Jersey Youth Parliament closing report – Mental Health (R.143/2022): Response Of The Minister For Children And Education

Recommendations

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Response

Comments

1

Listen  to  what  people have to say

MC ED

Agree – We remain committed to this.

We  agree  with  the  findings  of  the  Youth parliament  consultation  that  the  key  to tackling mental health issues is to listen to people.

Young  people  have  been  extensively consulted with to develop the strategy and new model of care. The fourth theme in the Children's  emotional  wellbeing  and mental Health  strategy  (2022-2025)  is  all  about listening  and  co-producing  with  young people. We listen to children, young people, and families about what helps, and this helps us to improve the quality of our services'.

Collaboration with external partners remains a key driver of the current management team. CAMHS  staff  meet  every  few  weeks  with Youthful Minds, have offered the same to the Youth Parliament, attend the Parents ADHD support group monthly, engage with parent carer forum, strategic advisory panel (which features young people), etc.

Young People have sat on all interviews in 2022  for  new  staff,  redesigned  CAMHS reception,  pathways,  leaflets  and  currently working on policy updates.

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There  is  clear  evidence  that  people  were listened to in the strategy development and the subsequent delivery of services such as new model  of  CAMHS,  commissioned  services e.g., Mind Jersey and Kooth.

2

Put a lot of time, effort and  funds  into  mental health facilities

MC ED

Agree  - significant finance is in place with a robust strategy and implementa tion plan.

We understand that Investment in services and care is required, and are ensuring funding is spent where it is needed.

Indicative  investment  of  £6  million  into CAMHS over three years 2022-2024 has been agreed,  with  £2.25  million  recurring  from 2025 onwards as part of Government Plan (2021-2024)  indicating  a  commitment  to invest in mental health services.

There  is  now  a  children's  mental  health facilities working group that is looking at the build and design of new Community mental health facilities. This will consult widely with the public throughout to ensure the best, most effective provision is built. There is a short pause to planning whilst the politicians debate the new hospital design and site which will impact on options.

3

Focus  on  initiatives  to reduce  stigma  and  raise awareness

MC ED

Agree – this is a key part off  the strategy.

We welcome the Youth Parliaments work in this area. It was good to see that the Youth  Parliament  created  an  up  to  date information  leaflet  that  was  shared  with schools, youth projects and through social media to help young people access support and tackle stigma.

Reducing  stigma  is  a  key  part  of  the children's  mental  health  strategy.  The second  theme  of  the  strategy  is  about making it easy for you to find out who can help and what support is available' this will help destigmatise access to mental health services. We asked young people if they have ever felt embarrassed or worried about asking for help or support with emotional wellbeing or mental health. 77% responded that they did. We asked young people how they would like to access support, 77% said

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face to face, 53% said online and 21% said over  the  phone.   The  Strategy  has  the following actions which are currently being implemented to reduce stigma

Implement  a  whole  educational  and community setting approach to wellbeing and resilience increasing protective factors and reducing risk factors

Develop an integrated parent/carer training and support offer that is relevant to their child and families need.

Identify  people  to  become mental  health ambassadors developed in partnership with a wide range of stakeholders including but not  limited  to;  Youthful  Minds,  Youth Parliament  and  those  that  are  home- schooled.

Easy to access support developed out of hours  e.g.,  Kooth,  out  of  hours  crisis support and phone line

A Mental Health Practitioner will sit within the Children and Families Hub to be able to provide  advice,  support,  signposting  and referral support to young people. Parents and professionals between 9-5pm Monday to Friday

A wellbeing community drop in is in place every Saturday at YES.

The Early Intervention Service is now live with CAMHS Practitioners attached to all

schools.

4

Consider the actual needs of young people

MC ED

Agree – we remain committed to this.

The Youth Parliament survey findings were very helpful, as were results of the children's survey 2021 the Youth Parliament refers to.

