Coventry RISE - Video and audio transcripts

And the final uh organisation is well the Rise service now so Callie you just popped on my screen so good to see you. Over to yourself thank you. Hi yeah, I've also got Rachel with me from PMHT and Katie and Haj from PMHT with me. I am going to whizz through this really quickly. I'm going to try we we did have half an hour last time you've only given us 20 minutes this time and we actually only have 15 minutes left for it so i'm gonna do my best to whizz. So next slide okay so so right I'm going to try and do a quick whizz overview of Rise taking particular focus on PMHT and MHST which are mental health support teams and our primary mental health teams. Okay next slide okay Rise is is like an umbrella term for lots and lots of different services and lots of people refer to or think of CAMHS when they think of children's mental health services but that's actually just the system um we are actually Rise um that's like the brand name and then underneath that we have our specialist mental health services we have a primary mental health which is early intervention and prevention, we have looked after children's services, youth justice, eating disorders, crisis and home treatment teams, mental health support teams. PMHT and MHST are the two teams that are going to go into a little bit more depth um later on um because they're the two teams that you will have more dealing with um than any other team hopefully because they're out in the community and part of our community offer um and our neurodevelopmental service often people they talk about waiting lists and we'll often hear CAMHS has a two-year waiting list often they're referring to our neurodevelopmental service, not our specialist mental health service and like I say CAMHS is a system it's not um the actual service so it's just keeping that mind at mind. Okay next slide uh part of our ethos is um we want every child to get the right support when they need it with no door is the wrong door so it shouldn't matter whether you go into a crisis door, a primary mental health door, MHST door, eating disorders door, if that if you've actually come into the wrong door we should navigate you to the right area that is our role and you just said you shouldn't have to be going out at different doors and into other doors that's part of our role with the service that's what we try to do so.

I don't know that that is a part of our ethos our delivery model so it looks like we have a navigation hub which is that's the place that holds all our referrals we then have our community hub and that's where PMHT from mental health and the mental health support teams kick sits into that community hope and the community offer part of that community offer does have a self-referral route for parents to access some support as a universal offer and then further then into our offer we have our specialist multi-disciplinary team that offers that real specialist high level support for our really poorly children. Okay that's our next slide Rich um just thinking of some priorities and the long term plan for our service so we've got a real um had some lovely money come in and that means we've got some expansions for our core eating disorder service because we have been inundated with referrals for eating disorder so there's uh developments happening at the moment for an intensive home treatment team which is amazing. We're expanding our service to now uh look at 18 and 19 year olds which is something new and then ARFID pathway lots of people have heard of ARFID it's avoidant restrictive food intake disorder it's quite a new thing but lots of people are hearing that word or phrase being bandied about now we're looking at developing a pathway because there's nowhere at the moment no pathway developed for it and nothing commissioned so we're looking at that at the moment so that's something that is a plan of ours. Our crisis team that has been obviously that's already been expanded but it's been expanded even more it's got a 24 hour seven day a week crisis line and we've also got CBT workforce supporting the patient flow and anxiety with anxiety and low mood. Um we've got a really good digital offer um and we're moving towards looking at e-referrals um and like a real good portal to make a real ease of referral for um professionals out there and maybe even looking down that route of self-referral that's where we're moving to and that's a real project that we're working on. Within early help we've got more rollouts of the mental health support team so that is the program a wave of schools um program that is happening from money from the national health England like fund that along and supported with commissioners and health so that is something that is rolling out and it's going to be in 50 to 60 percent of schools it's a great um offer and we've got the team here to talk to you about that a little bit more so there's further investment in that so that is great and that's part of our long-term plan. Next slide please some of the celebrations that we've got our AET team um we developed our AET team on the back of COVID really and the real influx of referrals that we had that our core teams core specialist teams were really struggling to um balance doing assessment mental health or mental health assessment and their um clinical work as well so we've sort of split the two we've made a specialist team that does focus purely on assessment and getting our children assessed so they become really skilled at assessing children and making sure they're going to access the right treatment so that has um been developed. We've developed a think family outreach team and that has now been permanently funded and that's right poorly children that sit in crisis that are waiting for a um an assessment or um treatment within the specialist mental health service they will be uh supported by I think family outreach treatment like I say further investment with MHST and uh we've got lovely work happening with our primary care network that is come to the PMHT world where that's we're going to be linking with GPs and things like that. We've got lots of recruits train posts increasing our workforce down that cbt route and family therapy. Uh we've increased our workforce with team leads to support the expansion of Rise. Um yeah we've got an intervention hub which is the first ever waiting list team so anybody that is waiting is being held in an intervention hub and there's you know contact there with patients out there that are waiting to be seen to make sure everyone is being held and fought up and kept in mind next slide.

