greater awareness of why good mental health is important and how it has a direct effect on physical health Provide workshops in schools for children and young people on: Anxiety Stress Depression Self-esteem Anti-bullying Emotional resilience Increase referrals and access to signposting and support for mild to moderate anxiety, stress and depression Improve treatment outcomes anxiety, stress and depression IW NHS Trust CCAMHS Service Lead / Service Leads for Voluntary Sector AQP Providers April 2017 Provide and easy access to advice and support from: Drug & alcohol services Family liaison offers School nursing Pastoral support/PSHE programmes AQP counselling services/ CCAMHS Single care pathway available to all referrers enabling step up and step down when required Children & YP Parents Carers Partner agencies Public Health Development Commissioner / IW NHS CCAMHS Service Lead / Service Leads for Voluntary Sector Organisations / YOT Service Lead July 2016 Engage schools in understanding transition supporting children and young people when moving from primary to secondary education Ensure screening assessment of all children to identify those with All Yr6/7 pupils will have a Health Check report which is shared with school, GP, parent/carer and provides onward referral to appropriate services where deemed necessary Public Health Development Commissioner School Nurse Team Lead April 2017
More children and young people will have a choice of where they go to get support More Children and young people will have more timely access to appropriate services supporting their emotional and mental health needs from all agencies both statutory, independent and voluntary Look at implementing CYP IAPT Exploring the use of the Young Devon Model of delivery Working with the voluntary sector to deliver this approach Explore the use of drop in clinics through the Tier 2 counselling service and ensure that all agencies are aware of the service provided including choices around venue and provider Increase numbers accessing treatment for mild to moderate anxiety, stress and depression Improve treatment outcomes anxiety, stress and depression More children and young people will self-refer and receive support earlier More children and young people will have a choice of where they go to get support Service Leads for Voluntary Sector Organisations / IW CCG Head of Commissioning for CYP By April 2016 Ensure from January 2016 that Isle of Wight CAMHS data is uploaded to the Mental Health Services Data set which has been approved through the SCCI process for collection Improved outcome data greater accessibility and choice Establish baseline Identify and fund growth to meet the need of children and people with mild to moderate anxiety, stress , depression and SMI’s Service Leads for Voluntary Sector Organisations / IW CCG Head of Commissioning for CYP / IW NHS Trust CCAMHS Service Lead By 2016 April 2017 April 2018 Develop self-help, peer and parent support groups with voluntary agencies providing volunteer co-ordination, Children, people, parents and carers will have an active involvement in the design and delivery of services Public Health By April 2018
Mindfulness for Mums Group All Schools will assess school environment and its impact on the emotional wellbeing of its pupils and will set clear goals and an action plan to implement changes where necessary More children will have access to a nurturing environment within school supporting their emotional wellbeing and improving access to education IW LA Education Officer / Primary & Secondary Heads By April 2018 Review CCG investment in YOT following planned reconfiguration with a on provision of support for mental health and emotional resilience Children and young people who are known to the criminal justice system will receive the emotional and mental health support they require IW CCG Head of Commissioning for CYP / YOT Service Lead By March 2016 All partners across education, health, social care and youth justice will work together to develop appropriate and bespoke care pathways that incorporate models of effective evidence based interventions Ensure access to appropriate joined up services and support via CCAMHS, Paediatrics and voluntary sector is made available particularly for those with a diagnosis of Learning Disability, ASD and/or ADHD. This will be achieved by: Review evaluation report recommendations Children and young people with a Learning Disability, ASD and/or ADHD will have access to pre and post diagnosis support which will contribute to: An enhanced health related quality of life for children with mental health conditions Increased expedient access for assessment, therapy, treatment and advice An enhanced positive experience of care in the community IW CCG Lead for CYP / IW NHS Lead Paediatric Consultant / IW LA Education Officer / Barnardo’s Service Lead December 2016
Service, CCAMHS and sector at a time and place most convenient to them CCAMH Service Lead/ IW NHS Trust School Nurse Team Lead / Voluntary Sector Service Leads community PCSO’s /local co-ordinators supporting children and young to be independent within communities Children, young people with learning disability, ASD, ADHD and or behaviour that challenges are supported to be independent within their own communities Police Neighbourhood and prevention Team Lead / Voluntary sector service / IW CCG Head of Commissioning for CYP By April 2017 access to psychiatric liaison children & Young people Children, young people with learning disability, ASD, ADHD, Mental Health their parents and carers will have access to support and guidance from a psychiatric liaision 24/7 IW CCG Head of Commissioning for CYP / IW LA Director of Childrens Services/ IWNHS Trust COO December 2018 4.Accountability and transparency Key Outcomes Action How we will know we have made a difference Lead Timescale Ensure EWMH consultation information, and finance information is publicly available and accessible Transformation Plan included on public website - commissioner By Jan 2016 Ensure all CAMHS data is uploaded as part of updated national CAMHS dataset CAMHS service manager By Jan 2016 Scope the current use of technology by services delivering support for children and young people WISER Programme manager By Jan 2016 How we will know we have made a difference Lead
