yet understood. This was adapted from the Evidence based SEAL programme.

Through the Healthy Schools Programme, resources have been provided to schools (primary, secondary and special) to encourage them to do sessions on stress, mental health, and emotional wellbeing. It is not clear how these have been used in practice, and what the impact of the resources has been. Clear and structured feedback on these resources needs to be collected to determine the benefits of this approach. This is now being collected through the Healthy Schools programme.

We have a number of generic services which have staff trained in Mental Health First Aid, however this does not form part of a local structured approach to workforce development at this stage. Likewise, we have a number of staff trained in the PENN resilience programme.

We have a high number of school based staff who are trained in bereavement support.

Our Sports Development Team and Outdoor Education team have all had training in positive discipline, emotional resilience techniques and basic mental health.

Targeted

Early Help Service

Services for Young People listened to the views around positive activities needed for young people with emotional / self-esteem problems. So they have set up groups (called Participa8) exclusively for young people who have confidence / esteem issues, may have Special Educational Needs and/or struggle to access mainstream positive activities. Children / young people can only join the group on a referral basis, age range is 8 plus.

Our Emotional Resilience Service offers 1-2-1 support for young people to ease transition or for young people who school refuse. The service has now extended to offer bereavement support.

Specialist

Youth Justice Service

The Youth Justice Service is a multi-agency team, which means that it is made up of staff from all the main local authority departments and agencies all working together. Its main aim is to prevent offending and anti-social behaviour by young people in the communities of South Tyneside. In terms of Mental health, there is a Senior Mental Health Practitioner that employed within the YOS to provide consultation, advice and support to YOS colleagues. They also provide an assessment service for young people referred by YOS staff. The Practitioner is part of the wider CAMHS (Child and Adolescent Mental Health Service), acting as a link between the YOS and Mental Health Services.

Leaving Care

South Tyneside leaving care service supports young people who are looked after with a variety of issues from employment, education, health and wellbeing. They act as a gateway to mental health support and health services.

Child and Adolescent Mental Health Services

Tier 2 Lifecycle Service - Commissioned by South Tyneside CCG; started on 1 October 2015 as part of a phased roll-out and full introduction in March 2016.

The Lifecycle Service provides a whole person tier 2 therapeutic and non-therapeutic services to young people of any age and their families. Tier two supports young people who have difficulties with attachment, behaviour, eating disorders, development, emerging OCD, anxiety and depression. A key role for the Lifecycle Service is providing the children and young people's IAPT programme (Increasing Access to Psychological Therapies). The lifecycle service collapses the age boundaries associated with young people service to ensure there are no issues with transition.

The Lifecycle service sees between 10 and 20 new children and young people cases per week with a constant case load of between 150 and 200 children. As well as holding a case load of children the service works closely with schools and children's professionals on training and education.

Children and Young People's Service (CYPS) - Provided by Northumberland Tyne and Wear and commissioned by South Tyneside CCG

The service consists of a multidisciplinary team of mental health practitioners including psychiatrists, nurses, social workers, psychological therapists and psychologists, occupational therapists and administrative staff. The integrated team operates to meet the tier 3 specialist mental health needs of all children and young people regardless of their circumstances or other needs. They operate within a multi-agency framework and undertake the delivery of the specialist mental health element a specific plans for a young person. The service can also provide consultation, advice and support directly to families but also to other agencies working with children and young people presenting with mental health.

NTW produces a monthly performance report for STCCG (who then also share this with partners). There is separate report on LAC referrals as a result of some challenges by People Select Committee on how the children and young people's services work together with Children's Social Care.The CYPS service sees around 100 referrals per month.

There have been some historical waiting time issues with CYPS, and this was highlighted by People Select in 2015. There has been significant progress against waiting time targets for accessing CYPS, with all historical long-term waiting time patients (prior to October 2014) now in treatment. Data for quarters 1,2 and 3 of 2015 / 16 also demonstrate that overall the number of young people waiting longer than 12 weeks for treatment has reduced, with 71% of children now waiting less than 12 weeks for treatment and 61% waiting less than 9 weeks.

Matrix

The MATRIX works with young people under 18 in South Tyneside, their families and carers. The service provides help, support and advice to those whose lives have been affected by drug and alcohol misuse or those who are at risk of developing drug and alcohol problems. Young people who access this project have access to a trained counsellor as well as robust signposting and referral pathway to mental health Services. The service is also a good example of a confidential, accessible and trusted service for young people.

In 2014-15 there were 154 young people (<18) in specialist services in the community (PHE, 2015). There has been a steady decline in numbers in treatment since 2012-13 (then 173 per year). Service users are largely males (68%), 65% in South Tyneside use two or more substances and 100% started using before the age of 15 - an absolutely crucial role for prevention here.

Key vulnerabilities include:

• Involved in offending/ ASB 44%
• Affected by domestic abuse 29%
• Affected by other substance misuse 22%
• NEET 19%
• LAC (5%) CIN (8%) CP (4%)

Gaps:

• Structured (evidence-based) training offer to young people and families in South Tyneside,
• Data and evidence of impact of the workforce development approach (and associated resources) in South Tyneside,
• A clearer estimate on the scale and impact of the current prevention offer needs to be understood. Is the current offer likely to have a significant impact on population outcomes?
• The local diagnostic pathway for Autistic Spectrum Disorder needs to be improved in line with NICE guidance, and input from children and their families.

Third Sector

Relationships Works

Relationship Works, based in Ocean Road Community Association, provides young people with advice about family and sexual relationships through a number of drop-in sessions and educational intervention at schools, to educate teenagers about healthy relationships.

Escape

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.
 

Bright Futures

Bright Futures works with young women aged 11 - 25 around a range of issues to raise their self-esteem and confidence around a range of issues which affect them including alcohol and substance misuse, sexual health and relationships, homelessness, family relationships, friendships, school, education, training, crime and anti-social behaviour. Bright Futures offers young women the opportunity to take part in educational group work sessions using interactive and engaging resources to make the sessions we deliver fun and suitable for all abilities.