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Transforming Mental Health services for children and young people, questions and answers


What is ‘Future in Mind’?

Future in Mind is a government report that sets out the case for change in delivery of mental health services for children and young people. It’s all about promoting, protecting and improving our children and young people’s mental health and wellbeing.

Future in Mind makes recommendations around improving early intervention and prevention; simplifying structures and improving access; sustaining a culture of evidence-based service improvements; and better joining up of mental health services.

What does this mean for Berkshire West?

The public bodies, voluntary and community organisations involved in supporting children and young people’s mental health are working together in partnership to develop Local Transformation Plans that will deliver improvements in mental health and wellbeing over the next 5 years.

Our vision is to ensure that every child or young person gets the help they need when and where they need it.

Clinical Commissioning groups have increased funding by an extra £1M each year for the specialist Child and Adolescent Mental Health Services (CAMHs) delivered by Berkshire Healthcare Foundation Trust (BHFT) and further additional funding has also been made available for areas of work such as Community Eating Disorder Services.

Local Transformation Plans cover the whole spectrum of services for children and young people’s emotional and mental health and wellbeing in Reading, West Berkshire and Wokingham Borough.

When will CAMHs waiting times be reduced by the implementation of the transformation plan?

Waiting times for services provided by BHFT specialist CAMHs are already starting to be reduced thanks to additional funding. A reduction in waiting times across all teams is expected over the next 6 months now that new staff have been appointed.

The local transformation plans bring every agency together that has a role to play in children and young people’s emotional well-being and mental health. If support can be put in place at a much earlier stage it means families will be able to access help before problems reach the point where a specialist mental health service is needed.

Families should start to see a difference over the next 12-18 months as a result of the local transformation plans for Berkshire West.

In the longer term, delivery of the plans will result in reduced demand on specialist services – which means that waiting times for this level of help and support will be further reduced.

What are current waiting times?

Children or young people referred to the BHFT specialist CAMHs should wait no longer than 6 weeks for a first contact from the CAMHs Common Point of Entry (CPE) team.

Specialist CAMHs nurses risk assess all referrals. If the referral indicates that a young person is at a high risk of immediate and significant harm, the CPE team will try to contact them or their family within 24 hours.

For young people with non-urgent presentations, the wait for treatment within CAMHs is currently between three and ten months.

We are now working hard to reduce waiting times to less than 12 weeks for the ASD diagnostic pathway, and to less than 6 weeks for CAMHs interventions.

Any young person currently waiting longer than 12 weeks can expect to be offered an appointment by Spring 2016.

Why are ASD referrals taking longer to be seen?

For the ASD service, which is a diagnostic only service for children or young people who are thought to have an Autistic Spectrum Disorder, the waiting time for a non-urgent assessment is currently 22 months.

The high number of referrals to the ASD team, combined with a shortage of staff trained to undertake this assessment has meant that waiting times for this pathway have not reduced as quickly as had been hoped.

A number of new staff have begun work in this team. The new staffing will start to make a difference to ASD referral waiting times, but it will still take over a year to bring the waiting time down to less than 12 weeks.

Meanwhile BHFT CAMHs are working closely with the Berkshire Autistic Society and also the three local authorities in Berkshire West to ensure appropriate support is being provided to families who may be waiting for an ASD assessment.

Will there be any short-term increases to the CAMHs waiting list as changes are implemented?

The number of referrals has increased year to date in Berkshire West and also nationally.

It is possible that, as we focus on children’s emotional wellbeing and mental health, we will find more children and young people who would benefit from support from CAMHs. This could apply further short term pressure to CAMHs waiting lists.

The focus of the local transformation plans is to improve support offered at the earliest possible opportunity, which should in future reduce demand on specialist CAMHs.

If a child or young person is referred from one pathway to another, will they go to the bottom of the waiting list for the new pathway?

Routes into emotional health and wellbeing services – whether these are delivered by BHFT, the voluntary sector or services commissioned by the local authority – are currently being reviewed. We want to ensure that children and young people access the services that they need as quickly as possible, taking into account their level of risk.

