Improving Children and Young People’s Mental Health Services in Bury

Rochdale, Oldham, Bury and Trafford Healthwatch worked together to gather the experiences of parents and carers whose children use, or who have used local mental health services, and those of professionals who work within schools and local services.

Findings – parents and carers

• 68% of parents felt that Healthy Young Minds (HYM) offered a very professional service with high levels of confidentiality and trust between the clinician and young person.
• Waiting times for referrals to HYM are too long with 40% waiting more than 3 months for their first appointment.
• There is little support for young people with a dual diagnosis of mental health and autism spectrum conditions.
• Most families stated that ‘having a good school behind you’ can make a positive difference to the young person’s experience.
• 78% of parents did not receive good advice on how to support their child after discharge

Findings - professionals

• There has been more training and information regarding Adverse Childhood Experiences - better understanding of underlying issues across Greater Manchester to help to move towards trauma informed settings
• Waiting times for referrals to Healthy Young Minds are too long.
•  Many referrals from schools do not meet Healthy Young Minds criteria but no feedback is given, and thresholds are too high.
• The support that is being offered is quickly saturated, due to the high level of need; this may mean an adequate preventative response is missed.
•  Many times, young people have reported not feeling able to be open and honest within their Healthy Young Minds appointments because they ‘don't know how’ or haven’t the time to build trust with the person they are talking to.

Recommendations

1. Reduce referral waiting times through early triage (within the first 4 weeks) and routinely signpost to on-line and low-level mental health support services to help manage delays accessing the Healthy Young Minds service.
2. Professionals who work with young people need to have access to up-to-date information on mental health services, including the types of support available, referral process and criteria, average waiting times from referral to first appointment and who to speak to for advice. Professionals to have mechanisms to routinely promote this information across mainstream services.
3. Explore options to join up or redesign existing provision to create services that support young people with a dual mental health issue and autism spectrum disorder or attention deficit disorder.
4. Through the Single Point of Access ensure that young people have information on the different treatments available, so they can find the one that is right for them and do so through a seamless process.
5. Provide a wider range of low-level mental health services, as part of a consistent mainstream offer across schools and community settings and increase the availability of low-level counselling for young people and their families.
6. Build in time for parents and carers to ask questions and gain practical advice and feedback, as a standard part of the Healthy Young Minds sessions and include a final review on discharge to explore how the family is coping and to provide information on other resources, for example, through a standard information pack or website resource.
7. Review the information currently provided to ensure that young people and parents have access to consistent information at the point when they need it.
8. Courses for professionals who need to update/develop more specialised skills and clarity regarding treatment plans.
9. Establish processes to fast track young people back into services if their situation is getting harder to manage after discharge and provide families with a clearly defined plan that provides information about what to do and who to speak to if the young person experiences a mental health crisis in the future.
10.  Establish clear clinical pathways, with timely support, for children and young people with a mental health crisis to access urgent care services.
11. Children and young people’s mental health services to be reviewed within 18 months of this report. A future review should gather feedback from young people about service improvements, as well as feedback from black, Asian and minority ethnic families, about children and young people’s mental health issues