Decision Maker: Health and Social Care Scrutiny Commission
Decision status: Recommendations Approved
Is Key decision?: No
Is subject to call in?: No
The chair invited Genette Laws, Director of Commissioning, Children’s and Adults’ Services, Southwark Council and Ross Graves, Managing Director, NHS Southwark Clinical Commissioning Group (CCG) to provide an update on Southwark’s joint Mental Health strategy.
Officers went through the presentation and explained that the cabinet had committed extra spending of 2 million to be spent in schools. The ambition to meet the 100% target of children and adolescents with Mental Health needs being addressed by 2020 is being overseen by Cllr Jasmine Ali’s CAMHS Commission. This will in part be achieved through improved open access service.
The chair invited the Commission members to ask questions:
i. Members asked if the additional 2 million pounds is a one off. Officers said it is, however the sum is likely to be spent over longer than one year. Some schools already spend a significant amount of their own budget on supporting mental health; for example East Dulwich Harris Girls spends approximately 100,000 a year. A legacy of this investment could be realised in programmes such as training.
ii. Is the Southwark 100% target higher than the NHS target? Officers confirmed it was.
iii. How will achieving the 100% target be monitored, and in particular how will officers know if the planned open access service will be reaching young people in need ? Officers said that around 50 children and young people are refused by CAMHS each month – this new service will see this cohort. Officers said the open access provision will not be the only answer. There will also be work to encourage young people to talk, including a digital offer, which incorporates virtual reality. The other strand is supporting families to support young people’s mental health. The open access centre will also be for the whole family. Members recommended that a good baseline of present access to Mental Health services is established, with timelines and milestones for reaching the 100% target.
iv. How will the children and young people who are furthest from schools and services be reached? For example children and young people who are truanting, or young carers , or young people who do not trust services enough to engage? Officers reported that have spoken to YouThink peer navigators who have entered the criminal justice system. They are also talking to educational Alternative Provision. The open access service could be attractive young people who are not otherwise engaged. Officers agreed that services do need to ensure that the most disengaged and excluded young people, who are often most in need, are being targeted and reached.
v. What about reaching young people in youth settings or where they congregating? Officers said that they are looking as coffee shops, and Wi-Fi spots for pop ups.
vi. Is the stigma of mental health still an issue; it appears to be reducing but still present? Officers agreed stigma is present and work is needed to further address this. This aspect links to equalities as the chances and fear of Sectioning is disproportionally higher in BAME communities. Services do need to demonstrate that they are available and viable sources of support for all young people.
vii. What about waiting times from doctors to CAMHS? How long are these? There are waits for assessment between GP and CAMHS. We are looking at GP training and linking with community and VCS support.
viii. Could we have more information on boys’ and men’s mental health, and ethnicity; the two themes of the scrutiny review? Officers reported that they are doing a deep dive on services, which may show underrepresentation for boys and different ethnicities. An event with FutureMen which looked at some of these issues. Officers will come back with some more information on these topics.
ix. What age is CAMHS? Up to 18. It is a hard stop and officers said they want to see a better transition. A recent workshop to inform this work also looked at transition from primary to secondary. These are the points that it is good to engage children early – and there is wide support for the benefits of preventative work at these transition points.
x. How long will the CAMHS Commission last for? This is scheduled for 2 years. The Terms of Reference is available; this went to members as part of its establishment. Cllr Ali is due to be interviewed in January and an update can be requested.
xi. Is children’s and young people’s mental health worsening, with the impact of social media and other pressures? The Children’s Commissioner wrote an interesting report recently. The previous report estimated that 1/10 children and young people were in mental distress, now this has risen to 1/8, so this does look like a worsening situation, although this could also be partly a result of a rising focus on this issue. We want the open access to catch young people in distress.
xii. What is the impact of drug and alcohol use and abuse on mental health, particularly the rise of more potent cannabis strains and link with psychosis, as well as new party drugs like poppers, which seem prevalent? Officers offered to follow up on this.
More information was requested on boys and men accessing mental health services, along with more information on BAME communities, and alcohol and substance misuse services, including:
· Breakdown of most common mental health conditions by sex and ethnicity
· Accessing CAMHS services by sex and ethnicity
· Sectioning by sex and ethnicity
· Suicide and self harm data and trends by sex and ethnicity
· Alcohol and substance misuse by sex and ethnicity
What are the current waiting times for CAMHS services?
What baseline data, timeline, outcomes and targets being used to measure the effectiveness of the programme to provide 100% access to mental health services for children and young people?
Publication date: 22/11/2019
Date of decision: 14/10/2019
Decided at meeting: 14/10/2019 - Health and Social Care Scrutiny Commission