Targeted youth support: redesigning services - improving the mental health of young people

Issue

Assessment data from across young people's services shows that increasing numbers of young people, especially those not in education, employment or training, are demonstrating mental health problems in Nottinghamshire.

Background

The integrated services partnership has encouraged multi-agency collaboration in identifying and working with young people with mental health problems in Nottinghamshire, especially the youth service, Connexions, educational psychology and educational welfare.

To meet its targets and the needs of young people, the local child and adolescent mental health services (CAMHS) identified a need to change its service delivery. This happened at around the same time as the start of the targeted youth support (TYS) pathfinder. As a result, the TYS and CAMHS developments were merged, creating one development programme.

There has also been, and continues to be, significant structural change within schools in the authority, including workforce reform and the development of extended services. These schools need help to support pupils with the most challenging behaviour (often with mental health issues) and to keep them in education.

Actions prompted by TYS

The participation of young people is a key theme of the TYS change process. Of the young people engaged in Nottinghamshire's process, 98% knew of the Connexions centre and its services. The young people asked for easier and more comprehensive early-intervention and prevention advice and support, rather than services reacting only when problems are established, by which stage they are often entrenched.

The TYS multi-agency workshops and change teams (made up of frontline staff from a range of agencies) have forged better communications and understanding between services and helped develop a shared language. This has begun to help shift a number of the rigid cultural boundaries between professionals and agencies and has enabled these agencies to develop a collaborative approach to improving mental health provision.

A strong focus of this redesign has been on maintaining and encouraging mental wellbeing, making early intervention rather than simply responding when problems manifest themselves. Implicit in this is the involvement of a range of agencies which, working together, are able to identify and support young people as soon as any issues arise -  tiers 1 and 2 provision.

Benefits and results

The CAMHS partnership has provided training to tiers 1 and 2 services (including voluntary sector services), around early identification and appropriate referral for young people at risk of and with mental health problems.

All the involved agencies are motivated and keen to further improve their multi-agency collaboration. Despite the internal requirements of reform, schools have participated in this collaboration in a more proactive way than they've done in the past and it is hoped the work with schools will develop further in the future.

As a consequence of the above changes, there is an expectation that there will be a reduction in referrals to tiers 3 and 4 CAMHS and an increase in the number of young people identified as having mental health problems, measured through assessment by Connexions and other tier 1 services. It is hoped that the support these young people receive will prevent the development of serious mental health issues.

I would be surprised if we don't see long term improvements in outcomes for young people
Jo Baker, operations Director for Connexions Nottinghamshire Connexions and TYS change team member

The local authority

Nottinghamshire is a large county authority. The TYS pathfinder focuses on Ashfield, an area of deprivation. The authority's statistical neighbours include Derbyshire, Staffordshire, Warwickshire, Lancashire, Cheshire, Kent, West Sussex and Worcestershire.

Click to read other case studies on redesigning services to help young people with particular needs.