Agenda item

The Integrated Care Board will provide an overview to the Board of Mental Health Services available to Children and Young People from preventative and early intervention to specialised services.

The Children, Young People Mental Health Support Team from the ICB, introduced and presented the report to highlight the services that are commissioned by the ICB and their impact in supporting children and young people’s mental health support and emotional wellbeing needs. It was noted that:

• Mental health support for children and young people (CYP) in the city was provided by Derbyshire United. There were two referral routes into the service, via GPs and an online self-referral option that CYP and parents could use. This approach aimed to reduce the need for GP visits and allowed individuals to complete referrals at a convenient time while sharing their story.
• Relate a Voluntary, Community and Social Enterprise (VCSE) ran two services, an early intervention service offering one-to-one counselling and a parent support programme for CYP aged 5-18. Following the closure of ADHD Solutions and they put on a pathway within their own service. Relate absorbed 1.5 team members to continue delivering support. The service had been operational since January.
• The Early Intervention Service is a step-down service from CAMHS that was provided by Leicester Partnerships Trust (LPT), offering evening appointments to improve access for CYP and parents. These appointments were based in the city centre to enhance attendance.
• Community Chill Out Zones operated at a preventive level for CYP, running in schools and community venues. Workshops were delivered in targeted areas to ensure support reached communities with health inequalities. The initiative had the capacity to reach up to 700 children per month. It also incorporated mental health assessment, diagnosis, and assistance.
• Child and Adolescent Mental Health Services (CAMHS) is a specialised mental health service offering support for CYP for more moderate to severe mental health presentation. They would receive an assessment, diagnosis and treatment for mental illness. There was a variety of teams within CAMHS such as CAMHS Eating Disorder Services, Access Service where assessments took place, Young Persons Teams. 
• A lot of work had been completed recently within CAMHS to improve waiting times, which had historically been long. Significant efforts had been made over the past year to reduce waiting periods, including the introduction of evening appointments. The current waiting list for urgent outpatient cases was 4 weeks, aligning with the target. Routine cases had an 8-9 week wait, with a target of 13 weeks for access to mental health support.
• First Steps ED, a VCSE provided service which offered various forms of eating disorder support, including one-to-one counselling, psychoeducation, befriending services, and sibling and parent support. First Steps worked closely with CAMHS and were closely integrated together.
• Work was ongoing to prevent CYP from being discharged from CAMHS eating disorder services without appropriate follow-up. Concerns were raised about the impact of inadequate support on family environments. A large-scale piece of work had been undertaken to improve referrals, particularly for ethnic minority communities, leading to a significant increase in referral numbers to 26% in a short period of time.
• Tell Me VCSE provided digital peer support for CYP aged 11 and above, with crisis intervention available if required. It was preponderated and there was a Pre-emptive Councillor should it be required. The service was monitored every 30 minutes and offered peer-to-peer support and therapy. Efforts were ongoing to raise awareness of the service, which had been introduced in April 2024 and was still being embedded.
• Mental Health Support Teams were being rolled out nationally in schools, supporting CYP with mild to moderate mental health needs. The service provided an early intervention service and group workshops, reaching a significant number of CYP. In Leicester City, the service had expanded to over 50% of schools, covering 57 schools and supporting 41,189 young people. The acceptance rate for referrals stood at 99%.
• Harmless VCSE offered specialist support for CYP at risk of self-harm and suicide. The service provided one-to-one cognitive behavioural therapy, psychological interventions, group work, and stabilization sessions contributing to the self-harm and suicide prevention strategy.
• The Tomorrow Project, a VCSE service, specialized in suicide bereavement support, offering one-to-one support and linking into the wider Suicide Prevention Strategy.
• The Mental Health Centre Access Point had replaced the previous Central Access Point (CAP) service, directing people to NHS 111, where option 2 was for mental health support. A 24/7 support line was available for mental health queries, with young people able to be triaged and, if necessary, referred for assessment at the Bradgate Unit or an urgent care hub. The service aimed to reduce pressure on A&E by offering alternative crisis support.
• Family Action Post Sexual Abuse Service was in place to provide direct trauma-informed support for CYP and their families. This specialist service worked with CYP over an extended period to offer tailored support.
• The City Early Intervention Psychological Support Service ran in partnership with LCC. The Service provided one-to-one and group psychological support for CYP with higher thresholds of need. The service involved educational and training psychologists and ran courses over 5-9 weeks, delivered in home and school environments. It differed from Mental Health Support Teams in Schools by focusing on progression through different intervention levels. Currently, the service operated in just over 50% of city schools, prioritizing those without existing mental health support and targeting areas with health inequalities. Efforts were being made to increase referrals where uptake had been low.
• A CYP Mental Health Directory had been commissioned, featuring both national and local services. It had been co-produced and co-signed by CYP, following a co-production event where young people expressed the need for a dedicated resource. Previously, directories were hosted on the ICB website and had been difficult to access, but the new directory featured a QR code for ease of use. CYP played a role in its design. By September 2024, the directory had been scanned 2,607 times, rising to 3,789 scans by March 2025. It was available for use by professionals and parents, with links to the Joy App for parental support.

In response to comments from members, it was noted that:

·       Members noted that the Joy platform had issues, and work was being completed to update the platform to include supportive information in the directory for CYP mental health support. It was noted that feedback had not been received and should be sent to Justin for review.

·       The directory was praised, members recalled when it had been a physical resource and welcomed its online availability. However, concerns were raised about search engine optimisation, noting that it was not appearing at the top of Google search results. It was asked whether work could be done to improve its ranking and commended the improvement in figures. Members were encouraged to publicise the directory in other meetings.

·       It was confirmed that priorities for 2025/26 funding had been secured to develop access for children and young people (CYP).

·       School nursing services were not commissioned by the ICB but were managed by public health. It was emphasised the importance of school nursing in providing mental health support for CYP and stressed to ensure this was embedded in discussions going forward.

·       The Chair acknowledged the broad range of available services but noted a gap between perception and reality, particularly among GPs. It was suggested that the ICB should focus on improving communication, ensuring that messages were clear and not misleading. Public health’s focus on prevention was highlighted, along with the need for good communication.

·       CAMHS had reduced waiting lists from a year to 8 weeks and it was noted that that different waiting lists existed for neurodevelopmental (ND) assessments and mental health assessments. The reduction in waiting times had been achieved through additional staff recruitment and offering evening appointments. Waiting times remained a national issue for people with ND.

AGREED:

1.     The report was noted.

2.     Slides be circulated to Members of the board.

3.     Feedback for the Joy Platform be sent over to Officers.

4.     The Chair and Public Health Officers would write to the Central Government and NHS to state that the board was concerned on information received about ND people and the support available.