Mental healthcare services

An independent review of Children and Adolescent Mental Health Services (CAMHS) (NHS England, 2014), indicated that many children and young people with mental health and emotional difficulties do not receive timely, high quality, accessible or evidence-based support.

In response, the government set out clear direction on how to make it easier for children and young people to access high quality mental health care when they need it in its strategy document Future in Mind (April 2015). 

Bracknell Forest Council works in close partnership with Berkshire Healthcare NHS Foundation Trust, GPs, schools and voluntary sector organisations to commission services for the local population.

In Bracknell Forest, there is a focus on addressing children and young people’s emotional and mental health concerns at an early stage so they do not escalate into more serious mental health conditions.

The Transformation Plan for Children and Young People in Bracknell Forest is a separate section on the JSNA website.

Key inequalities and risk factors

For detail on inequalities and risk factors see the JSNA chapter on Children and Young People’s Emotional Wellbeing.

Facts, Figures, Trends

For facts, figures and trends in need see the JSNA chapter on Children and Young People’s Emotional Wellbeing.

The national strategy ‘No health without mental health’ highlights six objectives to improve mental health:

  • more people will have good mental health
  • more people with mental health problems will recover
  • more people with mental health problems will have good physical health
  • more people will have a positive experience of care and support
  • fewer people will suffer avoidable harm
  • fewer people will experience stigma and discrimination

It also suggests that the following should be considered to help achieve these goals:

  • continued public awareness raising to reduce stigma of mental health
  • training for a wider range of professionals on mental health to improve general awareness of mental health and wellbeing
  • holistic consideration of how individuals needs could be met in the community after discharge from hospital, for example, appropriate accommodation and signposting to other support services.
  • systematic preventative approach with greater connectivity between other health and mental health services, e.g. smoking cessation and mental health services
  • capability to address high cost placements and facilitate early discharge back into local services
The local Transformation Plan sets out current provision, gaps and high level priorities for:
  • Integrated whole system approach to drive further improvements in outcomes  - the ultimate aim is to improve the mental health and wellbeing of children and young people together with partners from Bracknell Forest Council, the Royal Borough of Windsor& Maidenhead and Slough Borough Council
  • Emphasis on building resilience, promoting good mental health, wellbeing, prevention and early intervention  - supporting children and young people to remain resilient to be able to cope when things go wrong and reduce likelihood of mental health problems which can significantly impact in other aspects of life and affect life chances
  • Services designed around the needs of children, young people and families - working together to design and deliver our services taking into account the views of children, young people, carers and families
  • Improve access with the right support from the right service at the right time, close to home - ensure that children and young people get timely access to help and support, provided as far as possible within the local community
  • Joined up services that are easy to navigate for children and young people, including those most vulnerable – accessible services through a variety of contact methods and channels including online, face-to-face and in a range of venues including schools
  • Continuous evidence-based service improvement delivered by a workforce with the right skill mix, competencies and experience - working together with partners to develop the most appropriate workforce now and in the future
  • Improve transparency and accountability across the whole system – clear about resource usage, evidence-based collaborative decision making - a commitment to working collaboratively and accountably for expenditure, activity and outcomes across the whole system of delivery

Children and Adolescent Mental Health Service (CAMHS)

CAMHS services are provided by Berkshire Healthcare NHS Foundation Trust.  Services have been undergoing a process of improvement over a number of years to cope with increasing demand. Following a review in 2014, a number of recommendations were implemented in 2015.

Services are now accessed via a Common Point of Entry (CPE) with one telephone number for referrals or to get support/advice. The effectiveness of CPE will be evaluated during 2016/17 to assess if CPE leads to appropriate referrals and is supported with appropriate staffing.

There are a number of treatment paths:

  • ADHD (attention deficit hyperactivity disorder)  – assessment and treatment
  • ASD (autistic spectrum disorder) – diagnosis only
  • Anxiety and depression – moderate to severe cases
  • Eating Disorders – see section 6.4 for proposals to expand
  • Early Intervention in Psychosis (EIP) for 14+ years

CAMHS acute provision

One in ten children aged 5-16 years has a clinically diagnosable mental health problem and, of adults with long-term mental health problems, half will have experienced their first symptoms before the age of 14. Self-harming and substance abuse are known to be much more common in children and young people with mental health disorders – with ten per cent of 15-16 year olds having self-harmed. Failure to treat mental health disorders in children can have a devastating impact on their future, resulting in reduced job and life expectations.

In 2014/15, the rate of children and young people aged 0–17 living in Bracknell Forest who were admitted to hospital for a mental health condition (per 100,000 population) was 39.5 (accessed 4 May 2016).  This represents a downward trend which is also significantly lower than the value for England.

