Doncaster: Mental Health Champions

The challenge

Historically children, young people and families in Doncaster haven’t been involved in the commissioning cycle around the emotional wellbeing and mental health portfolio. This means that decisions have been made (with the best intent), without the direct input from children, young people and families.

Due to the tight timescales in writing and submitting the first Local Transformation Plan in 2015, Doncaster Clinical Commissioning Group were unable to actively engage with children, young people and their families to the level that they wanted to. Instead they pulled on previous engagement and consultation to help shape the plan.

This obviously meant that the voice of children and young people and families was limited in the shaping of future emotional wellbeing and mental health provision.

The solution

To tackle this, Doncaster wanted to develop a sustainable youth participation framework that promoted active engagement with children, young people and families, at every level of the commissioning cycle.  In order to do this, they set about creating a service specification, detailing the aims, objectives and desired outcomes and through a tender process, commissioned Young Minds to develop and deliver a five-year contract.

The rationale for a long contract was to give sufficient time for the provider to work within the local area, building on existing work to develop a sustainable model that truly gave a voice to young people. Clear direction was given to the provider on what outcomes were expected.  However, in terms of the actual model of delivery and mechanisms for developing the framework, the provider was given freedom to be innovative, building on their extensive experience of engagement in this field.

Partners have been fully engaged from the start of the programme, and this has been a real strength, ensuring that the work undertaken by Young Minds fitted into existing strategies, participation and engagement work streams.

Young Minds quickly developed a framework for taking this work forward, using three stages:

Phase One: designing the participation approach

Phase Two: piloting of the participation approach

Phase Three: ongoing support from YoungMinds (years three to five)

Extensive consultation with young people, parents, carers and professionals in Doncaster was completed in year one.  This informed the eight participation principles for the programme: enabling, system-wide, recognition, strengths-based, facilitating, peer led, flexible, diversity.

YoungMinds, currently 18 months into their contract, have worked through phase one, and are mid-delivery of phase two.  To date they have:

• Generated insights from local children, young people, parents and services that could be used by commissioners to promote local service improvement.
• Designed a sustainable approach to participation for implementing across children and young people’s mental health services.
• Identified local Participation Champions, who will lead the implementation of the approach. These champions will include young people and professionals from services.
• Facilitated a series of five co-production workshops which explored current stakeholder experiences of mental health services in Doncaster. The events developed an understanding of what stakeholder motivations would be for engaging with the participation model. They also used the events to gather ideas for how a local participation model would best work.
• Brought all of the above together into a final one-day workshop to co-design the model of participation. This included the creation of a set of recommendations for improving the experience of young people across the local system of mental health and mental health services.
• Provided bespoke participation support to commissioners, helping them to develop their vision for how young people and parents could engage with commissioning and service improvement.
• Recruited 15 Participation Champions comprising children and young people (five), parents and carers (five) and professionals (five).
• Produced a report with thematic analysis of insights gained from the stakeholder engagement, which detailed the proposed approach to participation endorsed by local stakeholders.

Work on the second phase is currently being delivered. Its purpose is to pilot the recommended approach, and create sustainable ways of working, that provide commissioners with a structure for routinely engaging local children, young people and families in their decision making. Young Minds will train, support and help the Participation Champions to develop small scale projects that address some of the priorities raised.

In the third phase Young Minds will continue to support the implementation of the participation model beyond the two year design and piloting phase. This will include holding annual participation events, bespoke consultancy and activity with the Participation Champions.

The impact

Whilst it is early days in the delivery of this five-year programme of engagement, there have been some notable benefits of adopting this approach. These include:

• huge interest from young people, parents, carers and professionals to become Participation Champions; 61 applications have already been received, leading to 15 appointments
• despite not all being recruited, the 46 remaining applicants are involved ‘virtually’ and are used as a wider reference group;
• a case for change has been built across a local children and young people’s system, with a definite culture change and growing interest in children’s mental health.

Demonstrating local leadership and accountability

The development of the Participation Champions and the framework to allow agencies to really listen and understand mental health concerns and needs was led from the front and in response to poor levels of previous engagement.  A sense of accountability and the duty to get it right for children and young people has driven this process.

The Health and Wellbeing Board has overall accountability for the Local Transformation Plan. Delegated authority is given the Mental Health and Wellbeing Strategy Group which includes key strategic and operational stakeholders. Young Minds have a representative on this group and the aspiration is for a Participation Champion(s) to sit on this group.

What happens after the five years? The whole basis of the model is to deliver a sustainable model, so that youth participation in mental health services is embedded and becomes standard practice, culture and every day business. The Health and Wellbeing Board will ensure that this is kept on the agenda and will hold partners to account for how the respond.

Contact

Lee Golze

Head of Strategy and Delivery, Doncaster Clinical Commissioning Group

[email protected]

This case study, written by Su Turner of Insight to Impact Consulting Ltd, is taken from the forthcoming LGA publication ‘Lessons in local leadership and accountability for children’s mental health services’.