Improving Children and Young People’s Mental Health in Lambeth

27/11/2019

Improving Children and Young People’s Mental Health Executive Summary

Taking feedback and learning from a cross-sector summit focussing on children and young people’s mental health (CYPMH), HEE London and Maudsley Learning delivered a one-day learning event for people working with CYP in Lambeth. The event aimed to improve interprofessional and multi-disciplinary collaboration for CYPMH and increase knowledge of services, organisations and initiatives in Lambeth.

The event was attended by nearly 100 people working with CYP from play specialists to paediatricians, GPs to teachers, and social workers to patient representatives, and was supported by the Children and Young People’s Health Partnership, CAMHS and Lambeth CCG. A broad audience was reached through the Young Lambeth Cooperative, London Borough of Lambeth and third sector organisations.

Evaluation of the day encompassed four domains aiming to assess the key project aims:
1. Monitoring social media and comms engagement to assess spreading awareness
2. Pre, post and follow-up data collection from attendees to assess their learning and translation
3. Feedback from speakers and key stakeholders to assess the day and inform next steps
4. Collation of themes and priorities discussed on the day, via group discussions and workshops

Evaluation found significant engagement and awareness raising across social media, as well as:
– Quantitative improvements to self-reported knowledge and confidence after 3 months
– Improved knowledge of services and learning from multi-disciplinary colleagues
– Evidence of sharing information and learning with colleagues post-event
– 100% of respondents fed back that they now felt more part of the mental health workforce
– Calls for more learning events, improved self-referral for CYP and better multi-agency collaboration

Key learning themes were:
– Knowledge of services available meaning more appropriate signposting, referral and support in practice
– Interacting with young people meaning enhanced communication, person-centred care and confidence
– Priority, enthusiasm, passion translating to inspiration, harnessing others’ work and renewed optimism
– Building networks and collaboration across organisations and professions through contact and outreach

The experience of organising, running and evaluating this event has provided useful learning to share to encourage such events across the health and social care system:
– Guiding principles: Aims, objectives, audience and stakeholders
– Design: Format (to meet aims), core content, outreach to contributors, develop activities, final program
– Logistics: event space, catering, dates and times, booking system, costs
– Communications: outline strategy, marketing channels, materials and activities, use gatekeepers
– Evaluation: determine strategy, methods (e.g. online/paper surveys), scope (e.g. feedback forms or follow-up collection)
– Preparation: presence of key stakeholders/leaders, event materials (delegate packs, name badges, other learning events)
– Final preparation: Confirmation of speakers, venue provisions, and delegates (e.g. reminder emails)
– On-the-day management: Physical space setup, housekeeping, keeping to time, supporting speakers
– Debrief: reflect on process and outcomes, lessons learned, build on progress, consider next steps, reporting
Background

The government published its Green Paper ‘Transforming Children and Young People’s Mental Health Provision’ in December 2107. This presents a large scale national programme to transform children and young people’s (CYP) mental health and emotional wellbeing services, affecting not only specialist CAMHS providers but all those who work with children and young people.

In response the HEE London team convened a summit in late 2018, ‘Improving Children and Young People’s Mental Health and Wellbeing’, bringing together healthcare providers from across CAMHS services, primary care (including Training Hubs), secondary care with voluntary sector partners, schools, local authorities, CCGs, STPs, the Metropolitan Police, children and young people’s representatives, local universities, the local Academic Health Sciences Network and Healthy London Partnership. The summit aimed to:

1. Highlight key policy areas in CYP mental health
2. Share good practice in CYP mental health education and transformation
3. Facilitate discussions on the next steps for transforming the CYP MH workforce in south London
4. Offer networking opportunities for all partners working with CYP in south London

Key findings form the event identified the importance of:

– Learning together to develop the workforce for young people
– Improving relationships between professional and voluntary sectors
– Using existing networks and building stronger relationships with the grassroots and supporting informal networks
– Increasing outreach
– Peer to peer support and ambassadors in a range of settings