Young  people  have  been  extensively consulted with to develop the strategy and new model of care. The fourth theme in the strategy  is  all  about  listening  and  co- producing with young people. We listen to children,  young  people,  and  families  about what helps, and this helps us to improve the quality of our services'

In terms of actions this means;

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• Care plans will be based around the individual child and family need

• There  will  be  increased  use  of advocated and peer support

• Clear evidence of you said, we did' including  on  the  entrance  board  at CAMHS

• Use  evidence-based  evaluation measures  in  everyday  practitioner practice  including  feedback  forms now  in  place  and  pre-post  impact measures

• Set  up  a  multi-agency  Strategic Advisory  Panel  (SAP)  ensuring meaningful input for young people

• Set  up  an  publish  a  yearly  quality report  which  evidence  impact  of strategy  implementation  across  the mental health system

Agree and audit best practice standards of care for wellbeing and mental health services.

5

A  fit  for  purpose Children's Mental Health Strategy with input from young people

MC ED

Agree - this is in place.

The Children's Mental Health Strategy was developed with a wide range of stakeholders including children and young people. C At the start of the strategy development in early 2020 a survey was made available to all children and young people on the Island advertised via GoJ social media, children's cluster groups. 59  children  and  young  people  aged  11-25 responded to tell us what was and was not working and opportunities for improvement. In  addition,  over  300  parents  and  carers responded and over 100 professionals. This helped us to prioritise strategy areas for action.

In  addition,  a  workshop  was  held  with Youthful  Minds  (Mind  Jersey)  on  the  24 February 2021 for their input into the strategy. There has been regular contact with Youthful Minds throughout the strategy development.

A  workshop  was  held  with  The  Youth Parliament Mental Health Subgroup on the 24th of May for their input into the Strategy and also with the Inclusion Project (young

Recommendations

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people with disabilities) at St Peters Youth Club on the 8th of June.

The draft strategy was out for consultation until  the  11th  of  June  2021,  this  was advertised via Youth groups, schools and GoJ social media. There were 264 responses, with 20  responses  being  on  behalf  of  an organisation  and  127  responses  from  those under 25 (115 were aged 0-17).

The final strategy was launched February 7th of 2022 at the start of children's mental health week. An additional consultation workshop was arranged with Youth Parliament Mental Health Subgroup to agree involvement with strategy implementation but unfortunately this was poorly attended by members.

The  strategy  implementation  is  being overseen by key stakeholders including young people aged 16-25 via the Strategic Advisory Panel  (SAP).  The  summary  version  was written by Youth Friendly which has a group of young people sense checking all content ensuring it is easy to read and understand by young people.

The strategy development has been reviewed externally by the Control and Auditor General who concluded, The approach to developing the  Strategy  has  been  comprehensive, thorough,  and  well  governed.  A  particular emphasis for the development has been a clear focus on engagement and co-production.'

6

Investment  in  services and  care,  ensuring funding is spent where it is

needed

MC ED

Agree  – significant additional finance is in place.

Indicative  investment  of  £6  million  into CAMHS over three years 2022-2024 has been agreed,  with  £2.25  million  recurring  from 2025 onwards as part of Government Plan (2021-2024)  indicating  a  commitment  to invest in mental health services.

7

Ongoing  reduction  of waiting times for support post Covid 19

MC ED

Agree  – good progress has been  made with  efforts continuing.

We are pleased to see in the Youth Parliament report that there is a feeling that CAMHS have taken lots of steps to improve the service and they are doing great work so far. Referral to CAMHS have grown from 661 in 2019 to 855 in  2021  and  continue  to  rise  in  2022.  All referrals are now triaged in the Children and

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families  Hub  by  multi  agencies  ensuring prompt  allocation  to  the  services  ideally placed  to  provide  the  required  support. Despite the volume of referrals CAMHS are currently  completing  Initial  Assessments  is less  than  21  days  after  receipt  of  referral. Waiting  times  for  Autism  assessments  are down to three months. Work is continuing to bring ADHD assessment waiting times down also  from  6-9  months.  There  has  been additional support added for children, young people  and  families  engaged  in  a neurodevelopmental assessment process.

These waiting times are better than any other UK Local Authority that we are aware of, yet we still strive to do better.

8

Age-appropriate admissions  care  with therapeutic intervention

MC ED

Agree

As in point 10 work is ongoing to improve the environments  young  people  may  access  to receive  inpatient  mental  health  treatment. There has also been investment into therapy posts including an additional 5 psychologists and 3 assistant psychologists from 2022 as part of the CAMHS redesign.

