Young people’s participation in Birmingham mental health services

ContactKatja Michel, Advanced Occupational Therapist/CAMHS Participation
Telephone0121 2550110
Emailkatja.michel@bch.nhs.uk
Websitehttp://www.lotsonyourmind.org.uk
AddressFinch Road Primary Care Centre, 1st Floor Finch Road, Lozells, Birmingham, B19 1HS

Lots on your mindThis project led by Birmingham Children’s Hospital NHS Foundation Trust aimed to increase young people’s participation in their local mental health services.

The Birmingham Children’s Hospital CAMHS Participation project aims to:

  • increase young people’s participation in their mental health service
  • get involved in service changes and developments
  • develop information resources
  • develop a new website
  • mental health promotional events, and
  • to improve the way we gather and act on feedback

The project group is for both young people and their Parents/Carers, but also for CAMHS staff to benefit from increased participation and understanding of young people’s experiences of the service. It is for young people and their parents to help CAMHS understand what is working well and what needs improving to make it an effective, meaningful and friendly service for children, young people and their families. It also involves young people in making protocols and resources more young people friendly to encourage and allow them to get more involved in their treatment and recovery.

Background

We are undergoing a large scale service re-design and as part of this, increased need for service user participation was identified.

Historically, while there is an established young people’s group at the acute site of Birmingham Children’s Hospital, there has not been an equivalent forum for Community CAMHS users to feed into service improvements and mental health service delivery. Young People’s participation was carried out at a more ad hoc basis and differed across different CAMHS sites across the city.

Although CAMHS has had a website that was linked to the Birmingham Children’s Hospital website, information lacked detail, it was difficult to find the website and it lacked content to what young people and families would find helpful and informative to understand our service and mental health presentations.

The change introduced and how this was done

A newly established working group was formed to focus on 3 specific areas of participation:

  1. Website development
  2. Service user Feedback
  3. Young People’s groups to contribute to service re-design and developments

Dedicated time for one of the clinicians to lead on the projects was made available. One Band 7 clinician is funded for 18 months (2 days back-fill funded) 2 days a week to focus on participation in order to progress on the website development and increase participation, engagement with young people and families and support the overall success of the Participation working group.

Working group consisted of clinicians and senior management from a range of CAMHS locations and specialities

Posters and competitions in waiting room to engage young people

Resources

Additional budget to fund 2 days a week Band 7 Occupational Therapist

Outcomes

  • Launch of a new CAMHS website that was developed together with young people and Parents. The website explains our CAMHS processes, (including our CAMHS inpatient service), provides information about transition, complaints, section 117, has links to local and national charities and support services; aims to be interactive with young people.
  • Since the launch of the new website, we have been approached by a sibling of a CAMHS user to develop additional resources for siblings
  • On-going communication with young people ensures that the website continues to develop and build on their feedback
  • Young people making changes in paperwork and information used in CAMHS
  • New care plans and protocols developed based on young people’s feedback and designs; new information leaflets are being developed and approved by young people
  • New ideas to enhance young people’s therapeutic engagement, understanding and collaboration in their treatment are being discussed as paper versions and they also feed into Birmingham CAMHS being a pilot site for a new web-based CAMHS portal
  • New feedback posters and cards designed by a young people to raise awareness of giving feedback and enhance information we receive
  • Dedicated time as Participation Worker allows contributions to national Mental Health campaigns, allows flexibility to get involved and contribute to a range of service changes and projects to advocate for young people, it allows time and opportunity to think creatively and respond quickly to opportunities to further enhance participation and also increase awareness of mental health service and challenges in the media
  • The role of expanding continuously
  • Creating a greater knowledge base and understanding of young people’s and parents’ experiences of the service and their mental health recovery, which allows us to critically examine our practices and improve, change, keep.
  • More transparent information for the public about our service, access criteria and how to get in contact
  • Validating young people and parents’ experiences and acting on them for them to see the outcome and contributions they have made
  • Electronic referrals are now accepted via the new website

Feedback

‘I would like to thank you so much for taking the time out to listen and then write this up so wonderfully. It means a lot to be heard.’

‘We looked at the CAMHS website today. I think it’s great and hope we can develop something similar for our trust.’

‘It looks fab and really accessible/user friendly for young people in my opinion! Just what’s needed for engagement.’

Challenges

  • Establishing a young people’s group at convenient time and venue for young people to feel comfortable and confident to engage – we have agreed on the most convenient times for young people and have continued face to face contacts, telephone and email contacts to maintain rapport and reduce anxiety for young people to become involved.
  • Being consistent across the Community CAMHS Service – each local area /specialist team (such as the learning disabilities team; the access team) has a ‘participation champion’ who is part of the participation working group.
  • Having multiple CAMHS sites and displaying information consistently across all sites – admin staff and ‘local champions’ have been extremely important in implementing this.
  • Building participation into the everyday workings in CAMHS and improve young people’s opportunities to feedback – we have developed regular reminders called ‘feedback Wednesday’ for a particular Wednesday a month, where clinicians and admin staff are reminded and encouraged to ask for feedback, posters are displayed in waiting areas to promote feedback on that day or the entire week of that Wednesday.
  • Affording clinicians’ time to contribute to the participation working group – dedicated 2 days a week has allowed one clinician to take forward aims and actions however, it has been difficult to maintain the group and allow clinicians to contribute as effectively as they would like due to other service changes and demands happening in in the service.
  • Involving our Learning Disability CAMHS Service users and making participation accessible and meaningful to them – we will be focusing on this for the next phase of the project and will set up more individual meetings, approach special schools for focus groups and evaluate this

Future plans

  • Continued support from Management Team.
  • Continued dedicated time to focus and progress on participation. Although this started as a specific project, the evidence demonstrates the need for dedicated time in a clinician’s job plan to continue engaging young people and parents and be able to continue developing a young people’s group that will contribute to CAMHS service developments but also be able to promote young people’s mental health in general to a wider audience.

Key learning

  • Need for dedicated time to focus on the project – there have been attempts for this work done previously , but in order to succeed and develop, time needs to be given within a clinician’s job plan
  • Perseverance to engage young people and a range of approaches to do this. Many young people are keen to get involved but their anxiety; school pressures, individual circumstances may prevent them from taking part. 1:1 meetings have been very helpful to build rapport and this aids engagement and allows them to contribute the way they want to
  • Management support for the project so that contributions and feedback can be acted on.

Further information

Birmingham Children’s Hospital NHS Foundation Trustwww.lotsonyourmind.org.uk is the dedicated CAMHS website developed with young people and parents.

www.bch.nhs.uk/feedback encourages instant feedback direct to service managers via a free mobile app which is widely promoted. The App was the first to be used in the NHS and was a winner for ‘Digital Excellence’ in the Guardian Public Service Awards 2013.

Download the app for: