'My Voice Matters' is the theme of this year's Children's Mental Health Week, placing a spotlight on empowering children and young people, equipping them with the essential tools to express themselves and ensure their voices are heard.
According to latest prevalence data, approximately one in five children and young people in England now have a probable mental disorder. This is up from one in six in 2021, and one in nine in 2017. Just shy of half a million children and young people are currently on mental health waiting lists, 85% higher than before the pandemic. Almost three times as many children and young people have been referred to crisis care than before the pandemic.
This week marks an opportunity to explore what trusts are doing, with children's voices at the centre, as they strive to deliver mental health care for children and young people. Enabling children and young people to have a say in how they want to receive care and working with them as equal partners can help services better meet their needs and manage rising levels of demand. Listening to service users, their families and carers is also a critical part of what is required to make much-needed improvements to the culture and quality of mental health inpatient services so all are consistently delivering safe, high quality care.
Making youth voices central to designing, transforming and delivering services
Coproduction enables trusts to foster mutual respect and shared ownership, and reshape services to be more person-centred, inclusive, and higher quality.
Humber Teaching NHS Foundation Trust's 45-member Youth Action Group (HYAG) – reflective of the diverse community it serves – expressed concern about the rising mental health challenges encountered by their peers and community. In response, the Youth Recovery and Wellbeing College was developed, to provide virtual and face-to-face experiences, workshops and activities, and serve as an alternative for young people facing long waits for mainstream services. The HYAG designed the website, co-produced the sessions available and remain involved as the provision grows further.
"The HYAG has helped me in more ways than I first expected. I have been included in conversations about various topics and felt as if my voice was heard. My ideas have contributed to make change to my community and it has given me a sense of belonging. My experiences have been validated as a brown person and I have heard other's perspectives to help me become more well rounded. I have thoroughly enjoyed working with these wonderful people." - HYAG member
The trust has worked hard to connect with all young people in their community and its HYAG is committed to reducing health inequalities and enhancing accessibility. Yet, the trust also hopes to understand and adapt provision to better meet the needs of a wider range of groups reflecting the diversity of the area it serves.
Other trusts have made coproduction central to projects to develop specific services, including the wards where they are provided.
One example is the King's Maudsley Partnership's Pears Maudsley Centre for Children and Young People. The King's Maudsley Partnership is a unique partnership between South London and Maudsley NHS Foundation Trust and King's College London's Institute of Psychiatry, Psychology & Neuroscience, with Maudsley Charity as its charity partner. From the first design phase to construction milestones, young voices have played a crucial role in its development. They asked for the building to be open and include natural daylight, and this informed the building concept, shapes, and room arrangements. The Partnership also considered the needs of autistic children and young people and those with heightened sensory experiences in the centre's design.
At Leeds and York Partnership NHS Foundation Trust, young people and their families were included in every step of the development of Red Kite View, a children and young people's mental health inpatient unit which opened in January 2022. Children also coproduced a new Patient Experience Measure to support gathering of meaningful feedback and service improvements have already taken place in response.
Redesigning recruitment
Trusts have also worked with children and young people to enhance their hiring processes to help ensure people with the right values and skills are delivering their children and young people's services.
Humber Teaching NHS Foundation Trust include young people on the recruitment panels. A recent example is recruitment of the clinical lead for children's services.
"One of my most memorable moments in the group is getting to sit on the interview panel for new health care assistants at the Inspire unit, as this was a very unique opportunity that I am very grateful for" - HYAG Member
Young people have also helped to develop interview questions and sat on the interview panels for most staff posts at Red Kite View at Leeds and York Partnership NHS Foundation Trust. More widely, the trust has around 20 former service users as part of a "Graduate Group" who are regularly invited to take part in recruitment, and other projects involving consultation, evaluation, and research.
Enhancing communication
Trusts are also working with children and young people on the way they communicate their services, ensuring information is accessible and relatable.
At Sussex Partnership NHS Foundation Trust, the children and young people's clinical advisory group (CAG) helped review the Core Principles underpinning the single point of access and advice offer. The CAG helped translate the principles into everyday language and provide a sense check for what was included, with the group's revisions adopted in the final principles document. Other trusts have consulted young people and their parents on social media content and marketing materials and campaigns.
This year's Children's Mental Health Week emphasises the pivotal role young people can play in shaping the services they use. The post-pandemic mental health challenge is significant, but there is an opportunity for trusts to continue to drive efforts towards transformational co-production. Embracing and valuing young voices leads to a more compassionate, responsive and effective mental health service.
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