It Is a Little Over Two Years Since Future in Mind Was Published

• Dr Jacqueline Cornish OBE
• 23 June 2017
• Posted in: Healthcare

I hesitate to use a term like “revolutionary”, but the consensus Future in mindachieved across the ‘whole system’ of health, education, social care and youth justice – that so much more could be done to improve the help offered to children, young people and families  – was unprecedented.

It helped galvanise the will of government and all those working with children and young people  to prioritise the mental health of the next generation , and invest in transforming services.

That priority and profile has only increased through the Five Year Forward View for Mental Health.

I do not believe any of us would claim the challenges facing children and young people’s mental health have been solved. You do not need to look too hard to find examples in the press or on social media each day where children and young people and their families feel the support on offer is not enough.

But I believe we must take time to acknowledge the huge progress that has already been made:

• During 2015-16, a number of local areas took part in the Department of Education/NHS England Schools Link Pilot, bringing local education and CYP mental health services together to develop integrated working. The evaluation of the pilot published in February 2017 found a positive impact on communication and joint working arrangements between schools and mental health services.

• Providers and commissioners are working together to change the way services are delivered, making them more responsive to the needs of CYP and use resources better. A good example of locally driven change is the ’i-THRIVE’ programme.  This implements  a need and  evidence-based  approach to working with children and young people, which  has spread across 50% of the country in a year.

• Local accountability has been strengthened, with all local areas covered by joint Local Transformation Plans for children and young people’s mental health. These are being aligned with the Sustainability and Transformation Partnerships (STPs).

• The Five Year Forward View for Mental Health dashboard was first published in 2016 and shows progress on mental health priorities for children and young people as well as wider NHS service users.

• Following the publication of an Evidence Based Treatment Pathway for children and young people’s eating disorders, 67 Community Eating Disorder teams are now in place across England and many areas are progressing well to meet the standard to see urgent cases in a week and routine cases in four weeks.

• A new national CQUIN designed to incentivise better transitions from Children and Young People’s mental health services to adult mental health services has been implemented from April 2017.

• The Children and Young People’s Improving Access to Psychological Therapies programme is now working with services covering 90% of the population, and is on course to achieve 100% next year.

• There are eight New Models of Care: Urgent and Emergency Vanguard sites focusing on crisis care for children and young people

• For inpatient care, NHS England Specialised Commissioning is moving ahead with plans to improve the distribution of ‘Tier 4’ beds around the country, helping to end unnecessary out of area placements for children and young people.

Although our plans around transforming mental health support for children and young people are ambitious, achieving them will not mark the end of the process. For example, achieving our aim to increase access for an additional 70,000 children and young people a year by 2020 will still mean that some two thirds of children and young people who may need help are not able to access it.

We need the widest possible approach to get this right.  This is about all agencies – the NHS, schools, social services, local authorities, justice voluntary sectors and more – working better, together to deliver the standard of care our children and young people deserve.

So the transformation must be seen as just the start of the task. We must build on and maintain the progress to date by being honest about the scale of the challenge ahead, whilst acknowledging the progress that has been achieved.

None of this would have been possible without the huge efforts of professionals, staff and volunteers working across health, care, education and youth justice.

But perhaps most importantly, this work is testament to the efforts of children and young people, their families and carers to engage with us and help us develop the kind of services they want and need, where and when they need them.