And this is just the website if you're ever not sure where to go what to do want to find out information this is the link to our website. Um there's so much on there please go and give it a visit we are going to be revamping that this is something really really new Rachel's going to be part of that she may not know that but she is and there's going to be lots of things happening about our websites it's going to be even more amazing than it already is but go and check that out. Rachel, I think it might be you next.

It is yeah okay so I'll try and be as quick you can email any questions, Um next slide please so I'm going to be talking about Coventry's primary mental health team so we're an early intervention and prevention service for children and young people's mental health and emotional well-being we aim to improve um mental health outcomes in children and young people, focus on delivering and applying best evidence-based practice and intervention so we support parents carers and professionals so those around that young person. We're made up of an MDT it includes a whole host of professions: occupational therapists, mental health nurse, counsellors, social workers, and also our well-being practitioners who we also have trainees as well. We're based at Paybody there is some remote working we're also based in schools with our enhanced offer which I'll cover on the following slide and also we spend some time in the hubs across the city next please.

So what we do our service in a nutshell is made up of an enhanced offer which um Callie said the mental health and schools team is in sort of 50 to 60% of schools we mop up the other schools. Each term we have um several schools we go into both primary and secondary and there's a certain offer that we cover within there which is in following slides. We also offer professional consultations so that's consultations to people working with young people around mental health difficulties with strategies and a plan we do solution focus parent and carer consultations and also professional training and parent workshops as well. So next slide please so the um parent carer consultation there's a different the referral process is through the navigation hub but also parents can access consultations through the enhanced work we do in schools and also through the hub work that we do as well so we focus on the dimensions tool which we use as a bit of a focus on unpicking we use strength based approach but we unpick the difficulties and the goals of that young person and the family. We often do sign posting on to other services which have been discussed today and onwards referral within our own service so it's very much collaborative working with the child at the centre of the focus. So the professional consultations are with school, social care, GP so any professional working with the child again it's solution focused often focuses on what's been unpicked with the parent um at that using the dimensions tool. Again it's around the right help the right time um that sort of ethos. So the work that we do in family hubs we our clinicians offer half a day per month to each of the hubs. The hub workers can book directly with our admin and consultations so they can be joint consultations to get that support and get that advice and those strategies over to that family and young person. Next please so we do professional training we can do bespoke all the training is free there's no cost associated for that school that professional um it's evidence based. Part one is all around the theory, part two is around strategy support and signposting. We often react and support with changing needs, changing themes within the city but our general role in offer is around mood attachment, self-harm, self-esteem, challenging behaviours, eating disorders, boomerang, transgender awareness, and staff well-being next please.

So the parent workshops are again less they are evidence-based of course theory is probably less intensive than the professional we have strategies support and signposting they're interactive generally at this minute in time they are remote and they're booked through the recovery academy it's been really successful. Um the topics that we currently have running are anxiety, low mood, sensory awareness, emotionally based school avoidance, self-esteem, self-harm, and emotional regulation. They're reviewed each year to make sure that evidence base and up to um where they need with regards to data etc next please.

So the enhanced offer is the school's work we do so we mop up schools that MHST don't cover. Again there is a bespoke element to this it's agreed term by term as to what schools we will go into. We run pupils assemblies, classroom sessions, they include emotional well-being, five ways to well-being, body image, and exam stress. We do parent and psycho-education around the introduction of mental health, managing emotions, understanding and supporting the child with mood and anxiety. We also run um parent consultations with um so if parents seek that consultation we can go into that enhanced school and do that with either the professional or with the parent independently. We've got a pilot running with the adult learning team they are running the positive parent foundation course within the enhanced school and that is going really successfully as the pilot. So we do staff training it's the same as our core workshops we also can join team meetings and offer professional consultations advice and support if needed. So we give general advice and guidance ongoing so that can be sought by emailing us. Lots of our work generates referrals on to our well-being practitioners and our trainee wellbeing practitioners and this is low intensity cognitive behavioural therapy approach interventions which cover mood and anxiety and also some behavioural elements to that or for example difficulties with sleep etc. In under 12s that is parent-led in over 12s that can be directly with that young person. So again psycho-education for parents we can offer an incredible years group which is an evidence-based parenting intervention. It's around nurturing skills and building relationships and it's very much capacity dependent but it's something we're hoping to run again in the near future. Next please so if you want to contact us you can email the Coventry email address or you can ring you can book on by emailing that address and asking for you know when is our next offer of training. It is all on our website our new training offer's on there for both parents and for professionals. I believe we're going on to the mental health and schools team. Any questions can be emailed because I'm sure obviously time is really ticking on so next please thank you.

