Youth Mental Health – setting up a       dedicated service in Norfolk      Dr Uju Ugochukwu (Consultant Adult Psychiatrist...
Acknowledgements• Professor David Fowler• Dr Jon Wilson• Debbie White
Collaborations for Leadership in AppliedHealth Research and Care For Cambridgeshire and Peterborough (CLAHRC CP) Fellowshi...
www.slideshare.net
How did it all start?• CAMHS perspective     • Problems with transfer to AMHS• AMHS/EI perspective     • Young people with...
Bridging the gap
Disease Incidence over Age
All Referrals - CAMHS and AMHS        September 2010 – August 2011                              All Contacts – CAMHS and A...
Making use of opportunities• New Chief Executive  – Visits to various teams (EI, Team C)• Trust vision• Cost Improvement P...
Clinicians who felt that young people                                     Guiding teamwere falling through                ...
Key people attended• Commissioners, senior managers, senior clinicians• Increased enthusiasm
Project Management• Project Teams• Stakeholders Group• Youth Advisory Council
Community resources:              Non-                            Education                                statutory      ...
YMH Declaration 2011 - Principles• Belief in young people and their potential• Respect for all young people• Protect young...
Buy in - stakeholder event in            October 2011Engage with youngpeople, commissioners and otheragencies             ...
What do our young people want?
Right information in the right way• Accurate and up to date  information   – Leaflets, websites• Staff qualifications• Pat...
Location and environment                                                      The Junction, Lowestoft• Public transport• N...
Accessibility• Flexible appointments• Different ways of  getting help  – Self referral• Quick assessments• Avoid repeated ...
Staff•   Honest and reliable•   Good knowledge base•   Experienced•   Caring and understanding•   “someone who makes you f...
Young people’s involvement• Youth Council  – Supported by Youngminds  – Vision statement  – Name for service• Involvement ...
funded by CLAHRC
Focus of 12 month pilot• 3 pilot sites• 14 – 25 year olds with complex mental health  problems  – HoNOS Clusters 5 to 17  ...
Where are we now?• Start date – April 2012• Resources  – Staff recruitment  – Staff training and induction• Partnership/ca...
Aims of the pilot service• Actively engage young people at highest risk of  developing enduring mental health difficulties...
Outcomes•   Waiting times for assessment•   Reduction in bed days•   Time use questionnaire•   Global Assessment of Functi...
Research• Prevention of long term social disability amongst  young people with emerging signs of severe  mental illness   ...
Challenges – NoNo• Resistance from some clinicians  – Early engagement is vital• Resources  – Time  – Cost improvement pro...
Change Management Process                                                   Communicate                 Pull Together    D...
Summary• Young people want to be an integral part  of the whole process   –Their feedback should make a difference• Early ...
Dr Uju Ugochukwu & Dr Sarah Maxwell - Developing A Youth Mental Health Service in Norfolk
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Dr Uju Ugochukwu & Dr Sarah Maxwell - Developing A Youth Mental Health Service in Norfolk

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Dr Uju Ugochukwu & Dr Sarah Maxwell - Developing A Youth Mental Health Service in Norfolk

