Changing the odds in favour of young people

Keith CoulstonHead of Mental Health & Wellbeing

• Young people 12 – 25 across Devon including young people in Care, Care leavers, Young Carers, Complex & Additional needs

• A range of services : supported lodgings, housing, YES centres, youth inclusion & volunteering

• Workforce development – training in Person Centred Planning & Young People’s Mental Health (+ core inc safeguarding)

Mental Health & Wellbeing

• Counselling & Psychotherapy Service

• RnB (complex needs)

• Plan B (complex needs, wrap around including accommodation)

Community-based Counselling & Psychotherapy

• Funding – DCC, NHS, grants from trusts• Early Intervention, Prevention, Rurality• Young people with range of needs• Range of therapeutic interventions

• 7 market towns & city of Exeter• Rurality issue

The South & West Devon Model(mainly funded by Devon NHS)

A range of staff qualified to meet different levels of need

• Psychotherapy

• Diploma Level Counselling

• Pre-Dip / Certificate Level Counselling

Located in Young Devon YES Centres, 6 schools & othercommunity based venues

• Volunteer Counsellors (approx 4 per team – I year minimum commitment)In training (2nd year) or qualified at Diploma level

• Counselling Co-ordinators (7 part time)Diploma Qualified & experience of working with young people

• Psychotherapists (4 self employed)Clinical Psychologist, Art Therapist, Group Analyst & Psychotherapist, Psychodynamic Psychotherapist

Clinical Governance

• BACP organisational membership• UKCP / BCP /BACP Individual membership

• Clinical supervision

Psychotherapists Child Psychotherapist

Counselling Co-ordinators Psychotherapist

Volunteer Counsellors Counselling Co-ordinator

Referral Pathways

Self referral Guided referral

Level 1 / 2 Counselling

Level 3Psychotherapy

Level 3 / 4CAMHS / CMHT

YES centresSchools

Carers/parents

SchoolsSocial ServicesG.P surgeries

CAMHS & AMH

Integrated Service Model

UNIVERSALSERVICES

TIERS 1/2

CAMHS EARLYRESPONSE

TIERS 2/3

CAMHS FURTHERRESPONSE

TIERS 3/4

AMH

YOUNG DEVON COUNSELLING & PSYCHOTHERAPY SERVICE

TIER 2 TIER 3

Outcome Monitoring (South & West Devon Service)

01.01.02 – 31.12.09• Over 14,000 sessions delivered• Over 1,500 young people in receipt of service2011• 330 young people seen• 2450 sessions delivered Other data systematically collected: gender,ethnicity, home area, response time, referral route,presenting problems, HoNOSCA

Ten Most Prevalent Presenting Issues

• Anxiety / Stress• Relationship with parents / carers• Low Self Esteem• Depression• Split family / separation• Communication difficulties• Relationships with Peers• Emotional Abuse• School/employment attendance

difficulties• Dysfunctional family

HoNOSCA

Initial HoNOSCA Score (sample size 949)00 – 19 57 % 20 – 29 37 % 30 + 6 %

[Scores 20 – 29 indicate a serious mental health problem; 30 + very serious]

Total number with both initial and completed HoNOSCA scores = 609 (100%)

• Numbers with an increase in score = 2%• Numbers with same score = 17%• Numbers with reduced score of

between 1 and 9 points = 54%• Numbers with reduced score of

10 points or more = 26%

Strengths evidence based value for moneyeasy access non-stigmatisingsupporting learning & ewb in schoolsQA & Clinical Governance

WeaknessesResources – operational development, CPD,research, marketing

Value for moneyCost - number of sessions divided by funding Outcome scores, systematic feedback from youngpeople & schools, case studies

RnB project

• The Rebuild and Become project is a development of a DCC funded project (cut in 2010) which helped vulnerable young people who put themselves at risk

• Spot purchase – special schools and mainstream schools (primary & secondary)

• Filling a gap between children’s services and mental health

• Young people reluctant to engage with ortrust anyone and have few inner resources to alter their behaviour

What does RnB do?

• Identifies and strengthens young people’s resilience and understand their rights

• Assists young people to work with others• Coaches young people to meet their potential

and want to make a change.• Supports young people to experience positive

relationships• Enthuses young people to contribute to society

Delivery methods

• range of bespoke one to one therapeutic mentoring programmes

• group work

• mediation for children, young people and families in Devon

• activities

• Staff: Play therapist, creative therapist, counsellor, psychotherapist

• Clinical supervision

• Evidence :

Devon Youth Achievement Award 2008.

Devon County Council audit highest score

Commendations from other professionals

SDQ

Conclusion

Challenges• Changes in Childrens’ Services & NHS• Level playing field

Opportunities• Partnership / relationship building• Filling a gap

• Advice

Commissioners - creativity

Providers - evidence