So over to the mental health and schools team.

Hi thanks Rach. So I’m Haj I’m the team lead for Coventry MHST I've got my colleague here Katie who'll follow on from me and can we skip to the context page and uh yeah this one here. So i'll give you a little bit of context around uh MHST and what led to it. Between 2004 2017 there was various studies um various studies and some of the outcomes of that were that children and young people with mental health problems are more likely to experience increased disruption to their education and that was via time off school and exclusions in comparison to children with no mental health problems. Uh young people with mental health problems are more likely to experience problems in their future employment with various longitudinal studies con suggesting long-term impact on economic activity such as receipt of welfare benefits income and continuous employment. So young people with conduct disorder are actually more likely to engage in criminal activity with research also suggesting that they are 20 times more likely to end up in prison and four times more likely to become dependent on drugs compared to the general population. So if you're looking at the green paper in 2017 and which was around transforming children and young people's mental health provision um the paper introduced the idea of establishing a mental health support teams um and this would be supervised by NHS CAMHS staff who would be linked to groups of schools and colleges. It was advised that these teams would have designated senior leads for mental health in schools and colleges and they would provide new capacity locally for addressing the needs of children with mild to moderate mental health issues. MHST would also provide the link with more specialist NHS mental health services so that children can more swiftly access help in a timely manner. These teams would be rolled out in a series of trailblazer areas so in July 2018 the department for education and department for health and social care response was um to test and evaluate some of the recommendations in the green paper. Um the findings and further recommendations were that mental health support teams would only provide evidence-based interventions and should be measured and evaluated on the same outcomes in different geographical areas. Respondents were keen for the teams to undertake prevention work with children and young people. The idea of groups of schools and colleges working together was advised so children and young people thought that MHST would be particularly helpful to guide those who are not aware of how or where to access mental health support. Um many children and young people also stated that the teams would improve links between schools, children's mental health services, and also GPS. Um the trailblazer areas were actually announced in December 2018. 25 areas were identified including our very own Warwickshire covering 59 MHSTs and in 2019 the 2019 the EMHP training began. um the EMHP role actually stemmed from the green paper and its government response so the aim of the EMHP role is to bridge the gap between NHS um and LA working within the MHSTs and promoting whole school approach. They're actually trained in evidence-based interventions and work with mild to moderate low mood, anxiety, and behavioural studies behavioural difficulties. That's a little bit around the context behind it if we move to the next slide this talks about some of the core functions of MHST so as you can see delivering evidence-based interventions we specifically deal with multi-moderate mental health and we have a um a staff member located at each school um giving timely advice to colleges schools liaising with external specialist services and that's to help children and young people to get the right support and stay in education. Next slide please um if we move on to the next one this is mainly related to the wider Rise service so MHST this is the structure um service manager has recently changed but we do have a service manager who is Callie that you met earlier we have a clinical lead and we have three MHST teams with team leads, specialist mental health practitioners with supervisory experience and responsibilities, we have senior mental health practitioners and we also have educational mental health practitioners also.

