HeadStart Hull offers a range of early intervention emotional wellbeing and mental health support services for children, young people and parents. By intervening early, it is hoped that the need for clinical support will be less likely and a key element of this is ensuring that the right support is identified at this stage.
At the start of the HeadStart Hull programme, a process was developed which enables professionals in discussion with the young person in need of support, to identify the right support, bringing services together to jointly identify and respond to need.
The ‘HeadStart Hull Checklist’ is completed by the supporting professional in collaboration with the young person, and involving the family where possible. The ‘checklist’ is described as a ‘request for additional support’ as opposed to a ‘referral’ form, as this is felt to better represent the collaborative and community-based ethos behind HeadStart Hull. A key element of this programme is developing an asset-based approach, enabling young people to identify a ‘Trio of Trusted Adults’ in the school, community and at home. The checklist supports professionals in maintaining involvement whilst identifying additional support for a young person, therefore beneficial in avoiding a sense of ‘handing over’ responsibility from one professional or service to another and supporting a programme aim for young people to be able to identify trusted adults.
The ‘checklist’ allows key protective and risk factors to be discussed with the child/young person and their family and offer a ‘menu of support’ which can assist a young person to decide which services feels right for them. Clear criteria details the support that the different HeadStart Hull services are able to offer and this enables the young person/family/professional to consider the best options. This process enables all options to be considered, as opposed to the most familiar service and therefore promotes equal opportunity of access across all services on offer.
Prior to the checklist, it was found that young people were not always selecting the most appropriate services for their needs and this could present challenges at a later stage. In the 1st year, HeadStart Hull reported 50% of referrals accessing services that were deemed inappropriate to meet the young person’s needs. This reduced to 15% in the 2nd year and 10% in subsequent years as strategies were put in place to improve the accuracy of applications by supporting professionals to have better understanding about what each service offered. More effective collaborative working with children and young people and HeadStart Hull services is encouraged in order to ascertain whether it is the right service for a particular young person before a ‘request for additional support’ (referral) is made. Additionally, holding briefings with schools, early help and social care teams and the VCS, co-creating webinars, trainings and a service guide for professionals supporting young people have contributed to a clearer understanding and better outcomes for those young people for whom referrals have been made to the right service at the right time.
This approach promoted awareness amongst relevant teams of the services on offer as well as information about the emotional wellbeing and mental health challenges faced by young people, and ways to support them. It created the opportunity for professionals to request specific types of training and support from HeadStart Hull which, in turn, increased their confidence and capacity to address psychological and social concerns in their professional capacities, before requesting additional support.
Training requests that have been implemented as part of Hull’s Emotional Health and Wellbeing Training plan include responding to self-harm and understanding how to have a conversation about mental health.
For some young people it may prove challenging when changes to trusted relationships and adults arise, particularly if there is a need for intervention from another service. For instance, a young person may refer to peer mentoring and then find that they may benefit further from counselling. This challenge is overcome through the project’s single point of entry, as young people only complete the HeadStart checklist once, which gives consent to refer to all services required, and can be used as many times as the young person needs. Each checklist contains an ‘action plan’ which allows brief outcomes to be described. This means that the action plan moves with them, and promotes a simple, effective and long-term point of access for young people.
ENABLING ACCESS TO SUPPORT
HeadStart Hull have also worked closely with the local authority and CCG in remodeling the referral and application processes for children and young people’s mental health services, which now offers the city’s full range of mental and emotional wellbeing support at the point of referral.
This is a rapid and individualised response to young people seeking psychological support for a range of issues, using a cross-systems approach for children and young people’s mental health services.
When children and young people are referred to CAMHS for support, and do not meet the threshold, the case is taken to a Multi-Disciplinary Assessment Team (MDT) meeting with information sharing agreements in place to discuss, agree upon and direct cases to the most suitable services. The team consists of workers from CAMHS Contact Point, HeadStart Hull services, Health Visiting and School Nursing service and EHASH - Early Help and Safeguarding point of entry, Early Help services and Early Years teams. This dynamic range of professionals enables effective information sharing that assists decision making around the most suitable support for children and young people.
MDT meetings are held on a weekly basis, and enable young people’s needs to be met in an accurate and timely manner that promotes not only the wellbeing of young people but the efficiency and uptake of other services whilst avoiding an unnecessary wait for CAMHS triage.
With consent the information flows between services so that young people are not required to start a new referral process and can be considered for additional support from other services.
Many difficulties experienced by young people seeking support through HeadStart Hull are common yet don’t fulfil the criteria for mental health support through CAMHS, such as bereavement, loneliness and bullying. This process means that MDT members from a range of health, VCS and local authority services, including HeadStart Hull counselling, resilience coaching, peer mentoring and school-based group work, direct young people to the right services for them, without discriminating between different kinds and intensities of support need.
In 2018/19, 1,171 young people were supported by HeadStart Targeted Early Help services and 97% of young people showed an improvement in the presenting issue. HeadStart early intervention services have had a positive impact on wellbeing in Hull and by preventing escalation of need, there is likely to be less need for CAMHS.
Pre-Covid data from Hull CCG suggested that there has been a reduction in CAMHS waiting times from over 12 months to 6 weeks for the low mood and anxiety-pathway due to decreased demand. This impacts also on those young people who do require CAMHS support and therefore will experience shorter waiting times and demonstrates the overall value of identifying appropriate emotional wellbeing and mental health support at the right time for children and young people, as well as local support systems.
 A single point of access staffed by clinicians as the ‘front door’ for CAMHS.
 Including services such as parenting support, children’s centres and youth services