Agenda item

Jenny Lingrell, Assistant Director Commissioning, Performance and Inclusion to present.

Following on from the SEMH Strategy, Jenny Lingrell continued with a second presentation in relation to the Mental Health Trailblazer.

 

Mental Health Support Team (MHST) Service Model

The mental health trailblazer pilot will see mental health support teams established in 22 schools and education settings across Rotherham.  Up to 8,000 children and young people will receive face-to-face support to help address and prevent mild to moderate mental health problems

 

Wave 1 – Whole School Approach including the senior designated mental health lead

Wave 2 – Delivered by the Education Mental Health Professionals

Wave 3 – MHST senior practitioners linked to CAMHS Locality and Advice Teams

Wave 4 – MHST clinical lead and liaison/case management function linked to CAMHS pathways

 

This project was not a replacement for the CAMHS service.  It provided a graduated response with a range of activities within each wave and needed to dovetail with and enhance what was in place.  Under wave 2 liaison with services to access the right support would help with triage.  Workers had been recruited and were at university but also working one or two days each week in schools already part of the time.

 

MHST Roles

•        Deliver evidence-based interventions 1:1 and to groups of children and young people, building on the support already in place, not replacing it

•        Support the senior mental health lead to introduce or develop a whole school approach

•        Give timely advice to school staff, and liaise with external  services, to help children and young people get the right support and stay in education.

 

Education Mental Health Professional Role

•        Delivering evidence-based intervention for children and young people, with mild to moderate mental health problems, in schools.

•        Helping children and young people who present with more severe problems to rapidly access more specialist service.

•        Supporting and facilitating staff in education settings to identify, and where appropriate, manage issues related to mental health and wellbeing.

 

Role of the MHST Strategic Lead

•        Strategic lead from the voluntary and community sector will  integrate the social model/trusted relationship approach to complement CAMHS clinical approach

•        Ensure effective dissemination of learning from the Trailblazer – viewed as key

•        Produce a MHST service model and referral pathway

•        Oversee the allocation of referrals across the schools

•        Establish how the views of young people and families are collated - done

•        Establish what schools need and how they will work together and share good practice -  a lot of time had been spent on this aspect

•        Following a competitive procurement process Barnardo’s will lead this work

•        Barnardo’s have significant experience of working in Rotherham schools.  They currently deliver services focused on  Child Sexual Exploitation, Child Criminal Exploitation, Harmful Sexual behaviour and young carers

 

Other slides

·       Diagram showing how MHST complement CAMHS Locality Model

·       Recruitment of MHST – 2 in Rotherham, fully recruited

·       Map of participating schools and colleges – some at different stages on the journey so the learning could be compared

·       Implementation milestones

 

Detailed discussion ensued on a number of issues.

 

·         Overall how did you see the project going and were you confident that the requirements of the Green Paper would be met?  How was the training going and what was the background and expertise of the practitioners? - People came from a variety of backgrounds and details on training and expected interventions could follow from CAMHS. 

 

·         Rotherham MIND used to carry out an effective schools mental health programme.  Was this still in place and was it connected in? - Yes MIND did still work in some schools and Maltby had their own delivery around counselling and mental health support  Early Help also delivered targeted interventions in some schools.  It was a mixed picture but many schools already had support for children with SEMH needs.  Mental Health Support Teams (MHST) were the “glue” between CAMHS and Early Help to ensure the right support at the right time.

 

·         Cllr Bird had declared an interest in this item but asked a broad question.  With the reduction in budgets for Children’s Centres, was money going from schools and elsewhere to fund this project? - This was separate money from RMBC funding and had come down through the NHS to deliver Future in Mind.  The Assistant Director clarified that her post was a joint RMBC/RCCG role but it was RCCG who led on the Trailblazer. 

 

·         Regarding the whole school approach with a senior mental health lead, was that person in a full time role within each school?  Or was it the lead from one of the two teams that were being established? - It was a separate school based role and varied between schools, which linked in but was supported through this funding for MHST.  It was not a case of one size fits all and some larger schools or a Multi-Academy Trust may have a full time designated person whereas in a smaller school or primary it might fit within the role of the SENCO or pastoral lead.

 

·         Were there any recommendations to schools of how large the role should be in terms of the school population? – In the absence of statutory guidance it was at schools’ discretion.  It was hoped that the project would provide a lot of information about how needs were met and what worked well.

