Children and Young People
Mental Health Policy
Challenges and Opportunities
Dr Miranda Wolpert
Reader in Evidence Based Practice and Research, UCL
Director of Evidence Based Practice Unit, the Anna Freud Centre
Director of Child Outcomes Research Consortium
Miranda.Wolpert@ucl.ac.uk
MQ Feb 2016
•
Published March 2015 – continues to set direction of travel for the new Government
• Published March 2015 – continues to set
direction of travel for the new Government
• Consensus across the whole system built on
principles of CYP IAPT
• A clear steer and some key principles about
how to make it easier for children and young
people to access high quality mental health
care when they need it.
• Consensus across the whole system built on
principles of CYP IAPT
•
A clear steer and some key principles about how to make it easier for children and young
people to access high quality mental health care when they need it.
Key themes:
•
•
•
•
•
Promoting resilience, prevention and early intervention
Improving access to effective support
Care for the most vulnerable
Accountability and transparency
Developing the workforce
Policy alignment
• Pilot link workers in
each of 255 schools
• CASCADE training
Policy Opportunities
• High interest and commitment
• Increasingly aligned models of what good looks like
• Ring-fenced funding to support ongoing transformation. £1.4 bn pledged
over the next 5 years, including £150m for eating disorders
• Increased collaborative working DH, DfE, NHSE and PHE
• Data to flow nationally from NHS services from 2016
• New national morbidity survey reports 2018
• Child Outcomes Research Consortium (CORC) Cross-sector data
initiatives
Strategic Opportunities
The following frameworks are aligned and build on each other
THRIVE – framework for CAMHS
Choice and Partnership Approach (CAPA)
CYP Improving Access to Psychological Therapies
(CYP IAPT)
Payment Systems proposal for CAMHS
What interventions help?
Categorising Mental Health Problems
1. Anxious away from care givers
(Separation anxiety)
11.Extremes of mood (Bipolar
disorder)
21.Family relationship difficulties
2. Anxious in social situations
(Social anxiety/phobia)
12. Delusional beliefs and
hallucinations (Psychosis)
22. Problems in attachment to
parent/carer (Attachment problems)
3. General anxiety (generalised
anxiety)
13. Drug and alcohol difficulties
(Substance abuse)
23. Peer relationship difficulties
4. Compelled to do or think things
(OCD)
14. Difficulties sitting still or
concentrating
(ADHD/Hyperactivity)
24. Persistent difficulties managing
relationships with others (includes
emerging personality disorder)
5. Panics (Panic Disorder)
15. Behavioural difficulties (CD or
ODD)
25. Does not speak (selective
mutism)
6. Avoids going out (Agoraphobia)
16. Poses risk to others
26. Gender discomfort Issues (GID)
7. Avoids specific things (Specific
phobia)
17.Carer management of CYP
behaviour (e.g. management of
child)
27. Unexplained physical symptoms
8. Repetitive problematic
behaviours (Habit problems)
18. Doesn’t go to the toilet in time
(Elimination problems)
28. Unexplained developmental
difficulties
9. Depression/low mood
(Depression)
19. Disturbed by traumatic event
(PTSD)
29.Self-care issues (includes medical
care management, obesity)
10.Self-harm (Self injury or selfharm)
20.Eating issues
(Anorexia/Bulimia)
30. Adjustment to health issues
See pages 15, 17 and 19 in Current view Tool Completion guide
Categorising Mental Health Problems
1. Anxious away from care givers
(Separation anxiety)
11.Extremes of mood (Bipolar
disorder)
21.Family relationship difficulties
2. Anxious in social situations
(Social anxiety/phobia)
12. Delusional beliefs and
hallucinations (Psychosis)
22. Problems in attachment to
parent/carer (Attachment problems)
3. General anxiety (generalised
anxiety)
13. Drug and alcohol difficulties
(Substance abuse)
23. Peer relationship difficulties
4. Compelled to do or think things
(OCD)
14. Difficulties sitting still or
concentrating
(ADHD/Hyperactivity)
24. Persistent difficulties managing
relationships with others (includes
emerging personality disorder)
5. Panics (Panic Disorder)
15. Behavioural difficulties (CD or
ODD)
25. Does not speak (selective
mutism)
6. Avoids going out (Agoraphobia)
16. Poses risk to others
26. Gender discomfort Issues (GID)
7. Avoids specific things (Specific
phobia)
17.Carer management of CYP
behaviour (e.g. management of
child)
27. Unexplained physical symptoms
8. Repetitive problematic
behaviours (Habit problems)
18. Doesn’t go to the toilet in time
(Elimination problems)
28. Unexplained developmental
difficulties
9. Depression/low mood
(Depression)
19. Disturbed by traumatic event
(PTSD)
29.Self-care issues (includes medical
care management, obesity)
10.Self-harm (Self injury or selfharm)
20.Eating issues
(Anorexia/Bulimia)
30. Adjustment to health issues
Tools: supporting young people to understand options
Ottawa decision guide
IncludeME
www.mycamhschoices.org
Tidier framework
1.Brief name
2.Why
3.What (materials)
4.What (procedures)
5.Who provides
6.Who receives
7.How
8.Where
9.When and how much
10.Tailoring
Reported outcomes and experience
Achieving goals
INTERVENTION
CHANGE MECHANISMS
OUTCOMES
Who is the
intervention for?
What is the
intervention?
Why does the
intervention work?
What difference
will it make?
UNDERSTANDING YOUR MODEL
TARGET
MODERATORS
Will it affect
everyone the same?
© Evidence
Based Practice
Unit (EBPU)
Unwarranted variation
Contact
• Miranda.Wolpert@ucl.ac.uk
• EBPU@annafreud.org
• CORC@annafreud.org