Role of Organisation
Newport Mind is a mental health organisation based in the city of Newport (Casnewydd) in South Wales, UK. We are part of Local Mind Associations in England and Wales.
We believe no one should have to face a mental health problem alone. We work for the better mental health of people in Newport by providing a range of services.
Our Vision: We won't give up until everyone experiencing a mental health problem gets both support and respect.
Our mission: We provide advice and support to empower anyone experiencing a mental health problem. We campaign to improve services, raise awareness and promote understanding.
Our values:
Open.We reach out to anyone who needs us.
Together.We're stronger in partnership.
Responsive.We listen, we act.
Independent.We speak out fearlessly.
Unstoppable.We never give up.
Brief Description
Newport Mind currently provides a comprehensive service to Children, Young People and Families who need support with their mental health. The Changing Minds Project is a Gwent wide, five year funded project delivering interventions to young people who are struggling with their mental health. We provide a substantial suite of self management courses, one to one transition support and peer support programs both in the community and educational settings.
Newport Mind as part of the Families First Wellbeing Strand provides two Family Wellbeing and Resilience’ workers who deliver interventions to families, young people and children struggling with mental health issues using the Resilience Framework and Five Ways to Wellbeing to enhance the resilience of family members to respond to their mental health difficulties. The workers are piloting a whole school approach to resilience with a Newport Secondary School and the feeder primary schools with the intention of rolling this out to other schools across Newport. The Families First Wellbeing Strand is part of the Team Around the Family allocation process
Specialist CAMHS
The extent to which new (and/or reconfigured) services are helping to reduce waiting times in specialist CAMHS. Whether the improvements in waiting times Welsh Government expected from CAMHS have been met.
1) Anecdotal evidence from young people using the Changing Minds project and from the project workers suggest that there have been some improvements in waiting times, whether the improvements are sufficient to justify the additional resources allocated is debateable. A comprehensive national early intervention and prevention service for young people with mental health problems, along the Changing Minds model, could have been developed for a similar or lower investment, with better outcomes and resulting in a reductions in demand for CAMHS with a knock on effect on waiting times. The focus on waiting times ignores the issue of the outcomes that CAMHS achieves for young people, with young people reporting that CAMHS does not meet their needs or support them to achieve the outcomes young people want.
What the data tells us about the variations in practice (equity of access) across Wales.
2) The Changing Minds Project offers support to young people aged 14-25 with mental health problems across Gwent and the anecdotal evidence is that access to the service is similar across the area but once CAMHS is accessed there are differences between localities.
The extent to which changes have addressed the over-referral of children and young people to CAMHS.
3) The changes that Newport Mind has experienced are twofold. Since the 2014 CAMHS Inquiry the Changing Minds Project has been increasingly used by the CAMHS service as an exit strategy for young people who have completed their sessions or who do not fit CAMHS criteria. We have examples of young people who have been referred to Changing Minds after one or two initial CAMHS appointments and some who have completed more intensive work. The project has also recently experienced a higher rate of referrals from CAMHS where the young person is experiencing a range of more complex mental health difficulties, often resulting in a re-referral to CAMHS.
4) These changes suggest CAMHS services are offering more time limited interventions and increased or more rapid rates of referral onwards to other services in order to address the over-referral to the service or as a result of focusing more on waiting times than on the needs of young people or the outcomes achieved.
5) As a third sector, early intervention project for young people with mental health problems we were heartened to hear the Minister reference early intervention in the initial Inquiry:
“We should always be attending carefully to that border line to make sure that those people who need a CAMHS service get it and that those young people whose needs can be better attended to by the more universal and general services get the help that they need there.”
However universal and general services dedicated to early intervention for children and young people is extremely limited especially when compared to increasing demands. Third sector organisations traditionally have the experience, expertise, history and success in delivering these interventions but many are time limited grant, such as Big Lottery, funded projects with end dates and no sustainability. T4CYP has highlighted early intervention, prevention and the third sector as well as the needs of young people, however this has not been matched by the recent funding and changes to the CAMHS service by the Welsh Assembly Government.
