Agenda item

The following reports outline the current factors that influence the emotional and mental well-being of children and young people (to age approximately 19) in the City, and how the local system can jointly support a high level of emotional and mental well being in the younger population.

The Director of Prevention, Commissioning and Education and Skills and the Director of Mental Health and Complex Care for NHS Vale of York Clinical Commissioning Group (CCG) Children’s Services presented a report to Members on the subject of Emotional and Mental Well-Being of Children and Young People.

They explained how early prevention could remove the need for CAMHS intervention and how workforce planning was in place to support its delivery.  It was highlighted that the School Wellbeing Service has been part funded by Future in Mind and the Council.  It was noted that the digital offer of the NHS long-term plan (LTP) enabled access 24 hours a day to telephone information and advice for parents.

The local service structure was explained and increase in demand for services was highlighted.  Areas causing concern at the system level were identified in Annex 1.  The future plans were explained and it was acknowledged that better integration with improved use of the skills and abilities from the voluntary sector was needed.  Issues that needed major support were; eating disorders, autism and high levels of anxiety.

Officers were asked questions about the reorganisation of NHS commissioning in 2022, performance targets, the summit of system leaders, commissioning in the third sector, early intervention, identifying need and improving the data.

They noted the following:

·        The Humber Coast and Vale Integrated Care Board and the Humber Coast and Vale Integrated Partnership was the replacement for the CCG.  North Yorkshire and York would operate as a sub system of Humber Coast and Vale, in which the City of York would be a Place.  The Integrated Care Board (ICB) was not yet appointed.  Certain functions and the budget for York would be delegated to the Health and Social Care Alliance which works between the council and the CCG.  Children’s mental health was a priority area for the alliance.

·        Tees Esk and Wear Valleys NHS Foundation Trust (TEWV) had been operating in excess of targets since they had been set in 2016.  Third sector commissioning such as CAMHS and York Mind are a contributing factor in achieving targets.

·        There had been no decision to reduce or ‘ration’ Mental Health provision through CCG commissioning or within the council.  Service vacancies were not coexistent with a planned reduction in staffing numbers.  There was no limit on mental health services and funding would prioritise children’s services.    

·        The full action plan, about the future of children’s mental health services in the city, from discussions between the summit of system leaders would be shared in due course.  The action plan would cover short term targets, such as addressing high levels of non-school attendance and longer term commissioning plans including the joint working approach.

·        There were a number of socio economic factors such as poverty/low income, poor housing, unemployment, family background and poor caring that can indicate a pre-disposal to mental health issues.  A number of different service providers and council departments, such as Housing and the Community Resilience Board, were working together to identify children at risk.

·        Virtual or face to face counselling takes place following the iThrive model of getting early help.  Websites are a part of the service and include information for parents.

·        A performance report was being  produced for the council’s Corporate Management Team (CMT), The report would include waiting times and would be available for further discussion across other committees.

Discussion took place  between Members, Officers and External Attendees.  Contributions from the external attendees are summarised below:

Sophia, a member of the York Youth Council and York’s Member for the UK Youth Parliament, explained that mental health had been identified by the Youth Council as the top issue for young people in York and nationally.  She explained that a system that had been introduced in her secondary school to enable students to request help via email, this was an approachable method that removed barriers.  She asked what plans were in place for young people who had early symptoms of undiagnosed serious daily mental health issues.  She also raised concerns about the increase in eating disorders among her peer group.

[19:02 Cllr Barnes and Cllr Cuthbertson left the meeting]

Carol Redmond, Head of Service for York, from Tees, Esk and Wear Valley NHS Foundation Trust (TEWV) gave a presentation on CAMHS.  She highlighted their aim to front load services through early intervention, in order to reduce waiting times.  She explained that eating disorders had increased both nationally and locally during the pandemic and were continuing to rise.  During the pandemic referrals had declined but they were now peaking at 300/350 per month.  All children in York could access the school well-being service as well as the counselling offer from York Mind, whilst they were waiting to access CAHMS services.  The Care Quality Commission (CQC) had undertaken a part inspection of CAMHS where the service had received a Section 29 notice regarding staffing levels, review systems and training.  Overall the service was rated as ‘requiring improvement’. By November 2021 there had been a review of the number of all young people waiting for treatment and key actions had been put in place for improvement.

In response to questions from Members, it was noted that there were specialist mental health staff shortages and that staffing the school-based teams had depleted the main teams. It was also noted that local training providers were increasing nurse training places with the aim of building expertise.

Elizabeth Hewitt, Systems Change Manager for York Mind described a ‘bottleneck’ for York’s mental health services.  They had interviewed young people and stakeholder groups and it was noted that young people did not know where to access  support and did not feel heard.  With funding from the Co-op resilience fund, a website to support young people’s mental health in the city was being constructed.  The website would include a referral system and access to early help. Ann information campaign on young people’s mental health services would be delivered to secondary schools.   A podcast was proposed to go alongside other proposals, and would include significant  level of co-production with young people.  Funding was needed to develop a specific youth mental health training programme to support teachers and GP’s.

[19:25 Cllr Vassie left the meeting]

Helen and Tasha, representatives from York Mind’s Young People’s Steering Group, highlighted the difficulties in transitioning from children’s to adult services.  They explained how important it was to acknowledge trauma and that that they had found it helpful to socialise with people in a similar position to themselves.

[19:32 Cllr Taylor left the meeting]

The Chair thanked all those who had written reports, attended and contributed to the meeting.

Resolved:  

                                     i.        That the reports be noted.

                                    ii.        That the Children and Young People’s Mental Health Scrutiny Review take their findings and recommendations to Executive.

Reason:              To keep the Committee updated on the progress of the task group and to inform the Executive of their findings.