Health and Well Being - Find a freedom of information request

1. What specific provision is available in your area for children and young people diagnosed with conduct disorder and those with conduct difficulties? Please list individual services and tiers they fall under (e.g. Tier two or targeted; Tier three or community specialist or Tier four or inpatient).

2. What mental health provision is available in your area for children and young people in contact with social services, including looked after children, children in need or children under child protection orders? Please list individual services and corresponding tiers as above.

3. Is there specific provision in your area to support young people transitioning from Child and Adolescent Mental Health Services (CAMHS) to adult mental health services? Yes or no answer please. Please specify if CAMHS in your area covers individuals aged 18 and over and please specify the age range covered.

4. Do you engage with any of the following to understand the mental health needs of children and young people in your area?

1. Online Counselling Service (universal service) (Kooth.com) for young people in Lincolnshire aged 11 to 18 years (25 SEND and or care leaver) that delivers and promotes online counselling support, message boards, forums and advice on a wide range of emotional wellbeing and mental health topics, including emotional regulation and challenging behaviour. 

Lincolnshire outreach support services for Lincolnshire schools and academies includes Behaviour Outreach Support Service (BOSS) and Autism and Learning Difficulties (ALD) Outreach (universal services). The aim of the outreach services is to provide a holistic, integrated range of specialist interventions that will help schools to improve their ability to support pupils at risk of exclusion (BOSS) and to work with schools to better support pupils with autism, moderate and severe learning difficulties and social communication challenges (ALD Outreach). Support includes training and development support for schools to upskill staff working with relevant pupils. BOSS also offers further intensive intervention support for pupils at the point of permanent exclusion. 

Parent Programme Delivery Unit (PPDU) offers parenting programmes to support parents manage their child's behaviour.

Healthy Minds Lincolnshire Service is an emotional wellbeing service for Lincolnshire children and young people (universal service) aged 0-19 (25 SEND and/or care leaver). The service supports a wide range of emotional wellbeing concerns including emotional regulation difficulties.  The service focuses on early intervention, promoting resilience and the prevention of wellbeing concerns escalation to mental health issues. This includes the delivery of direct evidence-based interventions for Lincolnshire Children and Young People (CYP) experiencing emotional wellbeing concerns (one-to-one and group interventions), training and support for pre-school and school staff, as well as advice/guidance for parents/carers.

Alternative (education) Provision (AP) Extended Key Stage four Service supports Lincolnshire pupils in Years nine to 11 who have been permanently excluded or at risk of permanent exclusion from mainstream secondary schools. Provides a broad and balanced curriculum offer designed to be flexible and tailored to meet the identified development needs of individual pupils often with complex social, emotional and behavioural needs. 

Educational Psychologists – traded service available to work with school-aged young people (25 SEND and/or care leaver) with most complex needs, including autism, attachment issues and emotional wellbeing concerns. Work with schools and parents/carers to support them in meeting the needs of the young person. This includes direct targeted interventions with young people as well as training and support for staff working with the young people.

CAMHS:

Advice and guidance support to parents/carers is available on the CAMHS website: http://wearecamhslincs.nhs.uk/whats-worrying-you-parents/   

Support to universal services via the Professional Advice Line, consultation and training.

Consultation and contribute to Multi-disciplinary Team (MDT) discussions.

Evidence based therapeutic interventions in accordance with the following National Institute for Health and Care Excellence (NICE) guidance:

CG158 Anti-social and conduct disorders in children and young people 2013.

QS59 Anti-social behaviour and conduct disorders in children and young people pathway 2014.

Therapeutic interventions include:

Family/parent/carer work and consultation including specific parenting interventions; parenting groups based on “Nurtured Heart” principles: Relational Awareness Programme (RAP) focuses on understanding emotional dynamics in parent/child relationship and is an approach that is particularly useful for difficult, challenging and intense children.

Home assessment, intervention and treatment to service users in their home environment, whether that be a family home, supported living or a care home delivered by the Community Home Assessment and Treatment (CHAT) team. A Positive Behaviour Support model provides intensive support to people who are experiencing deterioration in their mental health or an increase in behaviours of concern and associated risk to self and others. The service responds quickly and positively to assess the level of risk and put in place a plan of care to address the immediate concerns. Initially for 72 hours, with additional support for a further two weeks. Once the immediate risks have been addressed and a clear plan is in place the Care Home Assessment Team (CHAT) will liaise with the community hubs who will then continue with the ongoing care plan as needed.

Children and young people with conduct disorder/difficulties are supported by teams within Community CAMHS including Future4Me (Youth Offending Service) Psychologist and Speech and Language Therapist and Learning Disabilities.

Inpatient provision is commissioned directly by the National Health Service England (NHSE) any FOI in this regard would need to be submitted to the relevant NHSE Commissioner.

2. Lincolnshire County Council commissions mental health services for relevant and previously relevant children in accordance with the Children Act 1989.

Children and young people in contact with social services, including looked after children, children in need or children under child protection orders are supported through a child-centred, multi-disciplinary approach, including commissioned children and young people's mental health services. 

Universal:

Online Counselling Service (Kooth.com)

Online emotional wellbeing and mental health pathway: (www.lincolnshire.gov.uk/ewb)

Targeted:

Healthy Minds Lincolnshire Service

Specialist:

Community CAMHS:

Support to universal services via the Professional Advice Line, consultation and training.

Consultation and contribute to Multi-disciplinary Teams (MDT) discussions.

Evidence based therapeutic interventions in accordance with the following NICE guidance:

PH28 Looked-after children and young people 2010.

NG26 Children’s attachment: attachment in children and young people who are adopted from care, in care or at high risk of going into care 2015.

Consultation, advice and support to foster carers, residential social workers and adopted parents.

Assistance with placement stability including behavioural management strategies to help prevent breakdown of placements.

Training in areas such as attachment and other mental health issues of LAC.

Co-ordination and liaison by Crisis and Home Treatment should admission to inpatient provision be required.

Care Leavers can be supported by CAMHS up until the age of 24, if already receiving service from CAMHS and if transition to adult services is not appropriate for them.

The target wait time for face to face intervention for Looked After Children (LAC) is four weeks.

Inpatient provision is commissioned directly by NHSE any FOI in this regard would need to be submitted to the relevant NHSE Commissioner.

3. CAMHS:

Young people transitioning from CAMHS to adult mental health services are supported by core CAMHS services.

CAMHS is available to children and young people up to the age of 19 years, age of 25 if SEND and/or care leaver.

Lincolnshire CAMHS has a flexible, patient-focused approach and as such aims to complete treatment and avoid transition wherever possible; young people are not discharged or transitioned to AMHS according to age, but rather when it is right for the young person.

Transitions are managed in accordance with the NHSE National Specification for Transitions from CAMHS Guidance 2015.

Transitions are collaborative with the young person fully involved and informed through-out the process.

4. 

Healthwatch: Yes.

Children and young people and their families: Yes.

Community and/or faith groups: Yes.

Charities or other Non Government Organisations: Yes -  Lincolnshire Council for Voluntary Youth Services and Voluntary Sector Forum.