Referrals and access to CAMHS by individual Health Board, including the restrictions and thresholds imposed by CAMHS
6) The Changing Minds project has seen little if no change to the thresholds imposed by CAMHS. We have many examples of young people who use our service who have considerable mental health problems and do not fit into the medical model criteria set by CAMHS. We find that many young people with mental health problems can achieve positive outcomes with their mental health and life through the support we provide using the social model of mental health in contrast to some of the interventions provided by CAMHS.
7) The 2014 Inquiry highlighted “whilst Welsh Assembly Government strategy emphasises early intervention, ironically the drift seems to be in the opposite direction.” With the increased funding into specialist CAMHS and the recently unveiled school based CAMHS service it appears that the medical model of intervention is being heralded as the solution to the increasing levels of mental health problems facing children and young people continuing the drift in the wrong direction ultimately neglecting the “universal and general services” are needed by more and more children and young people.
Funding
How the additional funding has been used to improve provision for children and young people in local primary mental health support services
8) The Changing Minds Project and Families First Wellbeing Workers have positive relationship with the primary mental health support services and receiving a high percentage of the projects referrals from Primary Care. Since the increase in Primary Care services in Gwent and the introduction of Primary Care on the Families First allocations panel in Newport we have seen higher levels of communication and use of third sector services to provide additional support to children, young people and families.
Transition to Adult Services
How well planned and managed transitions to adult mental health services are.
9) Since the 2014 Inquiry and resulting changes to the CAMHS service, young people using our service have reported no changes in transition to adult mental health services. The Changing Minds Project operates between the ages of 14-25 and is receiving an increasing number of referrals for young people transitioning out of CAMHS to the services the project provides who then need almost immediate direct support from the project to access adult mental health services. The scenario potentially suggests CAMHS are not sufficiently focused on the needs of young people, or on supporting them to recover and live independently, or CAMHS is not recognising the young person’s need for ongoing support from adult mental health services and then putting in place the arrangements to support that transition.
Links with Education (emotional intelligence and healthy coping mechanisms)
The work being done to ensure children and young people are more resilient and better able to tackle poor mental well-being when it occurs including:
The development of the Health and Wellbeing Area of Learning and Experience as part of the new curriculum.
Children’s access to school nurses and the role schools nurses can play in building resilience and supporting emotional wellbeing.
The extent to which health, education and social care services are working together.
The take up and current provision of lower level support and early intervention services, for example, school counselling services.
10) We have welcomed the recent Donaldson report and the inclusion of health and wellbeing in the six areas of learning and experience which will be incorporated into the curriculum. Newport Minds Children, Young People and Families department has been working closely with many schools to train young people as peer mentors and training teachers in the basics of mental health and resilience. The positive moves made by the schools show their dedication and commitment towards improving the mental health of young people in their schools.
11) The recent unveiling of the pilot CAMHS schools initiative recognises the needs of young people and provides schools with more resources, however it does not respond to one of the key recommendations of the Making Sense Report which is not to medicalise growing up. It is a move away from an approach embedding emotional intelligence and healthy coping mechanisms into the curriculum. Our experience is that many young people, especially those who we most need to reach, do not want to access services provided by the statutory sector, or by their schools, or by officialdom, and prefer to access services that are independent, respond to their needs, genuinely include them in the design, delivery and coproduction of the services, such as evidenced by the success and demand from young people for the services of the Changing Minds Project and Families First services Newport Mind provides.
Conclusion
12) The Changing Minds Project and Families First strand at Newport Mind is dedicated to providing person centred support to Children, Young People and Families who are struggling with their mental health. To date the Changing Minds Project has supported over 3000 young people in Gwent and has a waiting list for one to one support of approximately 42 weeks. The demand for early intervention and community support, which is not based on medical models, is growing at such a rate that our services are at capacity. We have one year left of this 5 year funded project and based on our current waiting lists we will have to stop taking new referrals in May 2018. Without the Changing Minds Project both Primary Care and CAMHS services in Gwent will be at a loss to find ‘follow on’ services to aid young people in transitioning between services and exiting completely.
13) We acknowledge that CAMHS required funding to reduce waiting lists and provide a service fit for purpose and we are already seeing modest changes. We are, however, disappointed in the lack of consultation and funding of third sector, early intervention projects which supports young people and the statutory services alike.