It is hard to ask for helpSometimes they don’t realise that they need helpThey value knowing what different agencies have to offerThey don’t want to be judgedThey want to feel part of the solution not part of the problemThey want teachers and other adults to be able to recognise a problem and help them get helpThey want to be able to trust the people who are helping themThey want information in a language that they understandThey want to be involvedThey want services close to homeThey want services they don’t have to be ‘referred’ toFrom YoungMinds Better Outcomes New Delivery (BOND) http://www.youngminds.org.uk/training_services/bond_voluntary_sector
Less Speculation, More Fact.
Bite sizeAccessible on your termsInteractiveLive Commentary
Bite sizeAccessible on your termsInteractiveLive Commentary
Give examples of experiences that can affect each of the five senses
A list of do’s and don’ts (in small groups or big group, depending on time)
Young people can, and do, find ways of opening up in schools. Think of ideas of challenging stigma in classrooms/schools, enabling young people to ‘open up’. This can include teachers being ready to hear it, as well as having info non stigmatising info around school and including mention of voices and visions when covering ‘bullying’ and other emotional health topics. This can be done in pairs first before main feedback.
Youth Mental Health Summit Presentations November 2012
WELCOMEDedicated Youth Mental Health Services: The Human & Economic CaseSarah AmaniYouth Mental Health Network LeadTwitter: #YMHNTuesday 6th November 2012
We need to challenge & We need to connect & support services to delivermobilize grassroots & strategic better services for youngnetworks to commit to youth people... mental health… Dr Rick Fraser Sussex YMH Lead Dr Katrina Lake MH Programme Lead
The National Picture – Just some of the Developments in YMH Ireland– Get on Board Birmingham - YouthSpace Norfolk & Suffolk YMH Pilot CYP Health Needs Assessment Tool Sussex YMH Pilot Kent YMH Pilot Plymouth –The Zone Surrey’s Mindful Service
Income IndivEvents Mortality AllGenes Health care NHSFamily Social care Local AuthorityIncome HousingEmployment Mental DfE EducationResilience Health Criminal justice MoJTrauma Benefits DWPPhysical Env Employment FirmsChance Third sector CVOsEach of these links is evidence-based
What have young people told us about their needs? Appropriate and Recognition of what they accessible services want and need To be valued Involvement Not to be judged or Choice stigmatised Simple care pathways “No decision about me without me”
Economic EvaluationOf Services for 14-25 Year Olds
Time Item Speaker09:30 Welcome & Registration10:00 Youth Mental Health Network – What have we been Sarah Amani up to?10:25 My Journey Ali Moussa10:45 Coffee11:00 Surrey’s Mindful Service for 16-25 Year Olds Sharon Snape & Elaine Fynn11:30 Kent Youth Mental Health First Aid Pilot Yasmin Ishaq12:00 Buffet Lunch
Time Item Speaker13:00 Norfolk & Suffolk Youth Mental Health Pilot Service for Dr Jonathan Wilson 14-25 year olds13:30 A Local Perspective on Youth Graham Vagg – West Sussex Youth Services14:00 Sussex Youth Mental Health Pathfinder Dr Rick Fraser & Alex Jones14:30 Coffee15:00 What do young people want? Andy Rooney & Kevin Skinner15:20 Right Here Project Mark Cull, Rose Allett & Rob Tronce15:40 Voice Collective Claire Powell16:00 Closing & Next Steps Sarah Amani
Youth Mental Health SummitSurrey’s Mindful Service #YMHN Tuesday 6th November 2012
Surrey’s Mindful Service A service for 16 -25 year oldsWest Surrey – Sharon SnapeTelephone – 07771976770Email – Sharon.email@example.comEast Surrey – Elaine FynnTelephone – 01737773089Email – Elaine.firstname.lastname@example.org://www.sabp.nhs.uk/services/young-persons
The Mindful Service for Surrey sits within the Specialist Services Portfolio of theChildren’s and Young Peoples Services for Surrey and Borders Partnership NHSFoundation Trust.Mindful was created to promote engagement of hard to reach, hard toengage young people aged 16 -25 with emerging to moderate mental healthdifficulties who were not accessing traditional mental health services forvarious reasons.The service is an outreach service based in Guildford and Redhill.
