Early stages of mental health in school aged children

WQ.135/2019

WRITTEN QUESTION TO THE MINISTER FOR EDUCATION BY DEPUTY K.G. PAMPLIN OF ST. SAVIOUR

ANSWER TO BE TABLED ON TUESDAY 12th MARCH 2019

Question

Can the Minister for Education confirm what processes and support are in place to tackle loneliness, social isolation and the early stages of mental health problems among school-aged children; and what steps her Department is taking to provide additional processes and support in relation to such matters.

Answer

The Education Department provides services and support for children and young people thought schools, and the Youth Service , within the community. This is typically in response to children and young people who are either reporting or presenting with emerging mental health, well-being or other presenting needs, which prevention and early interventions and Early Help can be an appropriate response to (nipped in the bud'). All services are organised to ensure they are appropriate and accessible for children's age and stage.

Schools

Since 2015, an offer of services and support has been developed, which provides a graduated response for children, who may present with need that sit on a continuum of complexity. This ensures children are able to access the right support at the right time. This is further reflected in a redesigned and renamed service – Psychology and Well-being (PAWBS) – which ensures issues of well-being are visibly a priority for the Education Department. Key developments in the area of mental health and well-being include the following:

Workforce development

Since 2015 schools have been introduced to the concept of termly PARMs (Planning and review Meetings). The PARM is a multi-agency forum, empowered and informed by the school and their community needs. This can be attended by a range of professionals including Educational Psychologists, Well-being Facilitators, Primary Mental Health Workers, Education Welfare Officers, Family Support Workers and members of school staff. The focus of the PARM is to explore appropriate support for individual children and young people, review progress, streamline access to the appropriate service for further insight, discuss systemic issues and professional training needs and discuss what support needs to be offered to the school to promote early intervention and inclusivity. Whilst a theme underpinning each PARM is to have regard for mental health and well-being, associations with vulnerability, attendance, behaviour, special educational needs and adult support can also be discussed.

Since 2015, The Education Department has introduced a training offer for schools, which ensures school- based professionals are able to understand and respond proportionately to children with mental health and well-being needs. The offer includes training in the following areas: Supporting staff well-being; Mindfulness; Mental Health First Aid; Promoting positive mental health and resilience in children; Implementing the FRIENDS programme; Responding to bullying in schools; Responding to pupil distress; supporting anxious pupils; supporting self-harm; Understanding ADHD; LGBTQ (co-delivered with Liberate, Youth Service and CAMHS). This training is always well attended and positively evaluated and, with the exception of Mental Health First Aid (offered by MIND Jersey) is offered free of charge. 2018 has also witnessed many of the courses being offered to any professional who works with children and young people, with the PMHT offering to develop training specifically for teams/agencies in relevant areas, as demand arises, and an ability to offer training to teams on location if so desired.

Telephone consultation lines have also been in operation since October 2017, available to any professional working with children and young people seeking professional support, signposting etcetera to streamline access to appropriate services and upskill. These lines have been offered by the Educational Psychology Team, Well-being Team and Primary Mental Health Team and are now accessible to any family member including children and young people (excluding PMHT). Parentscope meetings are also in operation, taking place at three separate locations across island every 6 weeks, encouraging access to a range of services for families wishing to talk face to face and seeking consultation external to their school based environment.

Emotional Literacy Support Assistants (ELSAs)

The ELSA model has been introduced to the significant majority of schools in Jersey. ELSAs are school based professionals (typically keyworkers), who have attended a six day training course with indefinite, ongoing, half termly clinical supervision delivered by the Psychology and Well-being Service (PAWBS). This equips them with the skills to provide early support for all children presenting with emerging well- being needs. ELSAs are also provided with twice termly CPD sessions and an end of year annual conference facilitated by the PAWBS. There are currently 70 ELSAs providing support to children in Jersey schools with plans for further training of new cohorts available in June 2019 following demand from schools. All training, clinical supervision and CPD is delivered free of charge.

