National Assembly for Wales Children, Young People and Education Committee- Inquiry into Emotional Resilient Children and Young People.

Dyfodol Powys Futures welcomes the opportunity to submit evidence to the Children, Young People and Education Committee

1) Dyfodol Powys Futures (Dyfodol), created from the Powys Children and Families Forum Group, is a small charity working with children and families across the whole of Powys, delivering since its inception in 2008,a wide variety of projects in a very rural area The Dyfodol Finding Futures (FF’s)initiative, started in May 2015 developed from needs identified by Dyfodol from European funded – Genesis, Novus and Pont Novus which they ran. The  Finding Futures Project (FF’s) funded by Comic Relief 2015 to 2018, was developed to support young people who came outside of the remit of the previous projects.

The opportunity to submit evidence to the National Assembly for Wales’ Children, Young People and Education Committee concerning the inquiry on Emotionally Resilient Children and Young People is welcome.

As we do not have knowledge of the Together for Children and Young People programme, Dyfodol Powys Futures will focus specifically on evidence of relevant issues based on first hand experience from the perspective of children and young people accessing the FF’s project who are not engaging with society and have rejected any previous interventions.

· Of the 199 young people that FF’s has engaged with on a one to one session basis from the start of the project 47% have identified with mental health issues. That figure is a conservative estimate.   23% have stated they have abandoned all support from statutory and other providers 25% have identified that they have received CAMHS intervention. Both the previous figures are a conservative estimate.

Specialist CAMHS.

Waiting times for CAMHS have not changed significantly over the duration of the project. Specialist CAMHS intervention therapies however take longer to access and require children and young people to travel significant distances eg of 40 miles plus one way, and this has resulted for one young person in only two sessions being accessed face to face with the rest of the treatment therapy being offered over the telephone which proved very unsatisfactory for the young person.

Variations in practice are very noticeable in such a large county with very different availability and workers’ practice between North and South. Powys Teaching Health Board were approached to give clear information on what was available in each area but they were unable to provide a detailed answer. Powys does not have equity of access across the county.

The young people we see have difficulties engaging with people. CAMHS only meet in offices, normally hospitals, and this poses a big barrier for young people. If young people cannot attend these meetings they are often deemed as not engaging and their case closed. Once the case is closed through non attendance, if the young person can be encouraged to reconnect with CAMHS then the waiting period for an appointment has to start all over again.

FF’s  cannot comment on the over -referral question however the way criteria is interpreted is down to individual judgement  and this can vary.

FF’s experience does not support the view that additional funding has improved specialist CAMHS out of hours crisis support. When called in a crisis situation there was no one available as the person was on holiday.

In a serious situation where a parent had telephoned CAMHS in the early afternoon they were not able to come out to her daughter and the child had to wait until after hours  for the crisis team who should have been able to attend  however, on that occasion,  that was not possible. An ambulance was called and the child had to be taken to A & E. Her mother sensibly followed in the car taking all relevant notes of her daughter’s significant mental health problems  which were helpful to the CAMHS team in the hospital area as they may not have had access to her notes. The next day the child was assessed by them, having spent the night in A&E .

Children who have to receive specialist mental health services in a secure hospital have to be placed a great distance away from home, thus contact with family has to be compromised.

Funding

FF’s is not aware of any impact on improved services due to the increased funding for CAMHS.

The reduction in Local Authority Services that offer some additional  support to children and young people who access CAMHS has been reduced putting  significantly more reliance on 3^rd sector organisations who are chasing diminishing funding and having to restrict their services, leaving vulnerable young people without essential support. 

Transition to adult services

• Young people and their families have said that this transition has been difficult in all cases FF’s has worked with

• Young people with mental health difficulties do not like change and did not feel that they had enough time to get used to the change to Adult Services. They stated that they had 2 joint meetings if they were lucky and then they were on their own.
• The criteria for CAMHS and the Adult team is different so young people are often left high and dry.
• The Adult team works differently from CAMHS both in the structure and therapies used which is hard for young people and families to manage.
• The young people felt that the lack of handover meant that they were very much on their own at such a vulnerable time

· Adult Services with different criteria from CAMHS leaves some vulnerable 18 year olds with no support.

