“Children with a persistent mental health problem face unequal chances in life. This is one of the burning injustices of our time. It is our collective duty to ensure that we take action to promote and protect the mental wellbeing of our children and young people.”
The Government has published Transforming Children and Young People’s Mental Health Provision: A Green Paper, which proposes reforms to improve the mental health support that young people can get at school or college and to ensure they have better access to specialist NHS mental health services if they need it.
In January 2017, Prime Minister Theresa May gave a speech about the ‘shared society’, setting out her vision for improving the mental health of people of all ages, with an emphasis on early intervention for children and young people and the important role of schools. The green paper builds on the recommendations of Future in Mind (2015) and the plans in the NHS Five Year Forward View (2016).
The new measures outlined in the green paper are part of a £300m investment by the Department of Health and the Department of Education, which is in addition to the existing Government commitment of £1.4bn in funding to improve Children and Young People’s Mental Health provision up to 2020.
Plans for schools and the NHS to work together to improve support
The green paper places focus on schools as part of a wider mental health system that brings together services across the NHS, education, public health, the voluntary sector and the justice system. It makes three key proposals.
- A trained senior mental health lead in every school and college to ensure pupils can access pastoral support and set policies to tackle issues such as bullying. The senior leads model has been tested through the Mental Health Services and Schools Link Programme which DOE and NHS England piloted in 255 schools in 2015/16, and a second phase of the link pilot will test activity in 1,200 schools and colleges across 20 CCG areas. Training for senior mental health leads will be rolled out to all areas by 2025.
- Earlier access to services through the creation of Mental Health Support Teams to link NHS mental health services and schools – these teams will be trained staff, supervised by NHS CYPMH services, who will offer individual and group help for those with mild to moderate mental health issues such as anxiety, low mood and behavioural difficulties. They will work closely with the senior mental health leads in schools and will ensure that children can access help from specialist NHS services if they need it. The teams will provide an assessment and referral function, as well as additional support during treatment.
- A new maximum four week waiting time for all children and young people who need treatment by NHS CYPMH services. This builds on the introduction of waiting time standards for psychosis and eating disorders. The areas involved in the roll-out of Mental Health Support Teams will explore the best ways of reducing waiting times in preparation for the implementation of the new waiting time standard. In many areas, new models of delivery such as THRIVE and referrals via a single point of access are already improving access to services and reducing waiting times.
Phased roll out
These three new approaches will be rolled out in phases to cover 20-25% of the country by the end of 2022/23. Preparations for the introduction of Mental Health Support Teams will start with recruitment of trainees to teams in the trailblazer areas and training provision from September 2018. Trailblazer areas will pilot the new approaches from 2019 to gauge what will work, with further rollout and allocation of funding to be confirmed after 2020/21. Following evaluation of the trailblazer approaches to the first phase of implementation, the trailblazers will provide implementation support to other areas in the roll-out.
Wider action to support children and young people
In addition to the three new approaches for NHS services and schools working more closer together, the green paper proposes ‘wider action to support children and young people’, including:
- mental health awareness training for teachers and frontline professionals in every primary and secondary school
- changes to teacher training to help new teachers understand typical child and adolescent development and recognise emotional development and mental health issues
- teaching all pupils about how mental wellbeing can support healthy relationships as part of Personal, Social, Health and Economic Education (PHSE) and other lessons
- measuring impact and recognising what schools do, with Ofsted looking at evidence to inform the development of a new inspection framework for September 2019
- a report by the Children’s Commissioner on how the internet and social media affects the mental health of children and young people
- research into how to support better families who need help with their mental health, and how to prevent mental health problems in children and young people
- training one million members of the public in basic mental health awareness and first aid, starting in 2018, to help them take care of their own mental health and that of others
To support young adults making the transition between CYPMH and adult services, the government proposes a new national partnership to improve mental health services for those aged 16-25 years. The area of focus is to be decided but could be, for example, student mental health and closer working between health, education and local authority services. The second phase of the CQC’s thematic review will also identify good practice in the transition for young people between services.
The Government is asking people – including young people – for their views on the green paper, and this consultation, which is focused on how the proposals will be implemented, will close on 2nd March 2018. View a video about the consultation and contribute your views here.