 

·         With two teams across all schools, where would they be based and would they just go into schools according to demand? - Operational implementation was being worked out with schools being asked if they had space to accommodate a MHST, as it was hoped they would each have a permanent base in one school whilst working across a number of schools.  Schools were also asked about availability of space and having the necessary infrastructure and IT in place for a team when they did come in to a school.

 

·         Looking at the map, there appeared to be clusters of participating schools in some parts of the borough yet others with only one or a few.  – In part this reflected the nature and population of Rotherham as what is referred to as the central area is located quite high up on the map to the north.  In addition the workers were only in the schools that submitted a bid to be in the project and there had been a process around that.

 

·         How did it work in practice, through direct access for children and young people or via a teacher or teaching assistant?  - Yes face-to-face contact was intended, probably through an appointment system to be determined by schools.  The aim was to link MHST in with existing access and infrastructure.  The EMHPs would work with individual children and groups of children, not just with staff.  In 12 months it might be worth coming back to report on progress and outcomes.  As relationships varied flexibility was needed to ensure support from someone with whom the child was comfortable.

 

·         In 2016-17 a whole school approach mental health pilot had run in six schools.  Had that been reflected back on to inform this work and had there been a continuation of the work post-pilot as at the time schools had been keen to keep it going and sustainability was important? - To follow up.

 

·         Could you say more about the successful work of Barnardo’s?  - Improving Lives have considered several monitoring reports regarding Barnardo’s work on CSE through the ReachOut programme.  Individual contract monitoring also took place. 

 

·         What were the success measures for this pilot?  How would it be funded in the future if it worked, as we have seen issues with ongoing funding for other positive initiatives such as the Pause Project?  Would the money be found to sustain it and expand into other schools?  - As an NHS England programme clear outcomes were needed so measure would include a reduction in inappropriate referrals and increased confidence in schools which could be brought back in 12 months.  In terms of sustainability partners were mindful of funding but future funding from the NHS for mental health was yet to be confirmed

 

·         How would greater confidence as an outcome be measured -  School workforce perception surveys would be used as people reported feeling overwhelmed by the level of needs presented and meeting those needs in the way that they would wish.

 

·         The point was reiterated about needing to consider the money and future sustainability at the outset and about expectations being met.

 

·         There was still a lack of awareness about the Trailblazer across the wider workforce, including staff from Early Help, which a need to educate them.  - This would be taken back as a local reference group included staff from Early Help so information should be cascaded.

 

·         How will it contribute to schools as at present the support mentioned is low level, so what system is there for higher need levels and those close to exclusion?  - Others had fed this in as well and it was a case of challenging and unpicking.  It was still very early days and practitioners were still training but once embedded it would be clearer.  Existing pastoral support was good for children feeling “upset” and it was the next level where people needed support.

 

·         Reassurance was sought that the rumour that CAMHS support would be withdrawn from Trailblazer schools was untrue. – That rumour had been challenged very robustly.

 

·         What method was employed in choosing participating schools and was there any danger some with the most needs were overlooked?  Were there plans to roll it out more widely later?  - Levels of need in each school were considered and performance data, together with deprivation.  NHSE guidelines were also referred to regarding the number of students who would be involved.  Schools had to bid in and want to be part of the project.  Secondaries would also be expected to link in with their feeder primaries.  It was reiterated that the SEMH strategy and the priorities within it applied to all schools across the Borough not just those in Trailblazer.

 

·         A four week standard waiting time was referred to; what was it currently?  - Approximately six.

 

·         The Chair returned to two recommendations made at the previous meeting.  One had been for consideration to be given to having a lead case worker for families as their dedicated single point of contact.  Was this happening?  - Yes but this would depend where the child sat in the system and could be a social worker, someone from Early Help, the EHCP coordinator or a single point of contact within the  school.

 

·         The second had been for consideration to be given to support for LGB&T+ young people as Members were aware of long waits for Tavistock and Porterbrook Clinics.  Was there anything specific in the strategy or in Trailblazer for that cohort of young people?  - It had not been highlighted in either but that could be picked up.  Information about support through Early Help would be circulated again.

 

The officer was thanked for her attendance and presentations.

 

Resolved:

1)    To note progress on the implementation of the Mental Health Trailblazer pilot.

 

2)    That details of the training and types of interventions to be delivered in schools be provided for the Select Commission.

 

3)    That consideration be given to including support for LGBT+ young people as a cohort within the SEMH Strategy and within the Trailblazer Project.