• To provide signposting, consultation, assessment, intervention, training and liaison as appropriate for presenting concerns.• Consultation and training is aimed at enhancing the confidence and competence necessary to deliver an intervention provided by others, involved in the mental health care of young people.• To work alongside and target non statutory and voluntary services.• To raise awareness and increase knowledge of mental health needs in young people.• To provide training and workshops for staff and young people.
• To provide added value not already met by traditional statutory mental health services.• Not to duplicate services already being offered and provided.• Providing a mental health service that is not provided elsewhere for a group of young people who have a high level of need.• Prevention of long term mental health needs of this group• Partnership agency with a mental health focus for this age group.• Increasing mental health knowledge of staff involved with young people in this age range.• Increasing access & patient choice for very vulnerable young people.
Target Needs• Young people who are homeless.• Young people who have drug and/or alcohol difficulties• Young people in the PEET category• Young people leaving social care
Our Aims• to prevent the potential of long-term mental health needs of this group.• to work in partnership with other agencies to ensure the mental health needs for this age group are addressed.• to educate and advise those involved with young people about mental health issues.• to increase acce.ss and client choice for vulnerable young people
• Community, out-reach based service which is informal, flexible, accessible and non-stigmatising.• Flexibility in venues and meeting times, including out of hours if required.• Flexibility and ongoing attempts to engage if appointments are missed.• Close collaboration with other services involved in the young persons care.
Challenges• Two workers covering a large area• Prioritising workload• Expectations of non statutory services• Partnership working• The need for a flexible approach• Engaging ‘hard to reach’ young people
Youth Mental Health Summit Kent Youth Mental Health Pilot #YMHN Tuesday 6th November 2012
Kent Youth Mental Health Project Yasmin Ishaq Powerpoint by Roxie Parkins BSc (Hons) MBPsS, Assistant Psychologist, Kent and Medway NHS and Social Care Partnership Trust
AIMS, OBJECTIVES AND SCOPE• 3 objectives to the project1) To hear from young people in Kent and Medway what helps and hinders their mental health2) To build resources in the local communities to support young peoples mental well being3) Commissioning a youth mental health service
Youth Mental Health Declaration• 1. Engage young people and their families meaningfully in service development• 2. Improve understanding of youth mental health within communities• 3. Ensure access to youth friendly services and support• 4. Embrace a youth-focused, strengths based ethos of care• 5. Focus on resilience, hope and recovery
KENT PROJECT PLAN Investigate whether a youth mental health service model in Kent would provide a more robust young person orientated service. Understand the social, psychological and environmental stressors that impact on Kent’s young peoples emotional well being. Listen to the young people of Kent. Support the education/awareness of providers who work with young people in Kent.
Demographics KYMHP Kent and Medway• 58 participants • According to the 2011 Census, Kent‘s• All aged 12-25, median age: 17 population is 1,727,665 (Office of• Males and female equally National Statistics, 2012) represented, transgender heavily • 221,700 young people aged 15-25 in under-represented Kent (Kent County Council, 2012)• 62% of participants stated their • Males and Females currently ethic origin was ‘White’, 17% represent 51% and 49% of Kent’s ‘Black’, 17% were ‘Asian’ and 4% population respectively, currently no stated that their ethnic origin as statistics on the transgender ‘other’ representation of Kent’s population• 66% of participants stated their • Approximately 94% of people in Kent main occupation was in education, are of ‘White’ ethic origin and 6% 5% were in employment (including class themselves as BME apprenticeships) and 31% were NEET • In September 2012, 8270 young people in Kent were unemployed,• 90% of participants lived in the representing 6.84% of all 16-24 year North of Kent, with an even split olds in Kent (Kent County Council, between the NE and NW. 2012)
Some Key Points from focus groups• Overwhelmingly, young people felt that they were not being listened to by mental health professionalsThey don’t wanna hurt our feelings, they just wanna walk around the bush…why don’t you just tell me what’s wrong with me?!• Young people are all too aware of the stigma attached to having a mental health problem, and find that this comes from both the outside world and professionals I was gonna say that is actually the problem in itself, like, making it bad to have a problem… once I get to grips with the fact that if I do find out that I have a problem, the point is that it’s fixable.• When it comes to LGBTQ issues, many young people felt that medical professionals such as GPs were not approachable and did not know enough about the subject to help them, even letting their own prejudices affect their practice You wanna speak to someone with complete confidentiality… maybe a psychologist would be the best person to go to… get it off your chest, someone you can talk to… not very accessible though, you have to pay money to tell someone that you’re gay!
