1. © Duncan Law Making Feedback and Outcomes work for Children and Young People with Learning Disabilities, & their Families & Networks: A Workshop Ro Rossiter, Duncan Law, Isobel Fleming

2. © Duncan Law Setting the Context: CYP-IAPT and all that………. Duncan Law Clinical Lead for the London and South East CYP-IAPT Learning Collaborative

3. CAMHS Issues

4. ACCESS: % With anxiety or diagnosable depression not in contact with mental health services Source: Ford et al. (2005) Child & Adol Ment Health, 10:2-9 Dean et al., (2004) DoH; McCrone et al., (2008) King’s Fund 80% 70% 60% 50% 40% 30% 20% Adults with depression 5-15 year olds Percent unknown to any service 35%76%

5. Funding Only 6% of Mental Health funding goes to services aimed at children (Kennedy 2010) Spending on child mental health continues to be cut – by up to 95% in some local authorities (YoungMinds 2014) Savings in MH is 1.8% per annum, compared to 1.5% in physical health (DH 2014)

6. What is the problem – in summary? CAMHS is under-resourced and yet investment in CAMHS can save money across the whole health economy and, more importantly, save years of distress

7. CAMHS Opportunity?

8. Opportunities: CAMHS Select Committee inquiry Children's Task Force General Election Threats: Lack of good Data (c) Duncan Law & Alex Goforth - London & SE CYP-IAPT Learning Collabortive

9. What is CYP-IAPT? (a reminder?)

10. Template for appropriate CYP services: key components Improving access & engagement Access

11. Improving access & engagement Access Awareness Increasing MH awareness & decreasing stigmatisation Template for appropriate CYP services: key components

12. Improving access & engagement Access Awareness Increasing MH awareness & decreasing stigmatisation Participation Enhancing youth, carer and community participation Template for appropriate CYP services: key components

13. Improving access & engagement Access Awareness Increasing MH awareness & decreasing stigmatisation Participation EBP Delivery of evidence- based practices Template for appropriate CYP services: key components Enhancing youth, carer and community participation

14. Improving access & engagement Access Awareness Increasing MH awareness & decreasing stigmatisation Participation EBP Delivery of evidence- based practices Accountability Improving outcomes accountability Template for appropriate CYP services: key components Enhancing youth, carer and community participation CYP-IAPT

15. CYP-IAPT is a set of principles for Whole Service ‘Transformation’ The CYP-IAPT principles: 1.Better Evidence Based Practice 2.Better Collaborative practice - Clinically Meaningful use of feedback tools 3. Authentic participation of families and Young People who use the service 4.Rigorous outcomes monitoring Leading to effective and efficient use of resources (c) Duncan Law & Alex Goforth - London & SE CYP-IAPT Learning Collabortive

16. © Duncan Law Feedback & Outcomes Monitoring

17. Feedback & Outcomes Forms Why bother using them?

18. © Duncan Law Values behind outcomes and feedback 1.Demonstrate/celebrate/prove: effectiveness of interventions and service 1.Enhance collaborative practice: –Better service user voice in therapy (& supervision) –Facilitates good clinical practice

19. © Duncan Law Feedback & Outcomes Monitoring Demonstrating success

20. © Duncan Law Demonstrating effectiveness 90% target at least two time points with repeated, normed measure plus, at least one report of Education Employment and Training (EET) plus, consent http://www.iapt.nhs.uk/silo/files/90.pdf

21. © Duncan Law It’s not (just) about measurement, it’s about a culture of collaboration

22. © Duncan Law Feedback & Outcomes Monitoring Enhancing Collaborative Practice

23. Evidence Based Transformation Research evidence YP/Family’s goals preferences, values, and unique context Clinician expertise + + Frueh et al (2012) Evidence-Based Practice in Adult Mental Health. Handbook of Evidence-Based Practice in Clinical Psychology. Published online. Adapted and used with thanks to Peter Fonagy

24. Hertfordshire Partnership NHS Foundation Trust Goals Based Outcome Tool: What does it look like?

25. © Duncan Law, London & SE CYP-IAPT Collaborative Outreach

26. Session Rating Scale (SRS) 26

27. Resources and Other Information (c) Duncan Law & Alex Goforth - London & SE CYP-IAPT Learning Collabortive

28. © Duncan Law, Stephen Butler, & Alex Goforth For more information on outcomes and feedback http://www.corc.uk.net/resources/ad ditional-information-about-the- measures/

29. © Duncan Law Other Resources www.cypiapt.org www.corc.uk.net www.myapt.org.uk www.vimeo.com/tag:cyp+iapt www.MindEd.org

30. Contacts Duncan Law Clinical Lead London & South East CYP-IAPT Learning Collaborative Duncan.law@annafreud.org (c) Duncan Law - London & SE CYP-IAPT Learning Collaborative

31. Scene setting: feedback and outcomes, principles and practice - CYP-LD, their families and networks Ro Rossiter Consultant Clinical Psychologist/Research Fellow Member CYP-IAPT Outcomes and Evaluation Group

32. Drivers 1: Improve collaboration, focus, evaluation and demonstration of effectiveness Desire to collate practice experience for guidance (clinical psychology and multidisciplinary) LD Clinical Psychology Faculty had done similar project (adult focused, some themes in common)

33. Drivers 2 CYP IAPT begins Health inequalities and CYP-LD (access &recognition- eg Simonoff et al. (2006) only 15% IQ < 70 had a statement of special educational needs, yrs 8-9; Emerson & Baines (2010) lack of recognition of LD in mental health, care, education and criminal justice settings, therefore CYP-LD needs not met -contributes to health inequalities; prevalence of children with Complex Learning Difficulties and Disabilities increasing (Blackburn et al., 2010; DCFS, 2010; Carpenter et al., 2010). “Atypical” development &/or neurodevelopmental disorders- part of broader diversity/equalities agenda (race and culture, socioeconomic status etc.). Equalities legislation Passionate practitioners

34. Journey so far:

35. Journey so far 1: 2012- Paper for Children, Young People and their Families Clinical Psychology Faculty Review 2013 : CYP-IAPT LD ROMS Management Project (Swindon- Julie Pill and colleagues) CYP-IAPT Outcomes & Evaluation Group membership Chapter for ACAMH LD & Challenging Behaviour Briefing

36. Journey so far 2: 2014 Evaluation & Outcome tools survey (Phillips & Sopena) CYP-LD & families chapter in CYP-IAPT Guide to using outcomes and feedback tools chapter Today’s workshop What next? Share experience, plan actions (local, collaboratives, national levels- CYP-IAPT, Child Health eg CHUMS project?)

37. © Duncan Law We hope you found this presentation useful Feel free to use all are parts of it to help train other staff in your organisation & to further implement CYP-IAPT If you do use slides please reference the authors appropriately These slides must not be used in training for commercial gain