Agenda item

RESOLVED

The report be noted.

Witnesses

Cllr Barnham, Cabinet Member for Children and Young People

Pinaki Ghoshal, Executive Director for Children and Young People

Sara Rahman, Director of Families, Quality and Commissioning

Simon Whitlock,Head of Service – CYP Joint Commissioning

Claude Jousselin, Deputy Borough Director – Lewisham CAMHS (South London and Maudsley Hospital)

Maryland Ocansey, Services Manager – Lewisham CAMHS (South London and Maudsley Hospital)

Johanna Dench, CYP Emotional and Mental Health Joint Commissioner

5.1.     Sara Rahman and Simon Whitlock introduced the report.

Members and the Young Mayor and Advisor put questions to the witnesses. The following key points were raised:

5.2.     Events had been held and an anti-racist action plan was being developed to address the underrepresentation of Asian, Black and Mixed Race young people in referrals. In recognition that CAMHS (the Child and Adolescent Mental Health Service) was not reflective of the community and that making the workforce more representative would take time, a further programme was being considered under which paid mentors would encourage and support young Black, Asian and Mixed Race boys to attend appointments.

5.3.     For 2023/24, the representativeness of the workforce would be a focus; certain CAMHS teams would employ people with different levels of qualification and experience and train them to work in the services.

5.4.     In the spirit of cultural humility, South London and Maudsley Hospital (SLaM) was piloting a Patient Carer Race Equity Framework under which it would ask the community how CAMHS could be improved to increase access and engagement by minority communities. As the number of staff exceeded the number of residents in attendance at initial engagement event in November 2022, SLaM had engaged with the community at a recent well-attended parent exposition held by a voluntary organisation and planned a further engagement event for September 2023.

5.5.     CAMHS was reaching out young people and their families where they lived, rather than waiting for them to come to services. A walk-in service was being provided via general practices and services via schools.

5.6.     Services were encouraged to use voluntary and faith groups to engage with the community.

5.7.     To learn from The Big Conversation, links had been established with The Albany, which had been the key coordinator of the event. How the steering group resulting from the Big Conversation could be supported in the longer term was being considered.

5.8.     The increased number of children not attending school, due to absence or elective home education, was noted. CAMHS was providing assessments via the Virtual School and special educational needs and disability and had contributed to the new SEND strategy.

5.9.     Increased referrals to eating disorder services were contributed to by the Covid-19 pandemic and lockdowns. Research was underway to establish more recent drivers, which may have included the ‘cost of living crisis’.

5.10. In relation to the 117 young people waiting 38 to 52 weeks or more for assessment, it was reported 9 of them had to wait more than 52 weeks. All of those nine young people had appointments assigned for within the next three weeks; it was noted they had all missed about three previous appointments, contributing to their long waiting times. More suitable and accessible assessments were being offered, such as twice-monthly Saturday clinics, in addition to usual provision. Services understood peaks and troughs in demand and sought to configure capacity around them. Services were working with the voluntary sector to provide young people with support before they required more-specialist services. Young people who were waiting for assessment received contact, information and advice and group interventions from volunteers.

5.11. Following the increase resulting from the pandemic, demand for services was slowing but had not returned to pre-pandemic levels. National data and research indicated that increased children and young people mental health and wellbeing needs would remain; the situation was not unique to Lewisham or London.

5.12. The Chair noted that the Select Committee had warned 18 months ago that a sustained surge in demand inevitably leading to longer waiting lists for CAMHS was imminent. A proactive national strategy to address workforce challenges would be welcomed.

5.13. The Mulberry Centre, delivered by a voluntary organisation with NHS support, provided drop-in support in the north of the borough for young people. Kooth enabled young people to access online counselling and support of several forms, with the option of anonymity. How such services, self-referral and referral without parent or carer, school or GP involvement could be expanded were being explored. It was noted that many young people were unaware such support existed.

5.14. It was noted by the Young Advisor that when a young person acknowledged their mental health needs, it was likely those needs had been present for a while, and that accessing support was stigmatised and the support available from CAMHS were viewed negatively in the community.

5.15. Engagement had been undertaken with the local system regarding the development of a Single Point of Access (SPA) associated with the Family Hub programme. The SPA would provide an avenue for children and their families to access the most appropriate support available from a broad range of services delivered by a number of bodies, which would otherwise be confusing to navigate. The SPA was being designed locally in partnership as there was not a one-size-fits-all model. It would include the multi-agency safeguarding hub and CAMHS staff.

5.16. The Cabinet Member, accepting there remained cause for concern regarding waiting times, highlighted that the number of young people waiting a long time had significantly reduced and funding had substantially increased in recent years. The significant pressures faced by young people were reflected in increased demands on health, social care and education services. It was still not empirically proven that early help would reduce demand for acute services, but the Cabinet Member was hopeful such impact would become apparent in the next year. 

RESOLVED

The report be noted.

ACTION

Claude Jousselin, Deputy Borough Director – Lewisham CAMHS (South London and Maudsley Hospital) to provide the gender breakdown of referrals to eating disorder services.