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The importance of engaging children and young people in the commissioning and delivery of mental health services

Associate National Clinical Director for Children and Young People’s Mental Health at NHS England, Prathiba Chitsabesan, says work is well underway when it comes to listening and acting on the views of those who use services after commissioning the YoungMinds report to bring together the voices of children, young people, parents and carers.

I know from my 17 years of clinical experience working with children and young people and their families how essential it is to involve them (and when it’s appropriate, those who care for them) in every aspect of their care, from feedback on their own progress through to helping design and develop services.

So I am really excited about ‘Your Voices Amplified‘, which outlines children and young people’s, parents/carers’ and professionals’ views and experiences in every aspect of the young person’s mental health care – or participation for short.  It presents us with the perfect opportunity to think about where we are succeeding and where we need to do more.

It is the first report from Amplified, our national programme commissioned to support improvements in participation across the system, delivered by YoungMinds and available on their website. This report takes stock of the excellent work underway to make sure children, young people, parents and carers are involved in decision-making in a meaningful way.

There is a lot to build on and we should celebrate achievements such as the fact the Children and Young People’s (CYP) Improving Access to Psychological Therapies now covers 96 per cent of the 0-19 population.  It has a focus on making sure that children, young people, parents and carers share decision making about their care with professionals.  We should also celebrate the increased availability of good quality resources for children, young people, parents and carers like MindEd CYP.

The government has committed £1.4b in CYP mental health services over five years (2015-2020), which includes £30m a year going to improve community eating disorder services. There are now 70 new or expanded multi-disciplinary community eating disorder teams covering the country and there is also investment in community mental health teams, in-patient beds and crisis services.

However, it also means being honest about where we need to do more. Today’s report highlights that there is still a way to go to ensure that genuine collaboration with children, young people, parents and carers is a reality across the country. Half of those children and young people surveyed who were receiving mental health care didn’t feel involved in decisions about their treatment, and only 17 per cent said the service they were accessing had a youth participation or service user involvement group.

Many parents and carers felt that they had not been involved in their child’s mental health care, with only 34 per cent feeling confident in knowing where to find opportunities to get involved. As professionals, it is our responsibility to ensure that children, young people and their families and carers feel they are able to work with us.

YoungMinds Amplified programme includes masterclasses to help services to improve their skills in involving children and young people, and when appropriate their parents and carers, in their treatment, in service delivery and  development.

We also know of a number of areas in the country where services have found successful ways of involving children, young people, parents and carers, and this provides opportunities for us to learn from each other. I would like to flag a couple of brilliant examples of participation.

Firstly, Rollercoaster in Durham and Darlington, a parent/carer support group run in collaboration with parents and carers and the local CYP mental health service where parents and carers in the group are directly involved in development of the mental health service. Secondly, in Greenwich, the commissioning team work alongside a Youth Commissioners Programme, embedding the views of children and young people and their families in the commissioning of services. These are just two examples, and we know there are plenty more – but what we need to do now is make sure that every area and all services are involving children, young people, parents and carers in decisions about children and young people’s mental health services.

Now it is over to you. What is happening locally to you? Check out your local participation group, and if you find there isn’t one, why not set one up? To get involved in the Amplified programme, or for information on accessing masterclasses or toolkits to support you go to YoungMinds’ website. This is such a great opportunity to really think about how we are engaging with the children and young people who use our services.

Dr Prathiba Chitsabesan

Dr Prathiba Chitsabesan is the Associate National Clinical Director for Children and Young People’s Mental Health for NHS England.

Prathiba is a Consultant in Child and Adolescent Psychiatry working in a large mental health and community trust (Pennine Care NHS Foundation Trust). Lead consultant since 2005, she became Clinical Director in 2015 and continues to work clinically within a community child and adolescent mental health service in South Manchester. She graduated from Medicine (University of Manchester) before completing her MD, inspiring her interest in the needs of children and young people in contact with the criminal justice system.

Over the last 12 years she has published in journals and books and contributed to national reports and guidance for the Youth Justice Board and Office of the Children’s Commissioner.

She has contributed to the development of the Comprehensive Health Assessment Tool across the youth justice secure estate for the Department of Health and NHS England and continues to be research active as an Honorary Research Fellow and Lecturer for the Offender Health Research Network (University of Manchester).

As a clinical advisor (Greater Manchester and East Cheshire Strategic Clinical Networks), she has also promoted the development of regional clinical guidance across Greater Manchester.

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