· Isolated young people who are attempting to reengage find it difficult to adapt to the new people and new places required for adult support and need someone they know and trust to support this transition. FF’s has carried out this role.

· The lack of continuity in staffing in Children’s Services with 47 agency people employed currently (confirmed in local paper 19/1/18) impacts on young people with transition to adult services and the stability and flexible way of working FF’s offers has supported numbers of vulnerable young people.

· The reduction and uncertainty in the Youth Service has impacted whilst the opportunities the new structure may be able to offer are being developed and confidence in the new way of working built, vulnerable young people feel confused and unsupported.

· The location of youth worker based in High Schools has been seen as a positive development  in its early stages and will hopefully lead to earlier intervention for some young people.

• FF’s takes young people to meetings and helps to translate to the professionals what the young person wants/needs/thinks. FF’s  then tries to support the young person to make this journey themselves. The peer groups FF’s has developed support young people in social friendships and all the benefits that includes.

A case study that gives a flavour of the approach and work FF’s  has undertaken. There is a file of case studies  documented by FF’s.

A young lady on the project since February 2017. 

A client was referred from TAFF  as the family were at crisis point with the an attempted suicide by the young person a few weeks before. Finding Futures looked at the whole situation and saw that there were many people working with the family which may be having a negative impact  In  the first two weeks FF’s  spoke to them all and with the family twice. The family believed that the difficulties their daughter was experiencing was largely due to ASD.  Finding Futures carried out one of their initial assessment which immediately lowered the anxiety levels of the family as they felt someone was listening. Finding Futures working with the young lady looked at what mattered to her and over time discovered that an overriding ambition was to dance. A meeting with a local educational dance provider was arranged for her to discuss with them what opportunities for dance were available to her. She is now attending dance classes and is volunteering with the company and is out 3 times a week. Through the project, she is attending a peer support group Finding Futures has set up and is also engaging with 2 young people on line who FF’s has introduced her to. The client now feels that she does not need ‘counselling’ at the moment, as she is too busy enjoying herself.

This young lady, when first known to Finding Futures was unable to be in a room alone without her mother, she is now hoping to continue with the dance company and gain an apprenticeship. The young lady has referred a friend of hers to Finding Futures as she felt CAMHs was not helping her with her eating disorder.

Some of the reasons FF’s has identified  that explain  why the project has been able to support and help marginalised children and young people.

• Finding Futures works with clients at the pace of trust.

• When assessing a client Finding Futures can look at the wider situation in which the client functions, not focusing solely on their perceived difficulty   and in initial stages deal with things in the round branching out to other providers both statutory and third sector as appropriate and as the client is able and ready to engage.

• Finding Futures has a flexible approach because it is not constrained by statutory requirements.

• Finding Futures support is not been timeframed and has no waiting list.

• Finding Futures will meet with clients at a venue where they feel most confident, safe and secure. This has been for example engaging through a closed door until trust and respect has been established.
• Finding Futures is a vital advocate for clients as they have become confident enough to engage with other providers ensuring the voice of the client is heard and their needs and wishes are clearly understood and respected, thus greatly assisting the client moving forward in their life.

• Finding Futures advises and works with  other bodies, based on their knowledge and assessment of a client, in order to support a client as they move forward with their life and reengage with society.

• Finding Futures is able to support parents and carers of clients as they battle with the complex issues surrounding the client.

• Finding Futures does not have any connections with  the young peoples and their families past that they view in a less than positive light.  This helps with initial and continued engagement.                                                         

• Finding Futures has a flexible way of engaging with young people and their families. They can contact them via social media, text, phone calls or an initial meeting face to face. Once contact is made it continues to be flexible in maintaining contact by going at the pace of  the young person and using the method the young person feel most comfortable with .