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Taking a whole system approach to children’s mental health

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A new and independent Care Quality Commission (CQC) review of mental health services has set out how local systems can ensure that children and young people have timely access to high-quality mental health care.

The CQC was asked by the Prime Minister to conduct a review of children and young people’s mental health services in January 2017. The phase one report was published in October last year and summarises what is currently known about these services.  The phase two report published this month, draws on evidence gathered through fieldwork in ten health and wellbeing board areas of England and conversations with around 1,400 people.

The latest report contains a number of recommendations which will chime with local early help teams supporting children and families with mental health problems.

Key findings

  • The report recognises that across the mental health system, there is fragmentation at every point from planning and commissioning to oversight and regulation. These obstacles prevent those working at a local and regional level from realising the vision of joined-up, personalised care and support.
  • Listening to children, young people, their parents, families and carers, and involving them in decisions about their care, helps mental health professionals to provide personalised care that is tailored to individual needs.
  • Where children, young people, their parents, families and carers did not have a consistent relationship with the same members of staff over time, this was also detrimental to the quality of care. Staffing changes meant they could not build trusting relationships.
  • Too often, CQC found that children, young people, their parents, families and carers have to be at the point of crisis before being able to access the right support.
  • A number of useful practice examples are presented in the report, including one area putting in place a multi-agency partnership that brought together 15 of the different parts of the system involved in children and young people’s wellbeing. This included the police, social care, specialist CAMHS services and local ‘early help’ services that support families to address problems early on.

CQC recommendations

  • Sustainability and transformation partnerships (STPs) and integrated care systems to reach out to education, police, probation, the third sector and beyond, ensuring they are involved in designing and delivering better quality, more joined-up mental health support.
  • Existing Local Transformation Plans (LTPs) are given a statutory footing, ensuring local authorities explicitly set out a local offer for children and young people’s mental health and wellbeing in the same way the Children and Families Act 2014 requires for children who are disabled.
  • Local offers must also address the on-going problem of poorly planned, disjointed transitions by setting out how commissioners and providers of children’s services and adults’ services will jointly deliver evidence-based and person-centred transitions. This would make sure that local systems take a joined-up, holistic approach to planning and delivering mental health support for all children and young people who need it.
  • Services should identify a single member of staff to coordinate support for each child or young person who needs helps from more than one team. The coordinator should manage input from different teams and services to make sure care is joined-up and make sure that each child or young person, and their parents, families and carers, can build a relationship with a single member of staff who oversees their care.
  • The inter-ministerial group (IMG) on mental health oversees national progress in delivering the recommendations included in the phase two report, alongside its other work to coordinate the most significant and far-reaching improvements to mental health support for children and young people across the country.

Click here to find out more about the CQC review of mental health services for children and young people or please leave a comment below.

Cecil Sinclair, Troubled Families Policy Adviser
Ministry of Housing, Communities and Local Government


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