Um so the way it works is that we have an EMHP allocated to each school. They would initially conduct a school launch to tell them a little bit about what ema MHST does. They would then consul um conduct a assessment and audit to identify some of the areas of development where we would fit in and support and they would jointly work with the mental health lead to to facilitate that. We would then receive referrals uh from these schools and part of the work would be to um do some workshops with staff to be and with the young people also. Next slide um I'll pass you on to Katie to just to talk more about the clinical side of things. Thanks Haj um so yeah I'll take you briefly through some of the um clinical offer that we have in um each of our mental health support teams. So the first one as Haj earlier said and the green paper identified and developed the EMHP role so educational mental health practitioners um are the biggest cohort of staff we have in our mental health support teams and they work directly with the schools they're attached to. Obviously, the aim of that role is to offer early intervention. We really do this in two main strands one of these being the whole school approach work that we do but also some one-to-one support that we deliver through a low-intensity CBT. If we move to the next slide I'll briefly speak you through the whole school approach. So the whole school approach is made up of eight principles which were identified and by practitioner feedback and also the evidence base so we really use this as the model to shape um some of the support that we can offer within schools. Erm not exclusive but some of the offers of support that we can give we can obviously work directly with the schools and complete some classroom or pupil observations to support um assessment or formulation of that young person's difficulties and but also look at the environment within the school. Um we have helped some schools develop their mental health policy through evidence-based and working with other um agencies. We offer parent support and this can be on an individual basis through consultation but also some of our interventions. We have been involved in the curriculum and PHSE lessons and since more recently we've been able to get back into assemblies and parents evening obviously since COVID-19 restrictions changed. Um we complete a lot of staff consultations and training so um staff might ask for consultations if there's a young person they're thinking of referring to our service we can speak through if that's appropriate if not we can be the link as we said between other and children and young people and young people's mental health services so we can signpost and guide that. A key part of our role is probably a little bit different to other services is we complete audits with schools and as part of our launch this is really to sort of identify what's going well for school what's already in place but also using outcome measures and with young people to identify any um unmet needs and then we can work with the schools to develop a bit of a plan for how we might be able to meet some of them unmet needs and also we've got a suite of class workshops that we can deliver to young people and as identified by these audits. If we move on to the next slide um this this as we said the other part of the EMHP role is these one-to-one low-intensity CBT interventions I think Haj briefly mentioned that this is for young people with mild to moderate mental health difficulties. It's short-term support and we deliver it in schools this can be online and we still are do have that offer or we go face-to-face in schools um six to eight sessions they're short sessions of 30 to 45 minutes with homework tasks in between and we can involve parents in them as well. They're mainly focused on guided self-help and cognitive behavioural approaches so they are evidence-based interventions and our EMHPs can work with low mood, some different some different anxiety disorders, panic and also some simple phobias. If we move on and also the other roles within our team that we briefly mentioned we have got the senior mental health practitioner role. We were actually one of the pioneers of this role and so this these are educational mental health practitioners who with a little bit more experience so they can work with people who might have some additional needs so maybe a neurodevelopmental presentation or um require a bit more of an adapted approach and they're able to do that but they also hold some supervisory responsibility so um teaching and supervising our educational mental health practitioners and trainees that we have as part of our program and also special the specialist mental health practitioner role and so all the specialist mental health practitioners in the team are accredited CBT therapists um and all with a core profession so we there's a we have a background of social workers, mental health nurses and occupational therapists within the team and again we hold a clinical role but also a supervisory role and for our EMHPs within the team. If we move on to the next slide and there's a little bit of an overview of some of the specialist mental health interventions that the specialist mental health practitioners like myself would complete so we are able to work with mild to moderate ocd, social anxiety, um completing some work as part of our trauma pathway for single event trauma and so a single event trauma might be um experiencing a fire or a car accident we can work with young people on them. Again depression and anxiety presentations whether low-intensity intervention has not been appropriate we can step up to high intensity cbt-based interventions which are specialised for neurodevelopmental disorders but also maybe increase complexity increase complexity whilst still meeting the needs of that early intervention framework one that's not on there is actually we can work with some more complex phobias as well such as vomit phobia and or a blood phobia as well and that is also included. If we move on to the next slide I'll briefly take you through our supervision model. So as we said as part of the green paper part of this um model was that part of the EMHP role would be that there was supervision in place from experienced NHS practitioners. Um so we have two strands of supervision, one of these is case management supervision this is for an hour per week and this really allows the high volume caseload that the EMHPs hold to be worked with safely we look at risk and we discuss these at least every four weeks and we do also include an overview of the whole school approach so we can look at needs within the school but also clinical skills. As we said we're evidence-based practitioners we use evidence-based models of care so clinical skills allows um groups of EMHPs to identify learning needs and really focus on supervision questions that we're constantly developing as a team as part of our continuing professional development. So I believe that's it for a bit of a snapshot of what our team do and obviously the same people can send any questions to us if needed.

Thank you everyone. Thank you I really appreciate that and hopefully there's given a very whistle-stop tour of everything that's going on in Coventry. There's loads of different um support offers that we've gone through today um but yeah so do feel free to contact any organisation directly. Um I could put my contact details in the chat if anyone wants to have a chat with myself as well um but hopefully yeah people have found this really informative um and we hope to try and do these probably every year just to you know reinstate what we've got. I think it's always helpful or you know might try and look at different ways that we can try and engage with schools and professionals as well about the service offers but hopefully, that gives a very good overview around what we've got and just to know as well we have got a leaflet that we've developed through a working group that we've got which I'll just put on screen now. I mean this is updated every six months uh but with the latest version has just been updated so this is the version of it on screen now but we can share this round again um after with the slides and the video links and any questions that people may have so. Yeah all I can say is thank you for the presenters coming today and going through everything you've gone through and thank you for those who have joined us as well to listen to all the slides that we've gone through um I appreciate it's two hours 15 minutes of PowerPoint presentations is quite challenging but hopefully yeah you've got a lot of information you can take away from this as well equally. So thank you everyone once again. Has anybody got any final comments before I wrap up any final words? No well enjoy the rest of your evening everyone on a Thursday and yeah have a nice weekend if you're not at work tomorrow so thank you all so much thank you.