Well-being Team

The Well-being team (team of 4 representing 2.46 fte) provide a peripatetic service to all provided and non- provided primary schools. The role and contribution of this team has continued to develop and includes a mix of casework (1:1); small group work; whole class work, support and consultation for school based ELSAs and the development and delivery of training. The well-being team are all trained in, and implement the FRIENDS approach – this is a licensed, manual–based approach (CBT methodology) designed to support children with emerging symptoms of anxiety/depression to more complex well-being needs. As integral members of PAWBS they also co-develop and co-deliver relevant training modules with other PAWBS teams and colleagues from other agencies e.g. Sleep, Mindfulness, Fitting The Oxygen Mask (support for senior managers to nurture the well-being of staff). The Well-being Team are also attending further training across the academic year of 2018 -2019 focussing on working therapeutically with children and young people with the hope of reviewing the range of services on offer in the future to further enhance service delivery.

School-based Counselling (SBC) Services

A review of school-based counselling services was undertaken in 2014. This led to the development of professional, operational guidelines to support robust governance around these roles and a requirement on schools to report on the activity and performance of their SBC to the Education Department (via the Principal Educational Psychologist). This guidance has also been revised and updated in 2016 and 2018. The Psychology and Well-being Service oversee the clinical supervision of all SBCs. The number of SBCs has steadily increased and all but one secondary school provides a counselling service for its pupils (10 posts operating on island from September 2018). The most recent annual audit of this service indicates that students are seeking this form of school based therapeutic support with, for example, 615 students accessing a counselling service during the academic year 2017 – 2018 and 3158 therapeutic sessions delivered in total. SBCs are also encouraged to work in partnership with other PAWBS teams and are currently working with members of the Primary mental health Team to explore supporting exam stress and periods of transition.

Primary Mental Health Workers (PMHWs)

In partnership with Health and Community Services (CAMHS), 2.0 fte PMHWs have been seconded to the PAWBs since June 2017. These posts are new' and have been developed to extend the offer of support (and with this, expertise) available across all schools and the wider community, thereby encouraging and upskilling all to recognise their role as early intervention mental health practitioners. The post holders provide: consultation and advice; training and development; 1:1 and small group support in addition to developing and facilitating projects. A weekly triage clinic for children, young people and their families, alongside CAMHS colleagues, was also piloted from June 2017 to July 2018 but has currently paused whilst colleagues within CAMHS assess future focus. Parent workshops and a pop up information stand have been offered through the main library over the summer holidays whilst parent/family workshops are offered throughout the year via schools regarding core subjects e.g. supporting and managing anxiety, understanding ADHD. Mindfulness and compassion group workshops have also been offered to students and to parents with future plans to offer this service to professionals. Links with many voluntary sector agencies, professional agencies and all Jersey GP surgeries continue to be forged.

Counter-bullying

Due to the evidenced relationship between bullying and mental ill health, a project that looked to understand and respond to this issue has been prioritised and developed as a piece of ongoing action research over the last 18 months. This is being led by the PAWBS with active involvement from school representatives and other partner agencies e.g. The Police. The project has included: seeking the views of over 2000 pupils and 500 school–based professionals on issues of bullying (illuminative research); establishing a focus group to review local evidence and manage project activity; review and improve the Department's policy (with a view to achieving practice change in schools); develop resources and introduce approaches to support children; parents and school staff in this area. This will take place working actively with the Diana awards to further develop schools anti-bullying strategies and up skilling children to tackle bullying within schools.

Multi agency, partnership working

PAWBS chair a termly mental health network meeting devised to share ideas, news and good practice to better support the Jersey community by avoiding duplication, promoting the work achieved by all agencies and working together. To date representatives from the following agencies attend: MIND Jersey, Eating Disorders Group, YES, Liberate, Drug and Alcohol Service, Silkworth, Citizens Advice, You Matter, Hospice, NSPCC, Jersey Recovery College, Specialist Community Public Health Nursing, Libraries Services, Brook, The Primary Mental Health Team, the Educational Psychology Team and The Well-being Team.

