Agenda item

The Chair and Members of the Health and Adult Social Care Overview and Scrutiny Panel gave consideration to information provided to young adults (aged 18–25) experiencing mental health problems in Doncaster.  This included the support to young adults who transitioned from receiving support from Children and Adolescent Mental Health Services (CAMHS) to being supported by Adult Mental Health Services (AMHS).  An updated was also provided on a new provision established in Doncaster (‘Better You’), a service offering mental health support to young adults aged 18-25.

Reece spoke about his experiences with Better You and how it had been better than when previously dealing with social services and other services.  He explained that he had never felt listened to before and had struggled with confidence and opening up, however, this had changed once he had started engaging with this service.  He added that he can be himself and will only receive calls to check if he is ok which he greatly appreciated.  Reece spoke about how the service had helped him resolve issues with his Universal Credit and that he had progressed to gaining full-time employment.

A discussion took place that included the following areas;

Joint Appointments – It was shared that CAMHS took the lead with joint appointments and that there was a link to the Care Co-ordinator in the AMHS, when enabling a transition into adult services.  It was explained that there were also Peer Support Workers (who have lived experience of mental illness).  Reference was made to the Transition Policy currently in place and it was outlined that Care Co-ordinators tended to be Band 6 Nurses within Adult Services that supported the transfer.  It was noted that Mental Health Services were currently being redesigned and therefore roles may look different in time.

Specialist Wheelchairs - It was clarified that new wheelchairs and aids made available to children and young people were individual to the user.  In response to whether these wheelchairs continued for users entering into adulthood, it was confirmed that these were reassessed and redesigned as needs changed and formed part of an ageless service.  The Chair expressed a wish to discuss this further outside of the meeting.

Contract Extension – It was noted that the mobilisation of the Doncaster ‘Better You’ service had been delayed in terms of establishing the premises and services and was therefore still considered a pilot.  It was explained that to make informed decisions, a robust set of both qualitative and quantitative information over a period of around 12 months was required.

Andrea Butcher explained that they had commissioned an independent survey through the Citizens Network, who were designing the report and undertaking interviews with RDasH and referrers.  Members were informed that they were working closely with commissioners who had visited the service and received the data (which included individual stories) demonstrating the impact of the service.

It was explained that the root cause analysis was undertaken to ensure that gaps in the service or access with young children were identified.  It was added that this information would be fed back to commissioners and responded to as they arose.  It was explained that work was being undertaken such as accessing GP appointments and ensuring that young people felt that they were being listened to.

It was acknowledged that as a pilot, the project was in its infancy, dealing primarily with basic needs for young people such as housing and food.  It was continued that as part of the next phase, there was an intention to continue with person-centred planning and approach.  Examples of areas being considered going forward included focusing on certain mental health issues such as trauma and coping mechanisms.

Location of Premises – It was felt that the location of the building helped to anonymise the building which reduced stigmatism.  It was commented that there was relaxed atmosphere experienced by young people and the outside park space could be utilised.  It was added that there was security in place at night and no lone working undertaken.

Members were informed that surveys were carried out through Facebook and sought opinions from young people on issues such as opening times and activities.  It was added that the service was accountable to the Young Board of Advisers.

Referrals – It was considered positive that referrals were coming in through a wide range of partner agencies. The Panel was informed that the largest percentage of referrals at 44%, came from Safe Space (who had begun referring at an earlier stage), 12% Care Leavers, 18% DWP, 7.2% CAMHS and then from other partners that included South Yorkshire Police and the Youth Offending Team.  It was hoped that the referral process could be widened to include more partners.  Members were assured that partners were aware of the referral form, however, a process was in place to review this.

Communication – Regarding Kooth (the online mental health provision), it was explained that engagement had taken place since March 2022 and had targeted GPs through their practices and events.  It was explained that different ways had been used to communicate the message to children and young people such as through assemblies and information provided on business cards and planners. It was continued that Community Engagement Officers had visited most secondary schools and would be progressing this work with remaining secondary schools and Doncaster College.  Finally, the Panel heard that providers such as RDASH, PFG and Doncaster Autism Services had been approached and asked to encourage further use of the online service. 

It was explained that demographics of Kooth users were monitored.  Members heard that work was being undertaken which looked at sub-locations, and being used to consider different patterns, for example, why was one area not using Kooth compared to another and how can that be improved.  A Member commented that in terms of demographics that age, gender and ethnicity were important sets of data to include when monitoring.  Members were told that work was being undertaken with different faith groups, Me and MIND and RDasH, who had themselves carried out work with the Muslim community.

