Mental health service transitions for young people
Accessible and easy to use mental health services: Welcoming, approachable and flexible services
Principle
Make service transition a flexible, managed process with planning and assessments, continuity of care and follow-up. A period of shared or parallel care is good practice.
Staff in all services, for adults and young people, must be able to relate to young people and make them feel at ease, because young people are worried about facing stigma, and being made to feel unwelcome. Staff need expertise and skills in engaging with young people and to understand the issues and concerns that can affect them. The SCIE advisory group thought that AMHS staff in particular should try to think about the whole family and consider young people's issues as broadly as possible. Young people themselves also thought this.
Young people want:
- informal approaches and to be made welcome
- to be able to trust staff and to be listened to
- to feel supported and not pressurised
- continuity of staff wherever possible – so as not to have to keep re-telling their stories
- where appropriate, services from non-health settings and community-based services.
For example, meetings with professionals can be more of a 'conversation' and less about answering questions. One young person decided to maintain contact with their mental health nurse as the weekly meetings were seen as 'having a chat'.
I think mental health people need a lot more training, especially with young people.'
Poppy, Cornwall
Young people like flexible services which:
- can be stepped up and down according to need and don't taper off suddenly
- keep them 'on their books' even if they don't need services at the moment
- are accessible easily and quickly, at home, out of hours and at weekends
- offer a drop-in facility and telephone support as well as booked appointments
- use 'assertive outreach' techniques to help them engage, and show flexibility and perseverance if appointments are missed
- operate like 'one-stop shops', thus allowing a variety of different needs to be addressed from one venue
- have clear policies on confidentiality and handle the sharing of information sensitively (including with parents and carers), taking into account the views and wishes of young people where appropriate.
Practice examples
- Sheffield Y-Talk consulted with young people who wanted:
- a welcoming reception area offering refreshments
- to be accompanied by a chosen person
- reminders sent by text
- the confidentiality policy to be explained beforehand
- a venue which has other services also based there (e.g. a 'one-stop shop').
Staff in the practice enquiry suggested:
- a programme of inter-agency training
- ongoing consultancy and advice from the voluntary sector and CAMHS on listening to and engaging with young people, their families and carers.
Y-Talk has appointed a diverse team, skilled at sustaining relationships with (disadvantaged) young people. The initiative has created a space decorated in bright colours which provides informal seating, tissues, make-up remover and drinks. Y-Talk and Sheffield YMCA have forged links with other young people's services in the city and located core services within the office providing the bulk of the city's youth work and Connexion services. Improving accessibility, including the opportunity to self-refer, is the aim.
- Central Norfolk EIT aims to see young people in a variety of community-based settings such as the home, GP surgeries and school. The staff are specially trained to work at the earlier end of the age range, and there is an intensive outreach model, focusing on identifying and meeting individual needs.
