Future in Mind: Overview and Next Steps Claire Bethel, Deputy Director, Children and Young People’s Mental Health & Wellbeing VCS Event 13th July

Future in mind Promoting, protecting and improving our children and young people’s mental health and wellbeing Membership: Taskforce of Cross sector experts on children and young people’s mental health with knowledge of wider system transformation, including education, social care and health Contains: 49 proposals to transform the design and delivery of a local offer of services for children and young people with mental health needs Published: 17 March 2015

Future In Mind Overview Five key themes provide the structure of the report with recommendations: Participation and collaboration identified as a core principle - services designed with children, young people and families to meet their needs Contains 49 proposals to transform the design and delivery of a local offer of services for children and young people with mental health needs Promoting resilience, prevention and early intervention Improving access to effective support- a system without tiers Care for the most vulnerable Accountability and transparency Developing the workforce

Promoting resilience, prevention and early intervention Act early to prevent harm, by investing in the early years, supporting families/carers and building resilience through to adulthood, to reduce the burden of mental and physical ill health over the whole life course. An anti-stigma campaign to raise awareness, promotes improved attitudes to children and young people affected by mental health difficulties. Time to Change campaign Prevention and early intervention Whole school approaches to promoting mental health and wellbeing Enhancing existing maternal, perinatal and early years health services and parenting programmes. Supporting self care Building on time to change campaign Promoting and driving work on prevention and early intervention With additional investment: Supporting self care through development of new apps and digital tools (possibly with a kite-mark)

Improving access to effective support- a system without tiers Change how care is delivered and build it around the needs of children, young people and families, to ensure that children and young people have easy access to the right support from the right service at the right time. Moving away from tiered system A joint training programme to support lead contacts in mental health services and schools Harnessing the vital contribution of the voluntary sector Continuing to implement the Mental Health Crisis Care Concordat Named points of contact in mental health services and schools A set of access and waiting times standards A national, branded web-based portal for online tools/services Legislating to ensure no young person under the age of 18 is detained in a police cell place of safety Promoting implementation of best practice in transition

Care for the most vulnerable Drive improvements in delivery of care and standards of performance, to ensure a better understanding of how to get best outcomes for vulnerable children, young people and families/carers and value from investment. Making sure that mental health assessments include sensitive enquiry about the neglect, violence and abuse, including child sexual abuse and exploitation and for those 16 and above, a routine enquiry Making multi-agency teams available with flexible acceptance criteria for referrals concerning vulnerable children and young people. Subject to decisions taken by future governments: Improving skills of staff by working with professional bodies to ensure that staff are more aware of the impact that trauma has on mental health and on the wider use of evidence based interventions Piloting the roll-out of teams specialising in supporting vulnerable children and young people such as those who are looked after and adopted, possibly on a sub-regional basis and rolling these out successfully.

Accountability and transparency Drive improvements in delivery of care and standards of performance, to ensure a better understanding of how to get best outcomes for children, young people and families/carers and value from investment. Lead commissioning arrangements in every area for children and young people’s mental health and wellbeing services, responsible for developing a single integrated plan DH prevalence survey of children and young people’s mental health and wellbeing Health and Wellbeing Boards challenging and confirming Joint Strategic Needs Assessments and Health and Wellbeing Strategies Subject to decisions taken by future governments: Repeating a prevalence survey every 5 years

Developing the workforce A workforce that is ambitious, excellent in their practice, able to deliver the best evidenced care, committed to partnership and integrated working. Targeting the training of health and social care professionals Implementing the recommendations of the Carter Review of Initial Teacher Training (ITT) Continuing investment in commissioning capability and development through the national mental health commissioning programme Extending CYP IAPT curricula and training programmes Expanding CYP IAPT to cover the remaining 32% of the country Developing a comprehensive workforce strategy, including an audit of skills, capabilities, age, gender and ethnic mix

Vision for change The Government’s aspirations are that by 2020 we would see: Improved crisis care: right place, right time, close to home Improved transparency and accountability across whole system A better offer for the most vulnerable children and young people Improved public awareness less fear, stigma and discrimination Timely access to clinically effective support More evidence-based, outcomes focussed treatments More visible and accessible support Professionals who work with children and young people trained in child development and mental health A smooth and planned transition from children to adult mental health services Improved access for parents to evidence-based programmes of intervention and support

What work are we doing now? Investment commitments Extension and expansion of the Children and Young people’s Improving Access to Psychological Therapies Programme Local transformation plans- working with NHS England and other partners on development of the guidance for local transformation plans, and on out of hospital care Commissioning a new prevalence survey for CYP mental health Piloting single points of contact for mental health in schools Considering the introduction of routine enquires for violence and abuse in those 16 and over