Transition From Children to Adult Mental Services – Members welcomed the commitment that had been made to develop transition services.  It was explained that an extensive wraparound service was provided to the child and family, which as the child got older would be more focused on the individual.  It was explained that the young person might not want an adult present.  Members heard how relationships with the family change and assured Members that families would still be consulted with and kept informed as best as possible.  Reference was made to E Clinics that supported children and young people as well as their families.  It was continued that Virtual Reality headsets were being trialled to help treat issues such as social anxiety or supporting a young person to go into school.   Finally, it was noted that social media also provided an additional avenue to engage with and help support young people.

It was explained that the workforce would look different in Adult Mental Health Services as well as the interventions.  It was acknowledged that more work needed by working more closely together with the Children’s Mental Health Services.  Reference was made to the Mental Health Transformation programme and how aligning the pathways with children and young people were one of the areas being reviewed. 

It was explained that steps taken during the pandemic provided an opportunity to professionals to see the environment in which the child or young person lived and provided more thought around how families could be better involved.

An outline was provided on the Preparing for Adulthood Programme and the work being done to gather information on experiences of transitions as well as the challenges faced.  Reference was also made to occasions when various professionals (and young people and parents separately) had been brought together to look at what made a good transition.  Members heard that there was an ambition to develop a Transitions Charter describing a set of expectations so that young people and parents would feel better prepared during this time.

Regarding those children and young people who did not successfully transition over to adult services, it was explained that there was no set time limit but that a conversation would need to take place with services as the individual could not remain in child service indefinitely.  Reference was made back to the transitional work which would also include this element.

Adulthood Programme of Work – Members were told that the Preparing for Adulthood Programme (multi-agency piece of work) focused on identifying opportunities within existing arrangements and pathways.  It was noted that where possible, these ‘transitions’ would be made more timelier, more person-centred and better joined up.

New Targets - It was explained to Members that these targets were within Adult Social Care services when children and young people were transitioning from Children’s Social into Adult Social Care and consideration would be given to what support they would need.  It was felt that there was an opportunity to develop a rapport with the young person from 16 years old to find out more about them.  It was noted that this was an area of improvement and that late referrals meant that there was less time available to gather this information.

Supporting Individuals into Employment – It was shared that as part of Adult Mental Health services, there was the Independent Placements Support which was a national framework used to support people into employment.  Members heard that there was a joint working agreement between RDasH and South Yorkshire Housing who delivered the service as part of a collaboration which was embedded within the Community Mental Health Team.  It was added that Employment Support Workers worked with Talking Therapies service, as part of a new venture to be embedded into more services.  Members were informed that the Council itself had joined a Local Employment Initiative and appointed a Job Work Coach within the Community Learning Adult Disability Team.  It was explained that it was their role to support people to gain paid employment through personalised plans.

Care Leavers - Concern was raised that a high percentage of young people being referred through Safe Space were care leavers.  It was shared that it would be useful to develop a good understanding around perceptions of care and the issues faced.  Members were informed that joined up meetings were taking place with the Care Leavers team as well as regular contact with PAs , in efforts to establish more professional relationships.  Regarding pathways into further education for Care Leavers, it was explained that this was being explored with Northern College and the Adult Family Community Learning team.  It was continued that work was also being done with Big Ambitions, to help young people decide what they wanted to do and what that pathway could look like.  Members listened to how it was about considering different ways of supporting this and how other agencies could be involved

Localities – It was acknowledged that data, where available, would shape better services within localities and that there were strong links in place with locality leads.  It was explained that there was a robust governance process in place with commissioners and that colleagues attended localities meetings to share that work.  It was noted that information provided from the evaluation of the pilot, would also prove useful in those settings.   Members heard that there were meetings across Doncaster Place Partnership for both Starting Well and Living Well Mental Health forums and when the information was made available could be shared wider. 

Members were told about the work being undertaken with RDasH with the aim of developing a Peer Led Forum.  It was explained that this approach would allow these groups to be involved with new pieces of work to during the development stage.

There was a brief discussion around a future visit to the service.

The Chair thanked those in attendance for the presentation and information provided and expressed a special thank you to Reece for telling his own story to the Panel.

RESOLVED that the report and information provided be noted.