Self-harm

Self-harm is one of the top five causes of acute medical admission and those who self-harm have a 1 in 6 chance of repeat attendance at A&E within the year, it is often symptomatic of a range of other risk factors such as age, ethnicty, social circumstances, deprivation.

Self-harming in young people is not uncommon (10-13% of 15-16 year-olds in England have self-harmed in their lifetime), although only a fraction of cases are seen in hospital settings so figures risk being under-reported. Admissions for young women are much higher than admissions for young men. The rate of hospital admissions in 2014/15 (accessed 4 May 2016) in Bracknell Forest is significantly better than the all England rate:

Online support and counselling

To develop more widely available and accessible support, online counselling support and advice services for young people aged 11–18 were piloted in Bracknell Forest in 2015/16.

This lead to the commissioning of KOOTH which provides young people with a web-based alternative to existing face-to-face counselling services available seven days per week, between 12pm and 10pm weekdays and 6pm - 10pm at weekends.  GPs, schools and the Berkshire CAMHS service can signpost and young people can self-refer.  Performance data is reported annually in June. For more information on KOOTH visit their website for contact details:

 

Free, friendly and confidential online support  and information on anything drugs and alcohol realted is also available from the SMART website.

Online resources

The Bracknell Forest YouTube channel also has a number of short videos to view and share on reducing stigma by opening discussion about mental health: 

YouTube video link

And messages from young people themselves:

YouTube video link

Want to know more?

The following may be helpful for mental health commissioning to reach young people at a level that is appropriate to their need.

The Transformation Plan for Children and Young People in Bracknell Forest is a separate section on the JSNA website sets out current provision, gaps and high level priorities for action.

Best start in life: promoting good emotional wellbeing and mental health for children and young people (Local Government Association, 2016) - examples of councils that are looking at innovative ways to provide support with a focus on children and families rather than static services, as well as more information about the scale of the problem and what steps can be taken.

CAMHS Needs Assessment (National Child and Maternal Health Intelligence Network) – an aggregate of relevant data to help identify the needs of a target population and prioritise those needs to ensure good planning of local services.

The Child and adolescent mental health services (CAMHS) dynamic report synthesises a range of different sources of data to provide a holistic picture of need in the borough, including support for children with special education needs.

Future in Mind (Department of Health, 2015) – the government’s direction on how to promote, protect and maintain the mental health of children and young people by making it easier for the most vulnerable to get support that works, at the right time and delivered by an appopriately skilled workforce:

  • Better commissioning information - Not enough information is available about what services do, how many young people are seen, what it costs and what the results are. This information (data) is needed to make improvements.
  • Improved choice, appropriate referrals and reduced waiting times – consideration of a wider range of support including easily accessible online support and counselling to provide an alternative to, or supplement to, face-to-face or telephone support, as appropriate.
  • Accessible services at point of need – services available out of hours services at point of urgent need, suitable services across a range of identified support areas
  • Improved awareness –informed professionals across the health, social care, educational and other workforces to facilitate and enable appropriate signposting for young people and their parents
  • Support for young adults moving from CAMHS to the adult services with significant mental health issues
  • Longer term therapeutic input for children with enduring mental health or attachment issues who don’t meet the criteria for more specialist medical support.

Key facts and trends in mental health 2016 (NHS Confederation: Mental Health Network) - an overview of the major trends in the mental health sector compiled from a wide range of sources. Data relates to investment in services, trends in morbidity, suicide and homicide rates, service activity, use of mental health legislation, mental health of children and young people, service user experience, inequalities experienced by people with mental health problems and workforce and staff satisfaction.

MindEd (Royal College of Paediatrics and Child Health, 2016) - free educational resources on children and young people’s mental health for all adults.  topics such as e-safety, self-esteem, personal skills, digital risks such as cyberbullying, pornography and radicalisation.  MindEd is funded in part by government and led by our sector partner, the Royal College of Paediatricians and Child Health.

Social and emotional wellbeing for children and young people (NICE, 2013) – advice for commissioning services developing children’s social and emotional well-being.

State of the Nation (CentreForum Commission on Children and Young People’s Mental Health, April 2016) – reports higher numbers, higher thresholds for treatment, longer waiting times and explores the risks and barriers to effective implementation of the current policy agenda and then to make recommendations to government and local commissioners in order to support the process of transformation over the next five years.

Supporting public health; children, young people and families (PHE, updated 2016) - guidance to support local authorities and providers in the commissioning and delivery of services across the highest impact health and wellbeing outcomes for children and young people through the 0-19 healthy child programme.

 

This page was created in February 2014 and updated on 20 June 2016.

Cite this page:

Bracknell Forest Council. (2016). JSNA – Children and Young People’s Mental Healtcare Services. Available at: jsna.bracknell-forest.gov.uk/developing-well/children-and-young-peoples-wellbeing/mental-healthcare-services (Accessed: dd Mmmm yyyy)

 

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