The Highland PMHW team through GIRFEC and health and social care integration – how we got better at early intervention.

Highland

Population 232,950

Team lead and 12 Primary Mental Health Workers

Phoenix Centre

Support Worker

Social Worker

Behaviour Specialist

Children’s Services Worker

TeacherSpeech

and Language Therapist

School Nurses

DoctorResidential Worker

Early Years Centre

Health Visitor

Specialist Mental Health Worker

Primary Mental Health Worker

CARE and LEARNING SERVICE

Educational Psychologist

• Line managed in Community Health Partnerships (CHP’s)

• Different focuses in each CHP• Professional Lead from tier 3 service.• Occasional attempts every year to meet with a

team but never with a driving agenda or focus • Tier 2 and Tier 3 ‘issues’• Children and Young People’s Mental Health: A

framework for promotion, prevention and care (2004)

Pre 2012

1. A focus on improving outcomes for children, young people and their familiesbased on a shared understanding of well-being2. A common approach to gaining consent and to sharing information whereappropriate3. An integral role for children, young people and families in assessment, planningand intervention4. A co-ordinated and unified approach to identifying concerns, assessing needsand agreeing actions and outcomes, based on the Well-being Indicators5. Streamlined planning, assessment and decision-making processes that lead tothe right help at the right time6. Consistent high standards of co-operation, joint working and communicationwhen more than one agency needs to be involved, locally and across Scotland7. A Lead Professional to co-ordinate and monitor such planned support for a child.8. Maximise the skilled workforce within universal services to address needs andrisks at the earliest possible time9. A confident and competent workforce across all services for children, youngpeople and their families10. The capacity to securely share demographic, assessment and planninginformation within and across service and agency boundaries, using electronicsystems when possible.

Core ComponentsThe Highland Practice Model, based on Getting it right for every

child, is founded on10 core components which are applicable to all settings.

• 1. What is getting in the way of this child’s wellbeing?

• 2. Do I have all the information I need to help this child?

• 3. What can I do now to help this child?• 4. What can my agency do to help this child?• 5. What additional help, if any, may be needed

from other agencies?

5 questions

April 2012 – Lead agency model starts • NHS staff working in non hospital Children's

services transferred to Highland Council.• Highland council staff working in adult services

transferred to NHS Highland. October 2014 – Family teams developed

Health and social care integration

• Initially a worrying time – at start of process Practice Guidance written

• Managed in council within Additional Support Needs team

• For first time we all had one line manager• Line manager created a ‘sense of belonging’

PMHW team and integration

• Monthly team meetings • Mission Statement • Improvement Plan – based on outcomes in For

Highlands Children• Increase in joint working and planning with

other services including Tier 3 CAMHS• Developing clear pathways into the service –

Consultation leaflet • Clear roles and interventions within Early years

and School years

Moving forward

Primary Mental Health Worker Service

MISSION STATEMENT

“The Primary Mental Health Worker Service builds capacity within other agencies and provides early intervention to support the mental health and emotional wellbeing of children, young people and their families, within their local

communities, through consultation, direct intervention and training”

Our Professional Learning Community works within the following framework:

Principles: Valuing diversity Being open and confident as a team Being child/family led.

Delivery:

Evaluation of practice demonstrates quality and effectiveness Engagement in developing evidence based practice Practice/intervention is developed from themes emerging from

supervision/consultation

Process: Clear agreements communicated to others and adhered to by all

PMHWs (eg. admin, paperwork, file keeping etc) Provision of an equitable service across Highland. Appointment of a professional lead to support practice issues within

the team.

Training & Development: Agreed core training for all PMHWs Regular, on-going training for the PMHW team, informed by required

skills, individual interests, annual professional development reviews. Providing time for sharing good practice and feedback from training

attended.

• Children and young people are supported to achieve their potential in all areas of development.

• Children, young people and their families are supported well to develop the strengths and resilience needed to overcome any inequalities they experience.

• Improvement in service provision is determined by the participation of children, young people and families and by understanding their views, wishes, and expectations.

PMHW priorities from For Childrens 4 outcomes

Joint working/planning

Emotional Literacy training with Positive

relationship team ASIST training with adult services

VIG with Educational Psychology Scottish Mental Health

First Aid:Young People

Mindfulness Based Stress Reduction

Teen Screen

Self harm and suicide guidelines

Tragic incident policies

Curriculum for

Excellence

Early years services and development