The Highland PMHW team through GIRFEC and health and social care integration – how we got better at early intervention.

Highland Population 232,950 Team lead and 12 Primary Mental Health Workers Phoenix Centre

Support Worker Social Worker Behaviour Specialist Children’s Services Worker Teacher Speech and Language Therapist School Nurses Doctor Residential Worker Early Years Centre Health Visitor Specialist Mental Health Worker Primary Mental Health Worker CARE and LEARNING SERVICE Educational Psychologist

Line managed in Community Health Partnerships (CHP’s) Different focuses in each CHP Professional Lead from tier 3 service. Occasional attempts every year to meet with a team but never with a driving agenda or focus Tier 2 and Tier 3 ‘issues’ Children and Young People’s Mental Health: A framework for promotion, prevention and care (2004) Pre 2012

1. A focus on improving outcomes for children, young people and their families based on a shared understanding of well-being 2. A common approach to gaining consent and to sharing information where appropriate 3. An integral role for children, young people and families in assessment, planning and intervention 4. A co-ordinated and unified approach to identifying concerns, assessing needs and agreeing actions and outcomes, based on the Well-being Indicators 5. Streamlined planning, assessment and decision-making processes that lead to the right help at the right time 6. Consistent high standards of co-operation, joint working and communication when more than one agency needs to be involved, locally and across Scotland 7. A Lead Professional to co-ordinate and monitor such planned support for a child. 8. Maximise the skilled workforce within universal services to address needs and risks at the earliest possible time 9. A confident and competent workforce across all services for children, young people and their families 10. The capacity to securely share demographic, assessment and planning information within and across service and agency boundaries, using electronic systems when possible. Core Components The Highland Practice Model, based on Getting it right for every child, is founded on 10 core components which are applicable to all settings.

1. What is getting in the way of this child’s wellbeing? 2. Do I have all the information I need to help this child? 3. What can I do now to help this child? 4. What can my agency do to help this child? 5. What additional help, if any, may be needed from other agencies? 5 questions

April 2012 – Lead agency model starts NHS staff working in non hospital Children's services transferred to Highland Council. Highland council staff working in adult services transferred to NHS Highland. October 2014 – Family teams developed Health and social care integration

Initially a worrying time – at start of process Practice Guidance written Managed in council within Additional Support Needs team For first time we all had one line manager Line manager created a ‘sense of belonging’ PMHW team and integration

Monthly team meetings Mission Statement Improvement Plan – based on outcomes in For Highlands Children Increase in joint working and planning with other services including Tier 3 CAMHS Developing clear pathways into the service – Consultation leaflet Clear roles and interventions within Early years and School years Moving forward

Children and young people are supported to achieve their potential in all areas of development. Children, young people and their families are supported well to develop the strengths and resilience needed to overcome any inequalities they experience. Improvement in service provision is determined by the participation of children, young people and families and by understanding their views, wishes, and expectations. PMHW priorities from For Childrens 4 outcomes

Joint working/planning Emotional Literacy training with Positive relationship team ASIST training with adult services VIG with Educational Psychology Scottish Mental Health First Aid:Young People Mindfulness Based Stress Reduction Teen Screen Self harm and suicide guidelines Tragic incident policies Curriculum for Excellence Early years services and development