9

Develop  inpatient services and care where young  people  are  not isolated from friends and family networks

MC ED

Agree

We agree that the current inpatient facilities are not ideal.

Work is currently taking place at the Clinique Pinel site to build new individualised support flats for young people aged 16 and 17 who require inpatient support. These will be ready in Spring 2023 and will replace the use of Orchard House.

There is also acceptance that Robin ward is not  always  ideal  for  children  and  young people  experiencing  mental  health  crises, though at times there are associated medical and well as mental health issues that require inpatient hospital treatment. The new hospital design had previously detailed a separate and improved area for children and young people who required mental health treatment. As the new multi-site hospital is considered we will await plans for mental health treatment.

Recommendations

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Response

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In the last 12 months only one young person has gone off island for specialist mental health treatment.

All young people receiving inpatient care are offered independent advocacy support.

10

Continuity of care and a better  journey  through mental health services

MC ED

Agree

There have been historical concerns regarding transitions  from  CAMHS  to  Adult  Mental Health.  Continuity  of  care  as  suggested  is important. These have improved in 2022 with the  introduction  of  monthly  transition planning  meetings  between  services.  All young people aged 17.5 years are discussed in these  meetings  and  included  to  develop  a transition plan. The meetings included service managers,  nurses,  doctors  and  other  key practitioners. The transition policy is currently being  concluded  ahead  of  ratification. CAMHS has also ensured there is not a clear cut off at 18 years if they remain the best service for input at that stage.

11

Tackle  recruitment  and retention  problems  for professionals working in mental health services

MC ED

Agree  – recruitment has  been positive  in 2022.

CAMHS  has  had  a  very  successful recruitment campaign over the last 12 months, increasing  from  21  staff  to  56.  Further recruitment will take place over the next few months with additional staff funding in 2023. CAMHS is also part of the workforce strategy group in CYPES, that is exploring recruitment and  retention  issues  common  to  all Government departments.

12

Update the Jersey PSHE curriculum  to  include better  knowledge  of mental  health  and wellbeing

MC ED

Agree  – Anna Freud has  made similar recommend ations.

In 2021 the  Anna Freud National Centre for

Children and Families reviewed the role of education in Jersey supporting mental health. The Anna Freud Center play a leading role in the development of policy and practice in the UK and beyond to ensure that it is built on science, tested experience and has the input of children, young people and their families. For Jersey Anna Freud have recommended some changes  to  PSHE  curriculums,  described below which will be actioned:

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"Given the reported range in the quality and priority given to PSHE provision across the Island, we recommend the GoJ offer guidance to ensure consistent good practice across all schools. The approach to this might include: • Convening a task and finish group to lead this work  made  up  of  a  range  of  relevant professionals,  including  relevant professionals  from  CYPES  and  schools  • Drawing on existing good practice in Jersey schools • Drawing on guidance from the on PSHE association, including resources and material that can be used to develop a suitable PHSE program.

•  Considering  external  PSHE  packages

available  to  purchase,  for  example  Jigsaw PHSE which several schools in Jersey are already  using.  The  group  would  identify  a core set of PHSE subject areas in relation to mental  health  and  wellbeing  and  key messages, themes and learning outcomes, and signpost to relevant materials and content. The group would also articulate good practice expectations for Jersey schools in relation to PSHE and the capabilities needed for PHSE delivery staff. Appropriate training should be developed  and  provided  as  required.  An alternative approach could be a mental health and  wellbeing  PSHE  programme  based  on AFC resources available free on the website and supported by a Jersey specific training programme"

13

Ensure that young people know  how  to  access support

MC ED

Agree

All  support  for  CYPES  services,  including CAMHS, comes through the Child and Family Hub.  Youthful  Minds  supported  the development of new CAMHS leaflets in 2022 which are now compete and being distributed- which describe how to access support. Work is ongoing to develop a new website which will  also  describe  how  to  access  support. There is a Saturday Drop in facility at YES, featuring a CAMHS Practitioner, which can signpost children, young people, families and professionals to support. This has been widely advertised in schools and on social media. We will continue to work with Youthful Minds,

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Youth  parliament,  Education  and  Youth service, and other partners, to ensure clarity on how support can be accessed.