Strategic roles are also adopted which include:

• Education lead for Parentscope Project;
• Chair of the Mental Health Network;
• Education Lead for prevention of suicide;
• Virtual School Head teacher for Looked After Children (LAC) until 2018, now adopted by a member of SEMHIT (Social Emotional Mental Health and Inclusion Team);
• Membership of the multi-disciplinary Autism and Social Communication (ASC) diagnostic pathway and steering group;
• Previous Education representative on Mental Health Criminal Justice Forum;
• Education representative on Legal Information for Young People Project.

Since September 2017 the Principal Educational Psychologist has met with Youthful Minds every 6 weeks. This is a participation group formed by young people who have experienced mental health challenges and MIND Jersey. The meeting enables the Education Department to share ideas and thoughts with young people who also have the opportunity to feedback themes and concerns to inform future planning and joint work. Joint projects have included a review of CYP use of JOD (Jersey Online Directory), a pop up information stand at the local library during the summer holidays and support during recruitment processes for new staff.

Throughout 2018 the formation of the Jersey Student Council Network has also been a focus. All Jersey schools have been offered training and support in auditing or creating effective student councils within schools, promoting student voice and engagement. This has culminated in the first forum meeting in October 2018 when students from participating schools came together to establish a collective, capable of informing processes and professionals through voice and participation (VAP), identifying themes through consultation with their fellow students etcetera. Work continues to link this forum with The Children's Commissioner's Office and Youth Connect and to co-produce a process that empowers children and young people to share ideas, give advice and seek support when they feel they need it.

Youth Service

The Jersey Youth Service provides high quality preventative and early intervention service through a network of community / Parish based youth clubs for young people between the ages of 8yrs to 18yrs with the focus of this work with the 12 to 18yrs young people. The service reaches over 3000 Children and Young people annually. This is 33% of the population of the 12-18 year olds on island.

Its impact on social inclusion and development of vulnerable children & young people is evident from the specialist areas of work tha have been developed over the past 3 to 5 years.

The service is well connected with other agencies and services in the island with strong partnerships with the Police, Children's Service, MASH, Probation, 3rd Sector organisations, Parishes as well the private sector and business. These partnerships are imperative in keeping children and young people safe, engaged and having a voice in affair that impact on them.

The Jersey Youth Service, through its network of community based youth projects provides opportunities for children and young people to have a voice within their local Parish / community, a space to meet with peers, that is safe, have informal learning opportunities and have some fun as they grow from childhood into adulthood and avoid becoming isolated

The service operates from 18 different locations across the isle of Jersey with plans for this provision to be extended to 19 by 2021 when a designated Youth Centre for the North of Town should start to be built and cater for children & young people in one of the Islands most populated area of Jersey. This centre will provide a valuable link to the young people living in this area.

The Service also provides various youth work projects that target various groups of vulnerable young people within the Island to tackle loneliness, social isolation and the early stages of mental health problems, these being:

• Youth Enquiry Service (YES) which is the Islands Information, advice and counselling project for 14 to 25yrs
• LGBTQ Youth Jersey which supports our LGBTQ young people
• MyTime project for young carers – This provides support to tose young people that are providing care to someone else such as parents with substance or mental health issues
• Inclusion project with works with young people with disabilities
• Prince's Trust programmes to support NEET young people / adults
• Duke of Edinburgh Award
• Return home interviews for those young people going missing and young people at risk of Child Exploitation.

The Service also provided support and opportunities to all primary and secondary Schools thought its Outdoor Adventure Offer and the use of St Aubin's Fort, the Queens Silver Jubilee Activity Centre (Crabbe), water or land based activities such a powerboating, high ropes, residential opportunities, sailing etc.

Youth work focuses on the personal and social development of young people so that they can develop their knowledge, skills and confidence and the service is currently reviewing its offer of accredited learning outcomes, as well as how it measures its impact on the informal learning opportunities that arise from its work and the softer outcomes young people gain from their involvement with the service.