Calderdale Metropolitan Borough Council: Open Minds

In response to the recommendations of Future in Mind (2015), Calderdale Council, Calderdale Clinical Commissioning Group (CCG) and other local partners came together in a multi-agency Emotional Health and Wellbeing Taskforce to create and deliver a Calderdale Local Transformation Plan for Emotional Health and Wellbeing.

04 Apr 2021

The ambition

The Local Transformation Plan envisaged a system without tiers, with a breadth of provision offering choice and control to children and young people in how they access support. The new system intend to join up pathways to mental health support, create meaningful ways for young people and families to influence service provision, make mental health support more accessible, and improve access to early or preventative help.

The plan, which officially ran from 2015 to 2020, created Open Minds (CAMHS) and the Open Minds Partnership as a redesign of the traditional tiered CAMHS (Child and adolescent mental health services) arrangement. The Open Minds Partnership brings together emotional health and wellbeing support across the area. It is jointly commissioned by Calderdale Council and Calderdale CCG and delivered by a partnership including Yorkshire-based third sector provider Northpoint Wellbeing, South West Yorkshire Partnership NHS Foundation Trust and other partners.

The approach

The Open Minds Partnership in Calderdale adopts the Thrive framework, aiming to deliver a service offer which is integrated (support is embedded across the community, not just in one service), person centred, and needs led (needs are defined together by young people, families and practitioners – not by care pathways or tiered systems of severity). It conceptualises need in five categories: Thriving, Getting Advice and Signposting, Getting Help, Getting More Help and Getting Risk Support (Wolpert, 2019). The Open Minds Partnership incorporates a broad range of approaches addressing different categories within the Thrive Framework. Key initiatives include the First Point of Contact, Open Minds website, and the Tough Times Reference Group.

‘First Point of Contact’ is Calderdale’s single point of access for all referrals to children and young people’s services, other than those for young people who have presented directly to A&E. The service is operated by Northpoint Wellbeing and staffed by mental health practitioners with clinical support from specialist CAMHS. Schools and GPs are the main referrers into the service. Parents, carers and young people can now also self-refer to access the service directly. Extended opening times, to include evenings as well as normal office hours, have been implemented to further improve contact with young people and families.

The Open Minds website was launched after extensive consultation with young people, parents, carers, schools, and professionals. The website provides advice, resources, information, access to support, and signposting to emotional health and wellbeing services. It is easy to navigate and include sections tailored to young people under 17 years old, 16-25 year olds, parents and carers, and professionals. The section for 16-25 year olds connects young people to services which offer careers advice, help around healthy relationships, counselling, support for exam stress, emotional health support and specialist services. Website content was coproduced with young people; there is an ongoing commitment to include young people in further development. The parent section of the website included tailored information on available services, resources, and advice to help parents understand and navigate mental health support for young people, drugs and alcohol, exam stress, school transitions, child safety, healthy relationships, and other support locally.

Calderdale Council directly facilitates the Tough Times Reference Group, which brings young people together to inform and guide services and strategies. The group currently comprises 11 members but has been running for several years and involved many more young people during that time. Members of the group are generally aged between 14-25, have lived experience of mental health problems and mental health support, and come from diverse backgrounds including ethnic minority and faith communities, non-cisgender identities, learning disabilities, and experiences of living in care or adoption services. Tough Times members are paid by the council in recognition of the value of their time and expertise. The group influences provision in several ways, including:

attending Open Minds partnership and Local Transformation Plan meetings
attending and presenting at other local system meetings
leading the development of content for the Open Minds website
scrutinising and refining the language used online and wellbeing apps
reviewing and providing feedback on grant programmes and applications.

Additional elements of the Open Minds Partnership offer include dramatherapy for 13-17 year olds with complex needs; online counselling service Kooth, which is commissioned to support young people aged 10-25; school-based initiatives, including peer mentoring; and the Barnardo’s Positive Identities Service which supports LGBTQ+ children, young people up to the age of 24 and their families.

How this approach works with families

The Calderdale approach has strengthened the voice of parent and carers within services:

Representatives from local parent and carer forum Family Voice sit on several task groups including the Emotional Health and Wellbeing Taskforce
Surveys of parents and carers inform service planning and delivery – with over 2,000 responses to the general emotional health and wellbeing survey
Parents and carers are involved in the development of specific resources.

