Agenda item

To consider an annual update comprising a full overview of Rotherham’s Child and Adolescent Mental Health Services and two case studies.

Consideration was given to a fifth annual update report and presentation in respect of Child and Adolescent Mental Health Services. The presentation was delivered by Place Partners including the RDaSH Care Group Director as well as by CYPS officers including the Joint Assistant Director of Commissioning, Performance and Improvement; the Interim Service Manager for Neurodiversity; and the Service Manager for CAMHS and With Me in Mind. The presentation was introduced by the Cabinet Member for Children and Young People.

The presentation noted the progress made to implement strategies to support children and young people to have good mental health and emotional wellbeing. The presentation addressed:

•       Local Area SEND inspection in association with children and young people’s mental health,

•       Kooth digital mental health support

•       CAMHs pathways including progress in relation to implementing the re-designed neuro-developmental pathway

•       SEND sufficiency strategy

In discussion, Members requested clarification of the average wait time for CAMHS services. The response noted that the Service saw 70% of young people get help within 18 weeks. The longest wait times were 31 weeks.

Members noted a scenario that was representative of the difficulty encountered by families waiting on the neurodevelopmental pathway for diagnostic assessment. Members observed that two years’ wait can have a detrimental impact on a child’s long-term educational development and mental help. Members requested assurances that dispersed attention across multiple pathways, schemes and systems was not drawing resources away from working down the backlogs and reducing waiting lists for assessments that were needed most. The response from the Assistant Director for Commissioning, Performance, and Improvement, CYPS, noted that, in presenting the information around the number of children who were moving through the diagnostic pathway, this was not to suggest that the Service were not aware of the difficulty families were experiencing nor that the Service were not working very hard and doing all that they can to help reduce the waiting lists and ensure that children are able to access the services they need. The service acknowledged this and intended to present a rounded view of the services as a whole. The challenges associated with delivering a high volume of diagnostic assessments without reducing the quality of the assessments were described, and the Service were committed to ensuring that assessments delivered were of high quality. It was affirmed that access to resources and services should not be assessment dependent. New provision at Dinnington and further capacity being added to provide additional school places for children who would be on the waiting list for diagnostic assessment were also described. It was advised that if Members became aware of families that were not getting the support they needed because of not having a diagnostic assessment, please let the Service know. It was emphasised that support should not be diagnosis dependent.

The Cabinet Member for Children and Young People noted that budget pressures had been acknowledged nationally and emphasised the need to understand why children were experiencing mental health issues and poor mental wellbeing. Potential contributing factors were noted. Neurodiverse assessment was a separate issue. Schools needed to provide a graduated response for neurodiversity – an area that was highlighted in the SEND inspection. Children should have access to mainstream education at their local school as far as they possibly can, with the specialised neurodiverse support such as the resource base that the Service were working to put into place. There was a need to avoid labelling children unnecessarily with a mental health condition or pushing children through an assessment, raising the frequency of inappropriate referrals. Schools needed to provide graduated response and want to do so. Schools would need support to be able to deliver this, and the challenges faced by schools currently need to be considered. For example, schools were experiencing recruitment challenges congruent with other sectors. There was substantial work being undertaken in this area and results of the new consultation on the Government Green Paper was expected to be enacted in the New Year. Finance was important, but everyone involved agreed that children having access to the support they need was more important. Members with any concerns were asked to get in touch.

In discussion, Members noted the areas for improvement identified in the SEND inspection, requested more information around how parents and carers were being engaged. The response from the Cabinet Member indicated that the report had been tailored toward mental health. Progress had been made in these areas, and this information would be presented as part of a forthcoming report on SEND sufficiency that would be scrutinised at Improving Lives Select Commission. Members noted that the missing information would fit with the flow of the report.

Further clarification was requested regarding how the waiting list was prioritised and the safety nets in place. The response from officers noted that if something changes for the young person whilst waiting, they were asked to get back in touch with the Service. The Multi-Disciplinary Team conducted triage, and most young people received help within 18 weeks. If there was a more urgent need, the Service responded appropriately. The Service kept in touch with those waiting longer.

Further clarification was requested around access to support for families and the child whilst going through the process and after diagnosis. The response from officers noted the avenues to support. Educational specialist psychologist support was available and there was a lead practitioner throughout the process. Following diagnosis, there was a referral to the Service to make the appropriate appointments and address medication needs depending on the complexity. There was also support available through Early Help, SENDIASS, and the Parent Carer Forum. There would be more made available through the SEND sufficiency phase four. The Cabinet Member described the close partnership with Parent Carer Forum.

Additional clarification was requested around the support available within schools. The response from officers noted that the With Me in Mind programme was currently funded to reach 60% of schools. The hope was that the programme would be extended. The Cabinet Member described ongoing discussions with schools about support offered, and noted steps taken to continue the With Me in Mind programme.

Resolved:-

1.    That the report be noted and that the next update be submitted in 12 months’ time, to include performance data.

2.    That the information regarding engagement with parents and carers be circulated to Members.