Lincolnshire County Council have sought a different way to support their care experienced children with their mental health. Knowing that there are sometimes long waiting times for specialist support, the council identified a way to support social work staff to hold the mental health and emotional wellbeing needs of care associated children.
The challenge
Poor mental health can make it more difficult for children to excel in school, develop secure attachments and thrive in their lives. According to research from the UCL and King’s College London found that children in care are four times more likely to have a mental health problem than children living with their birth families. Some care leavers also report having significant mental health needs. These children and young people have unique needs that require a personalised and robust response. Nationally, fewer than 0.1 per cent of children in England are in care, but 4 per cent of children referred to specialist CAMHS services are in care.
The solution
There are different strands to Lincolnshire’s approach. To support older children, the county council, alongside Barnardo’s and health partners, pooled resources to joint fund a specialist mental health worker who works with children in care (aged 16 and above) and care experienced young people across the county including unaccompanied asylum seeking children and young people (UASC). This mental health nurse, working specifically to support looked after children, is based with the ‘Future 4 Me’ service (a combination of professionals from edge of care, early help, housing and youth offending teams) and has a link manager within Lincolnshire leaving care. The post holder develops training for leaving care workers to enhance their support to care experience young people, navigates the system, provides some one to one support with young people and focuses on trauma informed practice to support UASC care leavers. The post holder also reviews all serious safeguarding incidents in the service (that identify self-harming or mental health issues) and provides opportunity for reflection within the service which enables system change.
In addition, the council has built on its excellent working relationship with both the child and adolescent mental health service (CAMHS) and the in house “Future 4 Me” forensic service to bring together invaluable support, particularly for case formulation work with younger children in care. The forensic team, made up of two psychologists and employed by the council, supports professionals with developing strategies and approaches to supporting Children in Care who have mental health difficulties and challenges. Social workers are then supported to work creatively to find new approaches and solutions to very complex behaviours and diagnosis. The forensic team also review the placement planning model to identify what would better support children and young people.
The impact
The children in care and leaving care service has seen a real benefit to having a specialist mental health worker in the service. The team now has a direct link into adult mental health provision aiding excellent transition for all children and young people (which is something that needed to be strengthened).
“[The mental health worker] has really helped forge pathways." - Team leader.
With the new approach, staff are feeling more confident in their support of children and young people; this is building resilience in the teams and leading to less burn out. This is also resulting in children and young people having a better experience and being able to move into independence.
A young person was able to recover from significant trauma following direct support, detailed case formulation with the mental health service and risk management and public protection analysis from a forensic psychologist. The young person has had consistent support an input from the mental health and Future 4 Me services along with their social worker and NEST housing which has enabled this young person to sharing housing with other young people which is significant progress in 18 months.
A young person who is a care leaver has been able to move into supported yet independent housing from a tier four mental health unit. This is due to the mental health support they received and the support from staff in responding to crisis. The services demonstrated how they worked together to ensure the young person was supported at the most challenging times in their life.
Lessons learned
Investment in this bespoke inhouse service is felt to have really paid off. Whilst CAMHS is excellent, having an internal service where the local team can design approaches and set their own thresholds has enabled quicker easier access for young people, leading to improved longer-term outcomes.
Contact
Email: [email protected]