Solar was created to transform Solihull’s local provision from a four-tier 0-17 Child and Adolescent Mental Health Services (CAMHS) model with high service thresholds into an integrated approach with improved access for young people and families and better partnership working. The service takes a whole family approach, supporting families and carers as well as young people.
“Brightening young futures”
Solar was created to transform Solihull’s local provision from a four-tier 0-17 Child and Adolescent Mental Health Services (CAMHS) model with high service thresholds into an integrated approach with improved access for young people and families and better partnership working. In designing its approach to transformation, the local system aimed to deliver on the recommendations of Future in Mind and respond to local needs. The Local Transformation Board recognised frustrations from schools, services, young people and families which included long delays for support, problems accessing help, and limited service offers within the traditional tiered CAMHS arrangement.
Solar was first commissioned in 2015 as Solihull’s integrated, whole-system emotional wellbeing and mental health service for 0-19 year olds. It has since evolved and continues to be jointly recommissioned by Solihull Metropolitan Borough Council and Birmingham and Solihull CCG.
Solar is primarily delivered by Birmingham and Solihull Mental Health NHS Foundation Trust (BSMHFT), Barnardo’s, and Autism West Midlands. Staff from all three organisations operate under the Solar name, with shared governance and a centralised system for care planning and clinical records. BSMHFT delivers specialist child and young people’s secondary mental health services, Barnardo’s leads on lower intensity ‘primary’ mental health support, and Autism West Midlands delivers specific elements, such as autism support and education for service users. Some elements of the 0-19 model, including the crisis-home treatment team, work within both the primary and secondary elements of the service.
The service is designed around timely access to assessment and treatment through the single service. Solar accepts and encourages self-referrals directly from young people and families as well as professionals. An ‘open door’ single referral point means that young people and families are quickly able to access the right support for them from a range of options without having to obtain another referral. As levels of need change, the integrated approach helps young people move easily between different parts of the service. By using one clinical record and a single care plan, Solar also ensures that children and their families do not have to repeat their experiences and preferences as they navigate the system.
“I feel heard and understood - and not rushed.”
Young person (Solihull Together, 2019)
Following this single point of access, the Solar partnership can facilitate a range of interventions:
- Signposting, self-help resources, and support around social inclusion;
- Low intensity interventions, including individual and group talking therapies delivered in person and remotely, emotional resilience building, workshops, family and carer support, and parenting programmes;
- High intensity interventions, including cognitive behavioural therapy, family therapy, psychotherapy and other secondary mental health care; and
- Specialist services including crisis support, eating disorders services, psychological support for Looked After Children, and Learning Disabilities services.
The 0-19 approach aims to offer young people more flexibility and choice at key moments of transition to adulthood and to adult services. For those who are not fully ready to transition to adult services at the age of 19, support can be extended until the age of 21. As a future priority, and as part of the evolution of the approach, the Transformation Board is exploring how the local offer can be developed up to 25 year olds who need emotional wellbeing and mental health support, especially those young people leaving care, young people with special educational needs and disabilities, and other young people who have had adverse childhood experiences (Solihull Together, 2019).
How this approach works with families
The service takes a whole family approach, supporting families and carers as well as young people. The Solar Primary Mental Health Team includes a parenting coordinator who plans, prepares and oversees parenting courses across the borough for parents/carers of children aged up to 19. There are bespoke courses for parents of children and young people at different ages, and some groups are specifically designed to support parents of children with child protection or children in need plans.
Young people and families who use services helped design the service from the outset - the service name and motto, ‘brightening young futures’, was coproduced with young people. Children and young people also helped to design non-clinical service environments and helped produce a ‘Your journey through Solar’ guide for future service users (Birmingham and Solihull Mental Health NHS Foundation Trust, 2021). Young people coproduced a mental health conference, ‘You in Mind’, to raise awareness of mental health issues and the services available in Solihull. This conference was attended by young people from schools and FE colleges across the local area, who were able to feedback on the Solar service directly from young people.
Parents and young people are also members of the Local Transformation Board, which leads and oversees the Local Transformation Plan and has driven the development of Solar since its inception.
In 2018, the Solar service was rated by the Care Quality Commission (CQC) as ‘good’ for being safe, effective, caring, responsive and well-led. The CQC report highlighted effective joint across different organisations, including schools and the police (CQC, 2018). Positive reviews have also been delivered by the West Midlands Quality Review Service and Barnardo’s Corporate Audit and Inspection Unit, which found that the primary mental health element of Solar was ‘good with aspects of outstanding’.
There is evidence that the Solar model has been particularly important in facilitating access to support during a period in which local demand has increased. Solihull exceed the NHS England access target for 2017/18 of 30 per cent of children and young people with a diagnosable mental health problem receiving treatment, reaching 33.75 per cent. The number of referrals to Solar increased by 50 per cent between 2015/16 and 2017/18 (from 1,480 to 2,214) (Solihull Metropolitan Borough Council, 2019). Solar consistently accepts over 80 per cent of referrals to the services, which compares to an acceptance rate of 55 per cent for the previous service in 2014/15 (Vusio et al., 2020).
Sustainability and future plans
Solar is an established service which forms a substantial part of the Solihull children and young people’s mental health and wellbeing transformation plans. The service has developed over time, with improvements identified through regular feedback from young people and their families (Solihull Together, 2019). Current priorities for development include:
- developing services for 18-25 year olds who are care leavers, young people with special educational needs and disabilities, and those who have been subjected to exploitation or experienced adverse childhood experiences
- more workshops for parents, co-delivered by parents and young people who are experts by experience
- more peer support groups in Solihull for young people who are lesbian, gay, bisexual or transgender
- continued focus on transitions as young people move into adulthood
- ensuring the needs of autistic children and young people are understood
- further reduction in waiting times for support and the provision of good information to support mental health while young people are waiting.
Partnership working: The creation of a Health and Wellbeing Board was initially a useful vehicle to bring together the council, NHS services, and other key agencies, such as Police, Housing, Adult Services, Schools and voluntary sector organisations. This collaborative approach delivered the original tender specification for the integrated services. The service itself is delivered by a cross-sector partnership which works closely and effectively with other parts of the system, including schools and primary care.
Under one roof: The integrated model, with a single point of access to a full range of different services, has had a positive impact on the accessibility of support. It has also enabled young people and families to find the support they need in less restrictive, more community based environments.
Engaging young people and families: Through regular feedback, parent and carer forums, and coproduced annual conferences, the Solar service has adapted and evolved over time to better suit the needs of the local population. It has enabled the service to continuously improve and prioritise changes based on what people who use services want.
Birmingham and Solihull Mental Health NHS Foundation Trust (2021) ‘Your Journey Through Solar’
Solihull Metropolitan Borough Council (2019) Joint Strategic Needs Assessment Evidence Summary.
Solihull Together (2019) Solihull Emotional Wellbeing and Mental Health Services for Children and Young People: Local Transformation Plan.