Agenda item

The Aneurin Bevan University Health Board is the final partner to be held to account on their progress in delivering on the 6 Steps outlined in the Well-being Plan. The ABUHB presented on the Mental Health of Children and Young People.  Key findings included:

-          Interventions haven’t been early enough and thought needs to be given to critical interventions that could make a real difference.

-          There has been a substantial increase in referrals for mental health problems via GP’s and children’s services.

-          Deprived areas of Monmouthshire are at greatest risk, with research evidencing that children growing up in deprived communities within affluent areas are at significant risk of identifying the social divide ~ these children know they are deprived and the gap of inequality can create significant mental health problems

-          Adult mental health problems can be traced back to problems from 14 years, so early intervention is crucial and links with the Adverse Childhood Experience work that has already been presented to the committee. There is a need to address ‘generational issues’ with the help of family services team.

-          Mental Health Issues have been identified by the Youth Forum as a key priority and we need to listen to young people about their major concerns about their future.

-          Monmouthshire’s response needs to be different to some of the other local authorities due to nuances.  

There is a significant piece of work taking place across Gwent on targeting children’s mental health at an early stages as follows:

·       Building a culture of support for professionals and supporting families as opposed to the child in isolation

·       Addressing silos across different teams who provide mental health care needs through the creation of multi-agency teams which are being established across Monmouthshire (currently Caldicot). Members challenged how silos are being addressed through the ‘Early Help Panel’ which brings agencies together.

·       The provision of peer support through peri-natal mental health support services, diversifying school health nursing to include mental health needs, community psychology support embedded in schools and “Circle of security” work on attachment issues.

Challenge:

Ø  There was challenge around how silos are addressed, the committee feeling reassured that work is being undertaken to address this. There are arrangements for local authorities to refer across county, although referring across to England can be more difficult.

Ø  Members challenged ABUHB on how confident they are that they are addressing this. The committee heard that the service offered to young people who didn’t present with very serious mental health needs was very poor. This has now changed since the advent of the ‘Early Help Panel’, GP’s and teachers now knowing how to make referrals, so a wait of 18 months has changed dramatically with families being able to access help within weeks. Whilst the picture has improved dramatically, it isn’t perfect.

Ø  The committee were concerned about the funding situation, given that the transformation fund is available until 2021 and the ‘integrated care funding’ received historically has been absorbed into health and social care budgets. Welsh Government wants to see evidence that changes have been made. Members were concerned that as there is no indication that more funding will be available, there will be a need to find the funding within internal budgets.

Ø  The Committee wants to know what success looks like and whether our perspective of ‘success’ is the same as Welsh Government’s. Members heard that CAMS is a key priority and that Gwent is the only area to have developed a transformational model.

Outcome:

·       The committee were reassured that the ABUHB are delivering progress on the six steps and that they could evidence this through specific actions.

·       There was concern for the capacity of the community psychology. Ongoing funding is a major concern for the committee and they will want to explore this further with the health board.

·       There is as real concern about what success looks like and whether our view of that aligns with Welsh Government’s. The committee would ask that clarity be sought on this, given that future funding may be linked to demonstrating ‘successful outcomes’ achieved through the funding received so far.