An ability to learn new skills appropriate to age and developmental competence. Traditionally the CAMHS tiers are used to conceptualise the different elements of services available to support mental health well being, although the model is open to local interpretation and understanding: Tier 1 Universal services, early identification and prevention (GPs, health visitors, teachers, youth workers etc.) Tier 2 Uni-disciplinary working, consultation, assessment, training (primary mental health workers, psychologists, paediatric clinics) Tier 3 team, child psychiatry out patient, specialized mental health working Tier 4 Highly specialised services such as in-patient units or intensive outreach services. (SCMH, 1997 Ibid) for those with the most severe problems This service is expected to comply with all relevant legislation, regulations and statutory circulars insofar as they are applicable to the services provided, these include, but are not exclusive to those listed in 4.1 and 4.2 of this service specification. In addition the service is expected to comply with all local safeguarding policies and procedures. Strategic Context: The service will achieve relevant outcomes of the Child Matters: Change for Children programme and the National Service Framework for Children, Young People and Maternity Services, specifically, although not exclusively, Standard 9, The Mental Health and Psychological Well Being of Children and Young People. The service will also support the priorities agreed in the local Children and Young People’s Plan. The Isle of Wight Children & Young People’s Plan 2014-2017 identifies 5 priorities Securing children and Young Peoples, emotional, mental and physical health. Helping children and people to be safe and feel safe Improving education to provide all children and young people with outstanding learning opportunities Inspiring and providing equal opportunities for all children and young people to achieve their goals and dreams Addressing the incidence and reducing the impact of poverty on the achievement and life chances of children and young people The Isle of JSNA (2011-12) emphasised the need to continue to improve the emotional wellbeing and mental health of children and young people. 2. Outcomes
A range of psychological therapies as recommended by NICE, are offered. A typical outpatient treatment package for anorexia nervosa might last between 20 and 40 sessions. For bulimia nervosa, the typical treatment packages range from 10-20 sessions, although these can be extended depending on individual need. The team work closely with GPs to ensure safe management of the physical risks that often accompany an eating disorder. And strong links have been developed with specialist inpatient paediatricians. The out-patient interventions currently include: Cognitive Behavioural Therapy (brief CBT and CBT – enhanced), Cognitive Analytical Therapy (CAT), Family/Couple Therapy, Carer and family Support Group. There is a nursing team who can offer more intensive community support. This type of programme might be for those stepping down from in-patient care or for those wanting more intensive support than that provided in out-patient treatment alone. The intensive community programmes offer nursing nutritional input, supported mealtimes and a range of therapeutic groups, aimed at supporting individuals to address the psychological issues underlying their eating difficulties. The nutritional dietary recommendations are based on the (weight gaining) plan delivered at Leigh House Hospital, (Tier 4 inpatient provision). Moderations are made to the plan when children and young people reach a position of their optimal maintenance weight. This is also undertaken in negotiation with the primary care services. These programmes are currently run in Southampton five days a week. The structure of the treatment allows time practised and integrated into everyday life. The process of admission and discharge is also supported, for those needing an episode of care. There is a confidence that the package offered matches recommendations in the NHS England paper ‘Access and waiting time’s standard for children and young people with an eating disorder -Commissioning Guide, July 2015’. Waiting time compliance is already within the recommended timeframes, however more work is needed to accurately collect this information and capture it. Working with children and young people with eating disorders is integral to specialist CAMHS, which results in a comprehensive assessment, management of risk and governance, keeping skills updated for all staff. Outcome measures The service currently uses objective outcome measures: CGAS, EAT Questionnaire, RCADS, (for common co-morbidities). They also use height/weight checks and CT scans for delayed menstrual status in girls. The teams offer a variety of ways for users and carers to give feedback about the service development.
To record % of cases that received NICE concordant treatment within the standard's timeframes 69% seen within 4 weeks 75% seen within 4 weeks Mar-16 To record % of cases that have outcomes data entered electronically on to the IT system Not measured as new scheme 25% of active cases Mar-16 To accurately record patient status as either routine, urgent and emergency in % of Not measured as new scheme 95% of referrals Mar-16 Isle of Wight To record % of cases that received NICE concordant treatment within the standard's timeframes 100% seen within 4 weeks 100% seen within 4 weeks Mar-16 To record % of cases that have outcomes data entered electronically on to the IT system Not measured as new scheme 25% of active cases Mar-16 To accurately record patient status as either routine, urgent and emergency in % of cases Not measured as new scheme 95% of referrals Mar-16