Norfolk Mental Health Youth Services – extending provision to 25yrs

Background

Policy recommendations have often included reforming child and young people’s mental health services (CYP MH) to better reflect the needs of young people (e.g. Department of Health: Future in Mind).

Programme of research

A series of CLAHRC EoE Fellowship projects undertaken by early intervention clinicians at Norfolk and Suffolk NHS Foundation Trust (NSFT) and Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) have explored and informed the design and implementation of CYP MH services.

  • A CLAHRC systematic review of studies found that young people wanted better access to services, more information, and continuity of care
  • An examination of referral and contact rates in NSFT CAMHS suggesting 14-17year olds were engaging poorly with services at the point of most need and 18year olds had the highest referral rates but the fewest contacts;
  • An iterative consultation process with key NSFT stakeholder groups examined ways to better meet service users’ needs;
  • A 14-25years youth service pilot in NSFT explored the impact of extending beyond the 17-18years transition point with researchers re-examining referrals and contacts. The rate of service contacts improved for 18 year olds, and there was evidence of greater efficiency with more equitable rates of referrals and contacts for those aged 14-17. In addition, service users scored higher on measures of social and occupational functioning and spent more time in structured activity after intervention.

This research provided evidence for improved patient outcomes, when extending CYP MH service provision beyond the typical 17/18 year transition to adult services.

These CLAHRC fellowship projects stimulated the development of a rolling programme of research and evaluation in the NSFT Youth Service, undertaken in collaboration with young people and partnership agencies, including commissioners. It also involved collaborative working with the CLAHRC West Midlands ‘MILESTONE PROJECT’.

Outcomes of the research

A new 14-25year NSFT Youth Service was established, which is an innovative example of mental health service transformation in the UK. The programme gave confidence to commissioners in the model, which comprises a pragmatic, ‘youth friendly’ and evidence-based service transcending traditional service boundaries.

Next steps

CLAHRC are assisting an ongoing NSFT project utilising routine outcome data to improve the efficiency of the Youth Service assessment process.

A 2017 NSFT fellow reviewed CYP MH service design models and is taking this forward to inform CYP MH services nationally as Clinical Advisor at the East of England Clinical Network and in collaboration with lead CLAHRC CYP MH researchers.

Outputs and publications

Related work:

Early-Stage Innovation Centered on Making for Youth Mental Health: A Design-Led Approach

Contact

Dr Tim Clarke Timothy.Clarke@nsft.nhs.uk  

Dr Jon Wilson Jon.Wilson@nsft.nhs.uk 

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