The involvement of young people and families has helps shape local provision to support families as they, in turn, support young people.

Impact

The refresh of the Local Transformation Plan (2020) cited progress in achieving its aims, notably in partnership working, providing more holistic support that is needs-led, and facilitating children, young people and families to have a greater influence over how services are delivered.

The First Point of Contact service has increased its engagement with stakeholders in the wider system, including parents, GPs and schools. Between April 2019 and March 2020, the service received a total of 2,059 referrals (21 per cent increase on the previous year). Despite the increase in referrals, the average time to reach a referral outcome was reduced – at 4.58 days in 2019/20, down from 4.8 days in the previous years.

The Open Minds website has had significant reach and positive feedback from parents and young people. Over 11,000 first time users accessed the site in 2019/20.

“I was looking for support for both my daughter, who was in crisis, and myself as a parent on how best to support her. The website was easy to find…the way the website was laid out made it easy to navigate and find the information I was looking for. The website is really comprehensive and should we the first place that any child, young person or parent should turn to when looking for support…” Parent

Engagement with parents and carers has led to tangible service changes including:

a parent and carer section on the Open Minds website with accessible advice on supporting children and young people’s emotional health and wellbeing
a local service guide, coproduced with parents, carers and professionals, to support families whose children and young people are facing difficulties
an expansion of the First Point of Contact to enable referrals to be submitted directly from parents, carers and young people where appropriate
an expansion of mental health training to include parents and carers whose children are experiencing emotional health and wellbeing issues, delivered by the Open Minds School Link Worker, who trained 120 school staff to provide advice and support to parents

“I feel he [son] will grow up better able to express his emotions as I am better equipped to model and teach those behaviours.” Parent Feedback.

Sustainability and future plans

While the Local Transformation Plan for 2015-20 has now come to an end, the Open Minds Partnership continues to be the vehicle through which children and young people’s services are designed, commissioned and deliver. The Open Minds Partnership is currently developing a new plan which will build on progress to date and incorporate priorities including those linked to the impact of COVID-19.

The focus on partnership working has helped to establish an Integrated Commissioning Executive, which holds responsibility for the joint priorities of NHS commissioners and the local authority. The Executive has committed to joint working to develop an all-age mental health strategy for Calderdale, backed by a post jointly funded by the council and CCG, which will coordinate and implement the strategy.

Lessons learned

Meaningful engagement with young people: The Tough Times Reference Group is deeply embedded within the Open Minds approach. Young people’s contributions are clearly valued: they are paid for their time and they are present and listened to in strategic forums. Young people’s input has shaped support, created resources, and helped these be offered in accessible and acceptable ways. Young people with lived experience of mental health support and with experience as members of specific communities have helped the Open Minds Partnership access the value of their own perspectives and perspectives from within their wider networks (LGBT+ groups, faith groups, schools, service users).

“They’ve seen change, so they know their voices can be powerful”. Commissioning Engagement Officer

The whole council is committed: The Open Minds Partnership is part of a wider council focus on improving population mental health. The aspirations of the Calderdale Wellbeing Strategy for 2018/24 recognise that good mental health, just like physical health, allows people to participate in family life, the community and the workplace. The Wellbeing Strategy identifies objectives including developing new relationships with communities, shifting to prevention and health improvement, and joining up health and care services. ‘Developing Well’ during childhood and young adulthood (ages 6-25) is one of four keys strand of the all-age approach. These priorities echo key elements of the Open Minds approach and create a supportive environment for it to develop.

Joining up the system: Open Minds has provided a platform for services and system partners to operate in more integrated ways. It has improved experiences for young people and families, for whom help is more accessible (e g online or through the single point of access) and more joined up (a more holistic offer meeting a range of different needs more efficiently through better referrals and awareness raising within the system). The partnership approach encourages providers and commissioners from the NHS, local authority and elsewhere to combine efforts. This is a vital principle of the approach and has a promising legacy through the upcoming Open Minds Partnership plan and through the Integrated Commissioning Executive.