Key Points continued…• Many young people feel forgotten about by society, mental health professionals, education providers and other youth-orientated organisations Mum had depression… I looked after my younger sibling… I’d come home to check that Mum hadn’t killed herself and she’d say ‘Oh, I nearly slit my wrists in the bath today.’ I stopped going to school as I was scared to leave her, school just discarded me.• Young people feel that support is not available to them There’s nothing in your face kinda telling you we’re here to help you, it’s more like ‘when you’re sinking, then kinda wave, wave really hard and we’ll try to spot you or try to find you’.• When support is available, young people don’t always find it accessibleShe just kept using all these technical terms, I didn’t know what she was there for, I felt going there I came out more stressed, more depressed, more anxious.
3 X YMHFA COURSES• 3 courses run in East and West Kent and Medway commissioned from KSL (Knowledge, Support, Learning CiC).• Courses hosted by voluntary sector and educational institutions.• The courses ensured inclusion of non statutory providers.• Attendees included – Rethink CDWs, Higher and Further education staff, Shaw Trust(employment), KCA (drug and alcohol services), YOS, community projects for BME young people, Kent safeguarding police, Porchlight (housing and homeless project), Charlton Athletic Community Trust, Princes Trust, Platform 51(project for women).
HOW PARTICIPANTS WILL USE THEIR NEW SKILLS AFTER YMHFA “back up improve the “Immediately to support provided to the “To be more ready develop the children, young people with young people” quality of “Everyday and adults” Shaw Trust standards of our with the Disability coordinator current service”young people Platform 51 on my project” “Will use it on a Porchlight daily basis” Sandwich I will be more aware of what Technology symptoms to look for and be School able to react immediately” Caribbean teacher/mentor “To be more aware and understand how to help, “It has given me a better where to signpost understanding on how to people that need help” help young people” Charlton Athletic Charlton Athletic Community Trust Community Trust
CONFIDENCE TO SUPPORT YP AFTER YMHFA (evaluation by KSL)Personal confidence of how to Knowledge and understanding of support YP with a problem how best to support a YP
Royal College of GP 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
What Next• Report completion, conclusions and recommendations• Shift towards greater Public mental health (social/environmental determinants)• An orientation towards recovery in local systems and in services as well as in communities.• Public health with a much stronger emphasis in primary care and local authorities.• Using the vehicle of Health and Wellbeing Boards to enable commissioning of a service that encourages collaboration between councils, NHS, vol sector, communities and the public.• Promoting the principle of co-production
cont• Develop “asset based” approach (using the strength assets of young people to design the service)• Designing a service with wellbeing outcomes in mind• Using established well being evidence in service design• MWIA (tool)• Build community capacity in a more integrated and coherent way that is responsive to local need.• pilot YMH service (evidence based and evaluated)
Support should be offered up from the start, it should be based upon a relationship with individuals rather thanjust as-and-when which may not work for a lot of people as trust is needed for disclosure.
Youth Mental Health SummitNorfolk & Suffolk Youth Mental Health Pilot #YMHN Tuesday 6th November 2012
Youth Mental Health Summit• A few thoughts: Existing Services Youth Mental Health• Dilemma when a small, innovative solution is pitted against the larger, more established solutions.• Enthusiasm/energy vs pressure in the system, having the capacity to respond, financial constraints, feeling overwhelmed.
• “I can really see the benefits of the project and fully support the idea but if I’m honest it’s hard to think about how this type of work might help create a better pathway for people in the future when all I can consider at the moment is how am I going to manage my work for tomorrow and the day after that.”
What helped services?• Acceptance that it’s not easy to be innovative/creative/solution focussed when under stress.• Importance of whole system thinking.• Collaboration, communication and consistency.• Support during service transitions/restructuring.• Build sustainable coalitions across multiple stakeholders with different interests and strengths working towards shared goals• Mirrors what young people/adults have stated that they want from services.
