Healthy Minds Lincolnshire Service - Lincolnshire County Council

Qualified practitioners deliver direct evidence-based interventions to children and young people up to the age of 19 (25 if a care leaver or SEND).  Priority is given to vulnerable groups; however, the service is for all who are experiencing emotional well being concerns who do not meet the eligibility for other available services, thus impacting on their ability to thrive. 

The challenge

As Lincolnshire is a geographically widespread county with large rural areas, reaching across the seven districts can prove challenging in terms of travel time for appointments. The initial six months of delivery has proved the need for the service evidencing 1,174 children and young people (CYP) receiving 1-to-1 intervention support. Whilst this is very positive, sustaining that level of support may become a challenge.

The solution

Lincolnshire Healthy Minds is providing support in three key ways:

• cognitive behavioural therapy (CBT) techniques, which are designed to help young people think about things differently and learn to cope in a more positive way
• support and advice to parents and carers
• bespoke training to education and children’s services professionals designed to build confidence in dealing with emotional wellbeing issues and providing a toolkit to support children and young people’s needs.

Referrals have been accepted across all age groups, covering a wide range of emotional wellbeing concerns including anxiety, low mood, self-harm, relationship difficulties and eating concerns.

Priority is given to the following vulnerable groups;

• Looked After Children
• Children with an Adoption plan or Adopted children or under a Special Guardianship Order (SGO)
• CYP with a learning disability and an emotional wellbeing concern
• CYP within Youth Offending Services
• Other specialist groups that may have an increased likelihood of an emotional wellbeing concern escalating to a mental health issue, for example, but not limited to, CYP with life changing or life limiting health conditions who have experienced abuse or trauma.

Referral into the service is via completion of an Early Help Assessment Form.  Where appropriate, this has led to a 'Team Around the Child' (TAC) intervention where the multi-agency approach is able to address wider concerns to identify necessary support at the appropriate time.

Whilst working closely with CAMHS and other services Healthy Minds Lincolnshire is not a precursor or part of CAMHS service delivery.  Healthy Minds Lincolnshire offers low level support, for concerns such as anxiety, stress and low mood at a level which would not reach CAMHS intervention threshold.

The service is a Partnership Agreement led by Lincolnshire County Council (LCC) delivered by Lincolnshire Partnership NHS Foundation Trust (LPFT).

Training and support is available to Lincolnshire pre-school and school workforce (including state funded academies), as well as relevant children's services professionals, to build confidence and provide the tools to support children's emotional wellbeing concerns.  This includes working with providers of further education and teaching schools in Lincolnshire to contribute to the core training delivery of initial teacher trainee and child care qualification programmes.  

LCC promote the HML service via its website; LCC have also built a new wellbeing website. This has been developed particularly to support young people, parents/carers and professionals in the first instance to view self-help information, to identify and access relevant national and local emotional wellbeing, behaviour and mental health support services; ensuring access to the right service at the right time. 

The online Emotional Wellbeing/Behaviour Pathway is the first step for young people, parents/carers or professionals to access or refer to relevant services, including HML Service which has an advice line.

The impact

Analysis and review of service delivery over the first six months of the service, from October 2017 to March 2018, is now taking place.  However, initial data shows:

• there have been 5,101 direct 1-to-1 intervention sessions delivered to 1,174 individual children and young people over this period.
• 79 per cent of Lincolnshire schools (maintained and state funded academies) had at least one child or young person on roll referred to Healthy Minds Lincolnshire (HML) 

Anecdotal feedback includes

• "Your client has been glowing all lunchtime. Thank you." (Head teacher)
• "I love working with you" (young person)
• "(The HM worker was)loads better than people I've worked with before" (young person)
• Parent/carer – "Thank you for intervention, found it very useful" (parent/carer)
• "Working with you is one of the nice things in life" (young person)

How is the new approach being sustained?

The service is co-funded by schools as a result of wide engagement activities regarding the health needs of school age children. Following the initial findings over the first six months of service delivery, work has now begun between LCC, LPFT and schools working together to develop a model of group sessions for CYP where there is a common theme of concern.

The Partnership Agreement is currently in place until September 2020 with an option to extend for a further 2years.

LCC, LPFT and schools working together are looking to develop a model of group sessions for CYP where there is a common theme of concern, plus build on staff training to support even earlier intervention that can be carried out by the education setting as the need arises, thus preventing the need for escalation.  This will not only help with geographical issues, but will also promote sustainability. 

Lessons learned

We knew the service would be well received following extensive and thorough engagement activities prior to implementation of the service, however, due to this being a brand new service and therefore nothing to benchmark against, it was not possible to anticipate such high levels of 1-to-1 referrals into the service during the first six months.  Whilst LPFT have met demand, this has prevented as many training sessions for professionals as we had hoped.  Steps are now in place to support this need.