By Daisy Whittingham of Handsam Ltd. handsam.education
The creation of the Children and Young People’s Mental Health Task Force brought together a broad spectrum of professionals from the charity, education, healthcare and voluntary sectors, working closely with parents and young people to formulate an approach to mental health provision for children in the UK. The subsequent report, Future in Mind, was published in 2015 and achieved what the CEO of NHS England described as an ‘ideal middle ground’, which did not make sweeping generalisations nor revert to a clinical approach. The following article explores the Task Force’s findings and how staff can implement them on a daily basis, pursuing excellence in mental health care for children and young people everywhere.
1. Changing How We Think About Mental Health
Norman Lamb, then Minister of State for Care and Support, stated that a ‘fundamental shift in culture’ is required to establish the right outlook on mental health. There should not be a stigma attached to mental illness, as this can deter children and young people from seeking help. By developing what the report describes as a ‘national conversation’, we can approach a societal change that will facilitate the popular view that mental illness is nothing to be shy about and is rather something to be discussed, addressed and overcome.
2. Interagency Work
In the past a lack of clear leadership and accountability has led to vulnerable children slipping through the net. Future in Mind calls for an open, honest, accountable and transparent system of care in which everyone who works with young people, from teachers to midwives, counsellors to carers, knows how to recognise the signs, what to do and how to help. At each level there should be no doubt where the responsibility lies and what the next step is. The report states that, ‘you should only have to tell your story once, to someone who is dedicated to helping you’, as communication and the ability to work effectively together should do the rest.
3. Meeting Rising Cost with a Shrinking Budget
The failure to treat mental health issues correctly and early enough generates a huge cost to the British taxpayer. For example, children with early conduct disorders are 10 times more costly to the public sector by the age of 28 than their peers. Referrals are increasing, as are the complexity and severity of presenting issues and if no changes are made the cost to families, communities, services and society will continue to climb. As these figures rise, the budget figures drop, creating the dilemma of more need with less money to answer it. The report urges that all bodies pursue ‘an investment to save.’ The money allocated to schools, local authorities, voluntary organisations and the healthcare service must be utilised as effectively as possible. Prevention and early intervention are cost effective and reduce the future expense of untreated mental illness.
Sam Gyimah, then Parliamentary Under Secretary of State Department for Education stated that, ‘only by working in partnership, sharing expertise, and making best use of finite resources can we achieve the improvements in mental health outcomes that we all want to see, and make a reality of the vision.’
4. The Right Provision in the Right Place
Mental health care requires a flexible local structure which responds to the needs of the community. The report states that ‘models could and should be different in different types of locality; for example, a model which works well in rural Devon may fail to meet need if applied in inner-Manchester, and vice versa.’ Children and young people should have more freedom to dictate how they receive help, what form it takes and where. The goal is an outcomes-focused service, with a simple structure which is easy to access, manned by a workforce which is correctly trained for the appropriate place. Actions should be evidence-based and respond to need, rather than defined by organisational boundaries. The report also discusses the need to use technology to fill gaps. Apps and digital tools could form an additional route to reach those in need.
Mental health services should be delivered to the same high standard throughout the country. Approaches may differ, but they cannot be insufficient. A set of established waiting times and standards is set to be fully implemented nationally by 2020. It is hoped that rigorous national standards will place mental health on a par with physical, requiring an equally urgent and focused response. These standards will be informed by opinion. What do parents, children and young people think about mental health services? A constant feedback cycle utilised in conjunction with regular data captures can paint a national picture of mental health, allowing services to be tailored.
Future in Mind calls for an education system that tutors pupils from an early age in how to promote their wellbeing. Good mental health should be championed from infancy, allowing children to develop resilience and the ability to meet challenges with confidence and ambition. Alongside the promotion of a healthy lifestyle, the education sector needs to endeavour to prevent the development and deterioration of mental health issues. Pupils should know that help is there and were to access it if they need to.
To facilitate this the system requires educators who are trained in spotting the signs, are able to offer early support and are fully informed as to what steps to take. Schools form a key link in the interagency chain and perceptive and caring staff, in tolerant and positive environments will help reach vulnerable children early.
The report praised the progress already seen in the sector, from the success of whole school approaches to the correct use of peer mentor schemes, which allow suffering children to feel less alone. The inclusion of mental health in the PSHE curriculum is also to be celebrated as invaluable in the development of the child.