Children and young people today face a unique mix of challenges and anxieties. From the fallout from the pandemic to the current cost of living crisis, the impact of this turmoil has been devastating.
Teenage years are not a dress rehearsal for life. We know that if mental health needs are unmet in these critical years the consequences are hugely detrimental. But, after years of cutbacks and extra pressure from the pandemic, the current system can't keep up with the increasing demand. Average waits for a first appointment vary by NHS trust from 10 days to three years, with some trusts not offering treatment to 60% of young people referred by GPs.
Young people missing out on mental health support isn't novel. In 2018, we undertook a joint review with the former Southwark Clinical Commissioning Group of mental health services for children and young people aged 0-25 in the Southwark borough. This showed a shortfall for those who needed extra support with their mental health, but did not meet the criteria for specialist services.
We heard from young people about their struggle to get help. Some had even resorted to self-harming in a bid to be seen quicker. With an NHS target treatment rate of only 35%, there was no question we had to step in.
Given the scale and severity of the problem, we had to be bold. We began by being the first council to commit to 100% of children and young people in our borough having access to mental health support. We approved £2m towards fulfilling this pledge.
The earlier someone gets support for their mental health, the more effective that support will be. This informed our decision to set up an early support hub for young people with low-level mental health problems, such as anxiety and stress. Our aim was to reduce the number of young people reaching crisis point. Our service had to be open access so young people could walk in or call whenever they needed support.
Local young people helped us design and name our service The Nest. We appointed charity Groundwork London, who are leaders in social and environmental regeneration in London, to deliver free and confidential mental health support services from a drop-in hub at the heart of our borough.
The Nest launched during the first lockdown of the pandemic and costs about £500,000 a year to run. Various therapies are offered via one-to-one sessions, group work, and online resources, including art, music, play, psychodynamic and interpersonal therapy.
Two-thirds of young people who received longer-term support said they felt more confident, while 73% said they felt happier. The Nest's success paved the way for us to broaden our initial focus on 11-25-year-olds to supporting the youngest of children, involving their whole family. The Nest now offers bespoke support for parents and carers, as well as a dedicated team that works in schools across Southwark.
What has been one key takeaway in all of this? An early support hub cannot be successful without trust.
First, you need to build trust with young people, their families and other local partners. Since launching in May 2020, The Nest has received more than 1,500 referrals. Top referrers include schools, families, social workers, and early help staff. Other community venues, such as GP surgeries, are now starting to facilitate satellite therapeutic sessions offered by The Nest.
Second, you need to build trust with local NHS services. The council has built strong working relationships with colleagues in child and adolescent mental health services (CAMHS), including weekly multi-disciplinary case meetings.
Third, you need to build trust with the local community. The Nest has proved the effectiveness of early support hubs to respond to local needs. Two in three referrals are for young people from black and minority ethnic backgrounds, which maps onto the demographic of Southwark's young people as a whole.
We are all facing impossible decisions about what public services to prioritise. But if we do not act now, the crisis in young people's mental health is only set to become even more desperate. Early mental health support can be life-transforming, positively impacting every aspect of a person's life. We cannot ignore the ethical and moral reasons for prioritising this, for individuals and for society, even (perhaps especially) in hard times. We believe early support hubs are the answer for councils wanting to step in so that every child and young person can get the help they need, when they need it.
Genette Laws is director of commissioning at Southwark LBC
@lb_southwark
