To report on the mental health and well-being of children and young people in Haringey and, in particular, the impact of the pandemic and action taken to mitigate this.
Minutes:
Tim Miller, Joint Assistant Director for Vulnerable Adults and Children (Haringey Council and NHS North Central London CCG), reported on mental health and well-being of children and young people in the borough. Mental health services included the NHS, Council and voluntary sector and they were now working in a “whole system” way. Mental health needs arose from social needs, deprivation and difficulties in people’s lives. Services were critical to supporting the local population and particularly children and young people. It was known that Covid had had a huge impact, although the picture from data was complex.
Vivienne Okoh from Haringey CCG outlined the i-Thrive model, which was a national programme. Services had a skills mix so they were best able to meet the needs of young people. There were four parts to the model:
· Getting advice. There was a limited universal offer with small targeted services provided in schools and the community;
· Getting help. There was embedded support to schools and two specialist services;
· Getting more help. There were dedicated specialist mental health services, supported by some north central London (NCL) services; and
· Getting risk support. These services had grown significantly during Covid as part of NCL transformation and were NHS only offers. They included A&E diversion and a 24/7 crisis service. These aimed to manage risk and keep young children in the community.
Jeanne Faulet-Expitini from BEH Mental Health Trust reported that there had been a large increase in referrals during the Covid pandemic. Referrals came from a number of sources, including GPs, schools and social care services. Most referrals had been for anxiety and low mood. There were particular differences between boys and girls, with boys typically presenting earlier.
Recruitment and retention was a major challenge and a national issue. NCL CCG and providers were working as partners on solutions, including the creation of new roles to develop a sustainable workforce. There was also an opportunity to strengthen partnership and inter-agency working as the I-Thrive model was embedded.
Tina Read from BEH Mental Health Trust reported that the prime areas of investment had been concerned with crisis and a number of services had been developed. A 24/7 crisis line had been set up as well as an out of hours nurse led service. In addition, Diversion Hubs had been established. These aimed to see young people within four hours and prevent the need for them to go to hospital, which could be very distressing. Trailblazer was also being expanded to the west of the borough. The recommendations of the SEND inspection were currently being addressed by services. Waiting times for autism assessments were long throughout the NCL area and solutions to this were being worked on. An online platform on ADHD was shortly being rolled out. Significant service redesigns were taking place across BEH in order to remove unwarranted variations.
Ms Okoh reported that Haringey Borough Partnership had agreed the adoption of the Thrive Framework to provide a needs led, common framework to support emotional and mental health across the Council, Education, NHS and Voluntary services. New care pathways were also being developed to respond more efficiently to the children and young people in CAMHS Haringey and in-line with the NHS long term plan and the NCL CYP Mental Health and Wellbeing Transformation Plan.
In answer to a question, Ms Faulet-Expitini reported that the Trailblazer scheme had already been operating in 36 schools the east of the borough since 2019. A bid to extend the scheme to the west of the borough from September 2022 had been successful.
In answer to a question regarding the impact of Covid, the Panel noted that there had been increased need for crisis services and Crisis Centres had been set up, providing access within four hours. A dedicated telephone line to provide advice and guidance for schools had also been set up. Consultations had been moved on-line and the level of engagement with patients had been maintained. Telephone and video consultations would continue after the pandemic. Digital platforms such as Kooth and Silver Cloud had also been used. The response to the pandemic had required innovation and a system wide approach. Support was provided for patients in the way that suited them best.
In answer to a question, Ms Okoh reported that the Traiblazer scheme used the iThrive model. As part of this, it was envisaged that the children and young people that they worked with in schools would eventually become mental health champions.
In answer to a question regarding help for parents, Mr Miller reported that a webinar had been held for parents and professionals before children returned to school following one of the lockdowns in order to address anxiety. This had been very well subscribed. It had been recognised that parents needed support and services wished to work closely with the local community. Work was taking place to further develop services and strengthen earl intervention and prevention. The mental health support provided in schools through the Trailblazer scheme could also provide support for parents. There was also the Anchor Project with trained schools in how to work effectively with children and parents. In addition, every school now had an emotional well-being lead person. Training had be provided for parents and educational psychologists as well. CAMHS could also be contacted directly by e-mail if necessary.
Ms Okoh reported that a programme of specific work with parents and teachers had recently been agreed with MIND. In addition, consideration was also being given to how refugees from the Ukraine could be supported.