Success• We have a “go live” date for youth mental health hub.• Developing the mental health pages on the Yourspace website.• Working closely with Kate and the Free Your Mind Campaign.• Developing relationships with 3rd sector/voluntary providers – “Young Crawley.”• “Know your Goals” football project.
• Uncomfortable though it may be it’s sometimes more useful in the long term to learn from mistakes.
Rugby Analogy• At the beginning of the project focussed too much on expansive ideas
• Sometimes you need to move gradually forward in order to then expand thinking/opportunities/possibilities as confidence grows.• Much greater chance of sustainability if there’s balance between creativity and thoughtful small steps.
Youth Mental Health SummitSussex Youth Mental Health Pilot #YMHN Tuesday 6th November 2012
Sussex Youth Service Update Youth Summit Nov 6th 2012 Rick Fraser & Alex Jones Sussex Partnership NHS Foundation Trust Kate Moore Youth Parliament
Youth ServicesWhat might this look like?CollaborationsCollocationAcceptable, accessible, age appropriateSpecialist staffImprove transitions and reduce drop-out/lossBetter working with minority groups, offenders, NEETs, immigrants, LAC
Current Health Service System for Young People Primary Secondary Tertiary
A Youth Mental Health Service REFERRAL YOUTH SERVICE (15-25) DISCHARGE Accessible Acceptable/Appropriate GP, CAMHS, self, family, Awareness education, 3rd sector, (community) AMHS CJS, SSD, D&A Ability (staff) Primary Care 3rd sector Brief EIP, M&A, PD, ED, DD, D interventions/IAPT &A Acute services
Youth Mental Health Evidence BaseEI for Psychosis EI for Depression Early intervention services, cognitive Prevention of depression in at-risk behavioural therapy and family adolescents. A randomized controlled intervention in early psychosis: trial. Garber J. et al. JAMA. systematic review. Bird V., Kuipers E. 2009;301(21):2215-2224EI for BPAD et al. The British Journal of Psychiatry. 2010 197: 350-356 EI for BPDEI for Bipolar Disorder EI for Adolescents with Borderline First-episode mania: a neglected Personality Disorder using Cognitive priority for early intervention. Conus Analytic Therapy: randomized P., McGorry P. Aust N Z J Psychiatry. controlled trial. Chanen A., McGorry 2002 Apr;36(2):158-72. P. et al. The British Journal of Psychiatry, 2008;193: 477-484.
Sussex Update2010 – youth strategy group2011 – project grant from South Coast SHA2012 – Project manager appointed • Scoping exercise • Partnerships developed • Model developed • Evaluation – grant application (RF/KG) • ‘Go Live’ – November
ModelAccess and transition service‘One stop shop’Screening toolYouth assessment toolCAMHS, AMHS & EIS for health componentConnexions (Targeted Youth Support Service)Other collaborators – YMCA, West Sussex CC, YP SMS, Crawley College
TrainingTraining package developedEvaluationGoals – hybrid clinicians working confidently across age rangeUp-skilling by proximity
PromotionWebsite – ‘yourspace’Raising awarenessPrimary Care & beyondYouth platform
NextCrawley Town FCMHFAOther sitesLarger study
Who is involved?D/MYPsYouth CouncilsYouth CabinetsOther projectsMPsOther organisationsMental health organisationsThe list goes on...