What work are we doing now? CONT. Working on plans for legislation on S136 places of safety to ensure that no young person is placed in a prison cell as a place of safety when in crisis Working on an anti-stigma campaign Improved services for perinatal mental health Working on an NHS choices portal for Children and Young People’s mental health

What work are we doing now? Investment commitments Recent investment in eating disorders- £150m over five years – NHS England leading Improving children and young people’s mental health more generally- £1.25 billion to be allocated over the next five years across health, social care and education

What work are we doing now? Extension and expansion of the Children and Young people’s Access to Psychological therapies programme (CYP IAPT) By 2018 all local services will be in receipt of this transformative programme. DH have invested £54m into the CYP IAPT over 2011-15/16. The CYP IAPT programme is working with 82 CAMHS partnerships to improve access to evidence based psychological therapies. The CYP IAPT differs from the adult IAPT in that it is a transformation programme that works with existing services, training people to deliver evidence based interventions and aims that ensure that those working in CAMHS work more closely with children, young people and families.

What work are we doing now? Local Transformation Plans: DELIVERING THE VISION The development of local transformation plans will be produced collaboratively by local areas, outlining how access and services for children and young people can and will be improved locally. These plans will have an emphasis on local partnering and joint commissioning and will be published so they are publically available, improving transparency across mental health services for children and young people. NHS England and the Department of Health are working with partners to jointly produce national guidance to support local areas to develop these plans and coordinate the activity required to deliver the national ambition. NHS England aim to publish this guidance in July.

What work are we doing now? Commissioning a new prevalence survey for CYP mental health To ensure services are well informed and reflective of the needs of young people we are commissioning a new prevalence survey on mental health in children and young people, the first since 2004. This will be published at the late 2017.

What work are we doing now? Piloting single points for mental health of contact in schools The Department of Health is working with the Department for Education to pilot single points of contact for mental health in schools and joint training with staff to improve access to mental health advice and support in school. This will build on the guidance published by the Department for Education on mental health and behaviour, to help schools support young people with mental health needs and make direct referrals if necessary.

Encouraging sensitive enquiry in all ages What work are we doing now? Considering the introduction of routine enquires for violence and abuse in those 16 and over Implementing proposals in cross government child sexual exploitation report on routine enquiry at 16 and above Encouraging sensitive enquiry in all ages

What work are we doing now? Working on plans for legislation on S136 places of safety to ensure that no young person is placed in a prison cell as a place of safety when in crisis The Government will be reforming the law on the use of police cells for young people with a suspected mental health condition to end the unacceptable detention of children and young people who are in crisis under section 136 of the Mental Health Act. This will be backed by £15 million to improve the availability of alternative safe and health based places of safety.

What work are we doing now? Working on an anti-stigma campaign We are currently considering how we might develop a national social marketing campaign with a mechanism for dialogue so it can be drive by young people, children and carers. We know that organisations such as Young Minds, Time to Change, Mind, Headstart and many others are doing local work within schools, educational settings and online to address stigma head on. In the last few years we have seen remarkable progress in reducing levels of stigma in adults and it’s now time we did the same for children and young people.

What work are we doing now? Improved services for perinatal mental health Mental health services are being developed for women in the perinatal and postnatal period to look after maternal mental health and help strengthen parent child attachment to avoid exposure to trauma during infancy which can result in ill mental health in the child. We have prioritised improving mental health care and support for pregnant women and new mothers in our mandate to NHS England and we have taken steps to improve the size and capacity of the workforce. In England, the number of inpatient Mother and Baby Units specialising in psychiatric care during the perinatal period has increased from 10 units in 2010 to 17 units in 2014

What work are we doing now? Working on an NHS choices portal for Children and Young People’s mental health We are working on doing some scoping work with NHS choices to put together a portal area to have a “go-to” place for children and young people. This will be intended to help them understand more about mental health and where they can go for advice and support. We will be testing these ideas with young people over the summer through workshops.

The Mental Health Taskforce Brings together health and care leaders, experts and service users. Purpose is to develop a five year national strategy for all ages that will be published in autumn 2015. The Taskforce will be exploring the access and quality of services, look at outcomes for people who aren’t able to access services and prevention and early intervention. The Taskforce will draw from the work done in Future in Mind as they have acknowledged the report to be an effective summation of issues in children and young people’s mental health and wellbeing.

What is the role for the voluntary sector in continuing the work of Future in Mind? Over to you!