Development of integrated services in Leicester City

School and Community Mental Health Service

Outline

• Tell the story of Child Behaviour Intervention Initiative

• How and why of CBII• Recent developments TaMHS, CAMHS

Review (NAC)• Future plans• Threads running through these

developments

Purpose

“ To bring together the common agendas of Education, Social Services, Health and the Voluntary Agencies for children in Leicester.”

4 underpinning elements

1. A recognition that Education, achievement and reducing health inequalities are fundamental to improving life chances.

2. A commitment to life long learning to improve skills and confidence of parents

3. A shared new vision of mental health4. A commitment to improved access to

community based support

Aim development

S p e c ia lis t C A M H SR e d u ce w a it in g lis ts

Im p rove ap p rop ria te re fe rra ls

S o c ia l ca reR e d uce C h ild P ro te ctio n reg is tra tio ns

Im p ro ve su pp o rt fo r D u ty C a lls

E d uca tionS E N re g is tra tio n s lin ked to g rea te r n e ed

M o re e ffec tive u se o f sca re re sou rces

C B II

Stages

Pilot Stage 1999-2002

Careful evaluation: Psychologist/evaluators University of Leicester DeMontfort University

• 3 city areas – CAMHS waiting lists, Child protection registrations, SEN nos.

• 0 – 11 years

• Pilot results influenced national DfES design for BESTs

• City-wide roll out• Across all city• Across ages (0-16)• Increased staffing• Continual monitoring

and evaluation

CBII AIMS

1. To promote the life chances of children

2. To provide locally based support

3. To encourage a wider ownership of mental health

4. To ensure access to support for children and families

5. To engage coherently with voluntary agencies

6. To ensure issues affecting black and minority ethnic individuals are explicitly addressed.

Governance and management

Three levels

1. Daily management

2. Management group

3. Steering group

Linked to each other and parent agencies.

Governance and management

Management group(Responsible for the business plan)

Steering groupJoint CAMHSSteering groupParent agency

Line management

PMHW FSW EPsVol.

Sector

Ethics group

Cross agency staffing

• City Psychology Service Staff (Education)

• Family Support Staff (Social Service)

• Primary Mental Health Workers (CAMHS)

An illustration of CBII in action

• Over 5,000 children have received direct individual/group support (Aim 1)

• 60% Parents/carers reported improvement in family relations (Aim 2)

• Over 2,000 staff in city agencies received direct input/training (Aim 3)

• CAMHS waiting list reduced (Aim 4)• Voluntary sector rep involved in development of

business plan (Aim 5)• All referrals are monitored for ethnicity. (Aim 6)

CBII impact

Users:

•Direct access to CBII

•Fast response

•Targeted support

Providers:

•New initiative

•Engages all services

•Dual location

Planners:

•Brought together a wider ownership of service provision for children’s emotional well-being

Challenges and opportunities

• Better understanding of each other’s services

• Development of a shared understanding of language

• BEST development• Greater joint working through Children’s

Centres, Integrated Service Hubs (ISH)• CAF

Targeted Mental Health in Schools

• Additional funding• Leicester Phase 1 pathfinder• New multi agency team• CBII and TaMHS managed in Ed.

Psychology Service• PEP joint responsibility for CAMHS in LA• Now developing a School and Community

Mental health Team

TaMHS

• Aimed to link tier ½ to tier 2/3

• Specialist support• Training and advice• Staff support• Whole school mental

health support

School and Community Mental Health Service

• Adopt recommendations of CAMHS review

• Develop more integrated 0-19 services

• Better linkages with specialist CAMHS

• CYPS developments supported.

Lessons

• Holistic is better – may be more difficult!

• Planning is essential• Agreement prior to

development• Involve all (including

voluntary)• Keep child at centre.