AimsTwo main aims:To help break down the taboos surrounding mental health.We want to create a place for young people to ‘Free Their Minds’
Its now all about promoting andgetting work done now!We are really easy to contact if you want to get involved/contac t us for any other reason;Email:Twitter: @FreeYourMindUKFacebook:
ChallengesFears • Service ‘overwhelmed’ • Diverting already scarce resources • Risk managementRaising awarenessGovernance issuesDeveloping other ‘portals’Maintaining momentum – Alex Jones back to UHS Dec 2012Developing new service at time of financial austerity
In SummaryClear need for better services for young peopleCollaborative approachLocal approachInvolve young peopleGet started somewhereEvaluateMaintain the momentum
Youth Mental Health Summit Right Here Project #YMHN Tuesday 6th November 2012
Right Here Brighton and Hove• Who we are: – Lily Blackmore – Campaigns Volunteer – Rebecca Morley-Wilson – Campaigns Volunteer – Mark Cull – Project Manager – Rose Allett – Campaigns Coordinator – Rob Trounce – Digital Media Officer
Right Here initiative• 5 year pilot• Funded and managed by MHF and PHF• National Programme• Brighton & Hove, Fermanagh, Sheffield, Newham• Evaluated by the Tavistock Institute
Right Here Brighton & Hove• Sussex Central YMCA and Mind in Brighton & Hove• Resilience building activities• Campaigns and health promotion• Peer-led research• Fast track counselling
Our work with GPs – 1. GP research• GP research – Young people‟s views and experiences of GP services in relationship to emotional and mental health• Ask yourself: Do your clients (aged 16-25) understand what confidentiality means within your service? Do your clients have a choice of gender specific practitioners allocated to their care? Are young people who have been referred by a GP given enough information about your service before their first appointment with you? Is your service available at times which suit young people and their lifestyles? Are young people equal participants in decisions made about their care within your service? How knowledgeable are you about other services within your area that can help young people accessing your service? In the context of your service and your relationships with your clients, how empowered are the young people you support?
Our work with GPs – 2. Assessment visits• Good practice guide• GP practice visits• Sample questions: – How aware are your staff of young people‟s issues? – Are confidentiality policies clearly displayed and explained? – Is there information about young people‟s rights available on the website or in the surgery?
Case study - paired discussion• If you were using Doc Ready, what functions / features would be helpful to you with preparing this young person to go to their GP?• Please write answers on the provided Post-it notes• Some of your feedback…
Screenshots of the website (3 or 4) (particularly mental health pages)
Questions or comments?• Come and talk to us in the coffee break if you have questions about Doc Ready, Right Here creating a Where To Go For website in your locality, Right Here‟s work, or anything else!• Thanks for listening and taking part.
Youth Mental Health Summit Voice Collective #YMHN Tuesday 6th November 2012
+VoiceCollectivewww.voicecollective.co.uk Supporting Children & Young People Who Hear Voices: Claire Powell – Mind in Camden
+ About Voice Collective Mindin Camden‟s London-wide project, supporting children & young people who hear voices Direct Services Capacity Building Independent Evaluation (CAMHS Evidence Based Practice Unit) Funded by BBC Children In Need, Comic Relief & City Bridge Trust Part of a larger „London Hearing Voices Project‟
+ So, what do we offer? Responsive – Flexible - Connected Peer support For workers Voice Collective Group Training & Creative Arts Workshops Awareness Website Young people Online Forum Schools Support workshops for Youth organisations parents Specialist mental health 1-2-1 support teams For young people For parents
+ Safety “10 things I can do” Grounding strategies (“5 things I can see, hear & touch”, a grounding bag using all of the senses) Breathing and relaxation Creating safe spaces Safe objects
+ Distraction Distraction Music (creating a playlist) Xbox / Computers / Sudoku / Puzzles Football, physical activities Anything that helps occupy the mind Concurrent verbalization (singing or reading aloud) Earplugs (in one or both ears) Being around others
+ Expressing yourself Shadow boxing Worry box Creative writing (e.g. super heroes) Drawing and artwork (e.g. voice morphing) Model making
+ Taking the power back Saying „No‟ or „Not Yet‟ Setting limits Challenging the voices Becoming an interpreter Treatingthe voices with kindness
+ Finding a voice and peer support http://www.youtube.com/watch?v=BB9_Zy0I3VU
+ Contact Us: Claire Powell & Yan Weaver (Development Workers) Rachel Waddingham (project manager) Voice Collective, Mind in Camden Crossfields Centre, 8 Fairhazel Gardens, London, NW6 3SG Tel: 020 7625 9042 | Email: email@example.com Web: www.voicecollective.co.uk www.facebook.com/voicecollective www.twitter.com/voicecollective www.voicecollective.tumblr.com
Youth Mental Health SummitDedicated Youth Mental Health Services: The Human & Economic Case #YMHN Tuesday 6th November 2012