  1. 1. Youth Mental Health – setting up a dedicated service in Norfolk Dr Uju Ugochukwu (Consultant Adult Psychiatrist)Dr Sarah Maxwell (Consultant Child & Adolescent Psychiatrist) Norfolk and Suffolk NHS Foundation Trust
  2. 2. Acknowledgements• Professor David Fowler• Dr Jon Wilson• Debbie White
  3. 3. Collaborations for Leadership in AppliedHealth Research and Care For Cambridgeshire and Peterborough (CLAHRC CP) Fellowship• Quantitative mapping project – Description of the characteristics of 14 – 25 year olds within the service – Description of mental health services available to young people in Norfolk• Qualitative Study
  4. 4. www.slideshare.net
  5. 5. How did it all start?• CAMHS perspective • Problems with transfer to AMHS• AMHS/EI perspective • Young people with emerging disorders who are not psychotic• Central Norfolk EIT - Team C – Service to young people with emerging disorders – Mentioned as an example of good practice in SCIE: http://www.scie.org.uk/publications/guides/guide44/pr acticeexamples/norfolk.asp
  6. 6. Bridging the gap
  7. 7. Disease Incidence over Age
  8. 8. All Referrals - CAMHS and AMHS September 2010 – August 2011 All Contacts – CAMHS and AMHS 800 September 2010 – August 2011 8000 700 7000 600 6000 500 5000Referrals Contacts 400 4000 300 3000 200 2000 100 1000 0 0 14 15 16 17 18 19 20 21 22 23 24 25 Age Age Ugochukwu O, Maxwell S et al, unpublished, funded by CLAHRC
  9. 9. Making use of opportunities• New Chief Executive – Visits to various teams (EI, Team C)• Trust vision• Cost Improvement Program• Radical Pathway Redesign – Pathway C• Evidence base - EI
  10. 10. Clinicians who felt that young people Guiding teamwere falling through set the ball the gaps rolling Influential manager
  11. 11. Key people attended• Commissioners, senior managers, senior clinicians• Increased enthusiasm
  12. 12. Project Management• Project Teams• Stakeholders Group• Youth Advisory Council
  13. 13. Community resources: Non- Education statutory e.g. Statutory e.g. MIND, MAP PRU, Attendance Health Youth Groups teams Social Care e.g. Probation, TAD S Detection, Liaison and Supervision SPOA: Norfolk Wellbeing services & CAMHS (Includes IAPT) Youth Mental Health Service (Case Management, Assertive outreach, Liaison/Supervision) CRHT / Intensive Support Team Crisis Houses / Alternative to hospital CAMHS Tier 4 / Adult In-patient
  14. 14. YMH Declaration 2011 - Principles• Belief in young people and their potential• Respect for all young people• Protect young people’s right to participate in processes and decisions that affect them• Commitment to uncovering the strengths within young people, their families and communities• Respect for the right to recovery and social inclusion for all young people• Value the importance of personal, social, educational and employment outcomes• Provide accessible, youth-focused services and supports when and where young people need them• Respect for the rights of family and friends to participate and feel fully involved
  15. 15. Buy in - stakeholder event in October 2011Engage with youngpeople, commissioners and otheragencies Kevin Davis, Youngminds
  16. 16. What do our young people want?
  17. 17. Right information in the right way• Accurate and up to date information – Leaflets, websites• Staff qualifications• Patient rights• Confidentiality Adapted from report “Creating the best mental health service” Kevin Davis, Youngminds. Unpublished
  18. 18. Location and environment The Junction, Lowestoft• Public transport• Not too close to family• Should not be called a “mental health service”• Bright, airy, comfortable, saf e• “One-stop-shop” Adapted from report “Creating the best mental health service” Kevin Davis, Youngminds. Unpublished
  19. 19. Accessibility• Flexible appointments• Different ways of getting help – Self referral• Quick assessments• Avoid repeated assessments Adapted from report “Creating the best mental health service” Kevin Davis, Youngminds. Unpublished
  20. 20. Staff• Honest and reliable• Good knowledge base• Experienced• Caring and understanding• “someone who makes you feel like a person and not an illness” Adapted from report “Creating the best mental health service” Kevin Davis, Youngminds Unpublished
  21. 21. Young people’s involvement• Youth Council – Supported by Youngminds – Vision statement – Name for service• Involvement in project teams and wider steering group• Interview panels
  22. 22. funded by CLAHRC
  23. 23. Focus of 12 month pilot• 3 pilot sites• 14 – 25 year olds with complex mental health problems – HoNOS Clusters 5 to 17 – CGAS score, 50 and below• Caseload – 225 CAMHS and 75 AMHS• Consultant cover will be provided by Adult and Adolescent psychiatrists
  24. 24. Where are we now?• Start date – April 2012• Resources – Staff recruitment – Staff training and induction• Partnership/case discussion forums meetings• Website – one stop website
  25. 25. Aims of the pilot service• Actively engage young people at highest risk of developing enduring mental health difficulties• Offering therapeutic optimism• Provide a range of interventions – medical, psychological, social, vocational, physical health and family interventions• Prevent admission where possible through risk management with the IST / CRHT• Ensure that the young person is linked into appropriate community resources (education, youth groups etc.)• Provide step up and step down support working in collaboration with other statutory and non-statutory agencies
  26. 26. Outcomes• Waiting times for assessment• Reduction in bed days• Time use questionnaire• Global Assessment of Function (GAF)• Pathway to care• Experience of service questionnaire
  27. 27. Research• Prevention of long term social disability amongst young people with emerging signs of severe mental illness – A pilot randomised controlled trial of social recovery cognitive behaviour therapy for young people with emerging severe mental illness. (NIHR trials funded, UEA led with Manchester)• Detection and intervention with young people at high risk of social disabling severe mental illness (Programme grant bid, UEA with Manchester & Birmingham)• Professor David Fowler, UEA
  28. 28. Challenges – NoNo• Resistance from some clinicians – Early engagement is vital• Resources – Time – Cost improvement program – Negotiating for staff from teams with stretched resources• Changing culture and mindset
  29. 29. Change Management Process Communicate Pull Together Develop the Produce Short-Create a Sense for Empower Create a new the Guiding Change Vision term Wins Don’t Let Up of Urgency Understanding Others to Act Culture Team & Strategy & Buy-in Adapted from www.slideshare.net
  30. 30. Summary• Young people want to be an integral part of the whole process –Their feedback should make a difference• Early engagement of carers, other clinicians and the third sector is crucial Overall an exciting process!

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