changing the odds in favour of young people keith coulston head of mental health & wellbeing
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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