The Integrated Community Response (ICR) service is one such example, where Salford Council is working closely with 42nd Street, CAMHS and Salford Mind.
Salford has developed ‘an upfront approach to community support and easy access points’ mentions Simone Spray, the CEO of 42nd Street – a charity based in Greater Manchester – in our discussion. The Integrated Community Response (ICR) service is one such example, where Salford Council is working closely with 42nd Street, CAMHS and Salford Mind. Salford Council has also developed a model of place-based centres across its four localities, in which young people and their families can easily access a range of statutory and community services.
Young people’s needs sometimes do not fall clearly into the thresholds and distinctions of mental health – where traditionally NHS intervenes – or social care – where traditionally \s intervene. As their needs require support for both elements these young people often fall between the gaps causing their situations to escalate.
The Integrated Community Response (ICR) service was set up by partners in local mental health and social care statutory services and the voluntary sector across Salford and Manchester and was piloted almost five years ago. Mental health practitioners from 42nd Street were integrated into the early help and social work teams where they were able to quickly offer short term, deescalating therapeutic support as part of their broader package of support for young people, reducing escalation and avoiding long waiting times.
Following ICR’s initial evaluation, it was recognised that the service was a critical element of the integrated health and social care support available to some of the most vulnerable young people in Salford and Manchester. It was also evidenced that the programme had a significant financial impact on the system and had created cultural change in the workforce. The co-location of staff enabled open and honest conversations, which upskilled the Early Help workforce increasing their confidence and ability to support young people who were experiencing difficulties with their mental health. Support from leadership of all organisations involved was crucial in the success as there was a demand to do something different and do this together.
As a result, ICR is now mainstreamed in Salford’s and Manchester’s core mental health service and provided through Early Help Hubs developed in collaboration with the wider integrated system in both cities. Young people can often access ICR within the same day (maximum waiting time is three days). For now, access to the service stops at age 18, the team are considering extending access up to age 25.
Commenting on the ICR service, Angela Vallely says that it is an ‘excellent, cost-effective provision’. Working together, workers from the Early Help Hub and the ICR team in 42nd Street reach out to young people who are struggling and divert them to the most appropriate support for their needs. As a result of the joint and timely response, young people’s needs do not escalate, nor do they have to spend time on a waiting list.
Once young people are part of the ICR service they are also invited to join a ‘Changemakers’ programme that trains and supports them to engage in both volunteer and paid work with 42nd street, putting their experience to use and providing peer support to current service users.
How is the new approach being sustained?
Salford has developed and is currently expanding a model of place-based centres across its four localities (Central, North, South and West). Each place-based centre houses a range of services, including GPs, a branch of CAMHS, parental forums, libraries, etc. Placing mental health services within a community, multi-purpose building is especially important for fighting stigma associated with mental health. ‘So, you walk in and people wouldn’t know why you are there and which service it is you are looking to access’, mentions Angela Vallely.
When everything is housed under the same roof, it becomes easier to sign-post and refer people to the service most appropriate for them. The professionals develop better knowledge and understanding of other services operating alongside their own, and service users have easy access to all services regardless of whether they need to be diverted or not. For example, the worker in the ICR team, though based in Manchester, is co-located for part of the week with one of the Early Help teams in Salford.
Putting the right service in place before things reach a crisis’
– Angela Vallely, Early Help Locality Manager (Salford City Council)
‘You can’t do things on your own’, shares Angela Vallely and continues, ‘doing joint commissioning – it’s vital’. For joint commissioning to be successful, provisions should be made for a number of factors, including:
a) sharing the budget;
b) co-locating services and workers;
c) adopting a shared outcomes framework for everybody to be going in the same direction; and
d) inspiring leadership and accountability, so that it can be identified what needs to be done and who is accountable for achieving each step in that process.
And, of course, ‘listening to the community on what they want’ is an integral part of deciding upon the areas of joint commissioning, adds Angela Vallely. Capturing the voice of service users’ needs is one of the things constantly developed in Salford; for example, organising focus groups with multi-agency partners, or being advised by young people and their families so that the work the council designs and implements is influenced by them.
Angela Vallely - Angela.Vallely@salford.gov.uk
Early Help Locality Manager (Central), Early Help Service, People Directorate, Salford City Council
Simone Spray - Simone.Spray@42ndstreet.org.uk – CEO, 42nd Street