Forward thinking Birmingham

New Model of transformed services – Levels of Care for 0 to 25 service: Universal and Health Promotion

Universal and health promotion is focused on promoting resilience and emotional wellbeing by providing information, training and consultation.  This will be achieved through the voluntary community sector (VCS), family support and providing information in a wide range of mediums to reach the population of Birmingham.

We currently have limited information as to what is available at a universal and health promotion level specifically for Birmingham, however, there is an impetus to develop services at this level. This is reflected in the development of a voluntary sector offer to increase awareness and reduce stigma associated to mental health.  This is in development and some early work has taken place across the city including:

  • Celebration of world mental health day
  • Commissioning of a song developed for young people around mental health www.youtube.com/watch?v=wnOVLOSPA3U
  • Working with schools to understand what whole school based approaches are delivered to support emotional wellbeing – some of this work includes ‘anti-bullying themes in schools, self-esteem raising through  positive affirmations
  • Youthspace and Forward Thinking websites that provide information on services available

Our plans

There is more to be done to promote emotional wellbeing and mental health, some of the work that has been planned includes:

  • Promotion of mental health across VCS
  • Development and training of frontline practitioners across multi-disciplines to raise awareness of mental health
  •  Development of online resources and applications such as a resilience app  to support emotional wellbeing promotion
  • Developing local community campaigns to raise the awareness of mental health
  • To work with the Public Health around implementation of the Healthy Child Programme
  • To implement the Schools Link pilot
  • To support Birmingham Education Partnership  to develop and implement Birmingham Education Strategy that supports the education recommendations outlined within FiM

Universal Plus Partnership

Universal Plus Partnership aims to focus on developing resilience and attachment, as well as intervene early where low level emotional wellbeing concerns are being exhibited.  Key components of the service offer for Universal Plus Partnership includes:

  • An early focus on developing resilience and attachment – through working with partners to identify emotional wellbeing concerns
  • Provide information, guidance and consultation to organisations who have the skills to support low level emotional concerns
  • To work in partnership with organisations to increase resilience and build capacity at the frontline
  • Providing supervision to the front line

It is clear that there are a range of services that provide universal plus interventions, however, this is largely unknown due to much of this work taking place in Schools and within the Voluntary sector.

Birmingham City Council currently spends £571,046 on emotional wellbeing services. This is provided by a range of Voluntary sector providers including Barnardos, Spurgeons and Beyond the Horizon. They provide a range of interventions. However, under the current efficiency measures the Council cannot guarantee this level of spend in the future.

Birmingham Headstart for 2015/16 have funded services totalling £500,000. However Birmingham were unsuccessful in being selected as a scale up site for Headstart, therefore there is no additional funding to support this programme. However, we value the work that has taken place to date and are using some transformation money to support a new programme branded Newstart which will continue to realise the vision of the Headstart Strategy.

Our plans

  • Development of an Connect City Centre Hub that will offer a drop in service for children and young adults to self-refer or just to drop in and have a chat about issues that are of concern to them
  • Developing perinatal mental health services that support mothers pre-birth and after including those who would be deemed as ‘worried well’ who would not otherwise receive any support
  • Development of a peer support programme that is led by children, young people and parents/carers with appropriate support
  • Developing E-tools that support and aid self-help, provide good quality information on specific conditions that enable families to understand diagnosis

Brief interventions

Brief interventions are where children and young people may require short term support for common mental health concerns.  This is currently provided by a range of providers including CAMHS, VCS and Schools. Some of this provision includes;

  • Birmingham CAMHS are part of wave 3 of the Oxford and Reading Learning Collaborative for CYPIAPT.  They are committed to the principles and delivery of CYP IAPT.   Routine monitoring has become embedded in the approach for those who have undergone the training.  Birmingham is planning to invest in more staff to access additional curriculum.
  • Use of CAPA approach to support demand management up to 25 years old
  • Therapeutic Emotional Support provided to looked after children by a bespoke service within the local authority
  • A range of VCS providers commissioned to provide:
    • One to one Counselling
    • Short term interventions that include direct work with children and parents/carers where it has been identified that CYP demonstrate some of the risk factors identified with emotional and behavioural concerns
    • Parenting programmes

We commission a range of providers to provide specific emotional wellbeing support brief interventions; this includes Birmingham Community Healthcare Trust to provide speech and language therapy and emotional wellbeing nurses for looked after children.  The total costs for these services are £167,674.

We commission The Children’s Society to work with unaccompanied asylum seekers and Open Door Youth Counselling which costs £250,998.

Therapeutic Emotional Support Services provided by the Local Authority Children’s Social Care invests £1,800.000

Our total CAMHS spend across universal plus and complex interventions totals £6,678,888.

Our plans

  • As Birmingham is one of the only local sites to continue with the development and delivery of CYP IPAT the intention is for Birmingham CAMHS to develop a learning collaborative alongside one of the universities in the City.
  • Demonstrate outcomes in the treatment room through the purchasing of digital technology such as tablets to record live outcomes
  • Identify VCS who are delivering some of the pathway of care to be trained in CYP IAPT
  • Provide a joined up approach to SEND Local Offer and the Birmingham 0 to 25 CAYAMHS offer

Complex interventions

It is recognised that some children and young people will become unwell and require a multi-disciplinary approach to manage their condition. Complex interventions will provide this level of support that is coordinated to ensure the best outcomes are achieved.  They provide coordinated packages of care.

Our current complex interventions are provided by CAMHS over 170 members of staff are within the service and work across complex and brief interventions.   The workforce within CAMHS includes:

  • Psychologists
  • Psychiatrists
  • Nurses
  • Nurse prescribers
  • Bespoke Learning Disability Services
  • Family therapists