This report aims to understand how personalised care interventions can better support children and young people who experience poor mental health and social deprivation, and to develop evidence regarding what works to enhance the personalised care offer for this cohort. The report makes a series of recommendations aimed at improving the experiences of this group, based on engagement work undertaken across the three sites with 19 young people, 11 parents, and 7 site professionals.
This report aims to understand how personalised care interventions can better support children and young people who experience poor mental health and social deprivation, and to develop evidence regarding what works to enhance the personalised care offer for this cohort. The report makes a series of recommendations aimed at improving the experiences of this group, based on engagement work undertaken across the three sites with 19 young people, 11 parents, and 7 site professionals.
Impact of Personalised Approaches on Disadvantaged Young People
While those we interviewed expressed mixed experiences and varying outcomes from clinical mental health support provided by Child and Adolescent Mental Health Services (CAMHS), Emotional Wellbeing & Mental Health Service (EWMHS) or elsewhere, all of the young people and families we spoke to told us how the personalised support they had received had a positive impact on their life, mental health and wellbeing. Considering the nature of the impacts described below, this strongly indicates that personalised support is a highly effective option for young people from backgrounds of social deprivation.
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Several key impacts emerged across the sites:
Reduced Loneliness and Isolation
Young people aged 16-24 are the age group, particularly from socially deprived backgrounds, who report the highest levels of loneliness and isolation across the UK population (ONS Community Life Survey 2017). Several of the young people we spoke to said that the personalised support they had received had reduced their isolation and loneliness and enabled them to connect with others in their community.
Greater Access to Education, Training and Further Support, Improved Skills and Confidence
Several young people had returned to education and training or were able to access a range of support services they previously did not receive. Young people also explained that the personalised support had improved their skills and confidence, including life skills such as how to cook different meals, and how to budget effectively.
Personalisation
Many of the young people and families we spoke to highly valued the ways the support they received was tailored to their interests and needs, with the offer of choice and flexibility in how they were supported. Many young people explained how the process of receiving person-centred care had made them feel understood and cared for, in a way they hadn’t experienced from other forms of support. Many expressed concern about the lack of options for support in mental health services, which several young people described as being a ‘one size fits all’ approach that was unable to understand and properly meet their needs. Often young people had found talking therapies to be an inaccessible form of support.
Practical support
Social prescribing approaches and personal health budgets are accessed with agreement of the relevant NHS clinical team and focus on addressing health outcomes and can provide items and experiences which young people from socially deprived backgrounds would otherwise not be able to afford. In those studied here, it included arts and crafts materials; bus passes; driving lessons; laptops; musical instruments; a cooker; children’s toys; sports equipment; gym memberships, and more. Respondents from all sites valued how this practical support helped them address factors in their life that were causing significant stress, or enabled them to access protective activities against poor mental health. For example, several were able to receive bus passes or driving lessons, which reduced their isolation and improved their mental wellbeing.
Choice and control
Young people reported that one of the most important features of the support received was how they were allowed to make decisions. Having choice and control over their support options seems of particular value to young people from socially deprived and other disadvantaged backgrounds, who often have been given little agency in decisions.
Co-production
A significant aspect of this choice and control was that the services had been coproduced having evolved based on the feedback of young people. Young people were also involved in naming the services and, in one area, some had also been trained to volunteer and be part of the delivery of the programme.
Community-based support and Trust
Another particularly valuable aspect for young people from deprived backgrounds is that it is based in the community rather than in clinical settings and is seen as a less formal and more accessible form of support that had put them at ease. Several care leavers expressed low levels of trust in clinical services and reported feeling judged when accessing support. Young parents expressed particular wariness of statutory services because of a fear of having their child taken into care.
Holistic and integrated approach
Young people and one of the site professionals described the benefits of a holistic approach. It was noted that while most mental health care plans focused on mental health needs, and some may also explore access to education, there was a gap in holistic support, particularly around relationships and social opportunities. Many young people from socially deprived backgrounds have overlapping and complex needs and have had engagement from a range of statutory services. Several of the young people spoke about being in a near-constant process of referral and re-referrals. Many of the young people reported that holistic support had a positive impact on their physical health, confidence, family relationships, loneliness, education, as well as their mental health.