Will the transformation plan improve the information given to parents and carers on what they can do while they're waiting for their child to be assessed?

Berkshire Health Foundation Trust (BHFT) have been working closely with service users to compile a range of resources for parents and young people to access via the CAMHs website. This will include online resources, links to supportive voluntary organisations and recommended reading for young people and families where appropriate.

BHFT are also working to develop the Children, Young People and Families Toolkit which will provide a comprehensive information resource on a full range of physical and mental health issues experienced by young people. This has involved work with service users to identify the most helpful themes relevant to child and adolescent mental health.

BHFT are also reviewing, with the help of service users, the information packs which are routinely sent to families who have been referred to CAMHs to ensure these are as helpful as possible during their wait. This information will be complemented by the addition of new CAMHs leaflets in 2016 which will explain the functioning of each of the CAMHs Pathways in more detail.

Will the transformation plan mean that children, young people, and parents / carers get support and interventions from CAMHs after a diagnosis?

The ASD service provided by BHFT is diagnostic only. However there are a number of support services already in place across Berkshire to provide support to young people and their families, both before and after diagnosis.

The comprehensive assessment and report conducted by the ASD service contains recommendations and strategies that can be adopted by families and schools, regardless of the outcome of assessments as well as sign posting or on-going referral to relevant support agencies, such as parenting special children or specialist ASD teachers.

The ASD service also works closely with the Berkshire Autistic Society (see ‘voluntary sector support’, below) to provide access to workshops for families needing vital information and support whilst awaiting their child’s assessment.

How would you describe the difference the transformation plans will make?

We want to integrate and build resources within the local community so that emotional health and wellbeing support is offered at the earliest opportunity, thereby reducing the number of children and mothers at the perinatal stage whose needs escalate to require a specialist intervention, a crisis response or in-patient admission.

This means that:

  • Good emotional health and wellbeing is promoted from the earliest age
  • Children, young people and their families are emotionally resilient
  • The whole children’s workforce including teachers, early years providers and GPs are able to identify issues early, enable families to find solutions, provide advice and access help
  • Help is provided in a coordinated, easy to access way. All services in the local area work together so that children and young people get the best possible help at the right time and in the right place. The help provided takes account of the family’s circumstances and the child or young person’s views.
  • Pregnant women and new mothers with emerging perinatal mental health problems can access help quickly and effectively.
  • Vulnerable children can access the help that they need more easily. This includes; better links with Sexual Assault Referral Centres (SARCs)and developing Liaison and Diversion services for offenders with mental health or learning disabilities when they come into contact with the criminal justice system.
  • Fewer children and young people escalate into crisis. Fewer children and young people require in patient admission.
  • If a child or young person’s needs escalate into crisis, good quality care will be available quickly and will be delivered in a safe place. After the crisis the child or young person will be supported to recover in the least restrictive environment possible, as close to home as possible.
  • When young a person requires in patient care, this is provided as close to home as possible. Local services support timely transition back into the local area.
  • More young people and families report a positive experience of transition.

Voluntary sector support

The National Autistic Society (NAS) holds a wealth of information about ASD. The NAS will often run short courses locally and they have a variety of parent-to-parent help lines, and offer services such as befriending - www.autism.org.uk

Berkshire Autistic Society (BAS) is an excellent local resource. It co-ordinates a programme of local events and can offer support and sign posting services, including a post-diagnosis service. The Berkshire Autistic Society also runs groups providing help and support to parent teenagers on the autistic spectrum - www.autismberkshire.org.uk 

Parenting special children offers a Diagnostic Support Service to parents and carers in Reading, Newbury and Wokingham and also provide parenting programmes specifically written for parents who have children with special needs - http://parentingspecialchildren.co.uk 

How do I submit a question for this page?

This page will be updated with new questions. To submit a question, email the Patient and Public Involvement team at , or contact them by telephone on 0118 982 2709 (Monday to Friday 9:30am to 4:30pm). Please note that questions should be general in nature and not include any specific patient-identifiable information.

 

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