Specific feedback and actions identified by attendees at the event included:

Listening to healthcare professionals and learning about what services they provide and bringing this information back to training groups (Met police representative)
Looking at systems of joining up services so children and young people, their parents and careers only tell their story once (CCG lead)
Raising awareness for mental health for all front line staff in schools, GP surgeries, youth clubs etc (CCG lead)
Further promoting joint working within roles (CYP hospital provider)
Encouraging communication (CYP hospital provider)
Exploring ways to collaboratively work with both health, voluntary and local authorities to improve the care and access for services for the young people I work with (CYP MH provider)
Sharing learning with my team […] to improve awareness of MH resources available and challenge any archaic attitudes towards MH (Met police representative)

To build on the momentum generated by the summit and to act on event findings and feedback, HEE London asked Maudsley Learning to develop, pilot and evaluate a one–day learning event for people working with CYP in the London Borough of Lambeth.
Improving Children and Young People’s Mental Health in Lambeth – A 1-day Learning Event

Key aims of the event were to:
1. Improve interprofessional and multi-disciplinary collaboration in Lambeth CYPMH
2. Increase knowledge of services, organisations and initiatives for CYP mental health in Lambeth

Core project deliverables:
1. A collaborative learning event for those working with CYPMH in Lambeth, building system alignment
2. A multi-disciplinary, multi-agency audience of people across the whole system in Lambeth
3. Evaluate the process and outcomes of the event for all stakeholder involved, including at follow-up

Core project activities:
– Design and organisation of a learning event to encourage networking and system alignment
– Engagement with key multi-agency stakeholders across Lambeth to provide content on CYPMH
– Communications campaign surrounding the event and subject area, including traceable activity
– Production and dissemination of evaluation materials (100% digital) to assess impact
– On-the-day management of a large-scale learning event with multiple contributors
– Analysis of multiple forms of data, and collation into useful findings, including a ‘how to’ event guide
– Project reporting, sustainability and next steps

Key details:
– The event was held in April 2019 at the ORTUS learning and events centre, Camberwell.
– Nearly 100 people working with CYP attended, from play specialists to paediatricians, GPs to teachers, social workers to patient representatives, reaching across the whole system in Lambeth
– Morning talks were based on service users connections with services at various points
– Lunchtime marketplace hosted stalls, including early help services, digital support, training teams
– Afternoon workshops focused on changing practice with pupils, parents, youths, and patients

Event collaborators:

Improving Children and Young People’s Mental Health

Improving Children and Young People’s Mental Health

Communications activities:

We worked particularly closely with the Children and Young People’s Health Partnership (CYPHP), SLaM CAMHS and Lambeth CCG on outreach. This was broadened out through the Young Lambeth Cooperative, London Borough of Lambeth and third sector organisations.

Consequently, we ensured a mix of attendees on the day that reflected people working with CYPMH in Lambeth. We ensured that our engagement extended to social media before, during, and after the day (with metrics recorded under evaluations), and follow up communications (social media and news article) were disseminated through Lambeth and South London, i.e. via CYPHP, King’s Health Partners, Maudsley Learning, and stakeholders from the day.

This approach aimed to recruit attendees but also to maximise the potential of the event to reach a broader audience that one-the-day attendees, and continue to build momentum in this important area. Notable within these considerations was engagement with social media, which is an important communications channel for both the field of mental health and the schools and education sector.

Figure 1. Example of slides with social media optimisation and co-branding.

Improving Children and Young People’s Mental Health in Lambeth

Improving Children and Young People’s Mental Health in Lambeth

Evaluation
Evaluation strategy:
Evaluation of the day encompassed four domains aiming to assess the key project aims.
1. Monitoring social media and comms engagement to assess spreading awareness
2. Pre, post and follow-up data collection from attendees to assess their learning and translation
3. Feedback from speakers and key stakeholders to assess the day and inform next steps
4. Collation of themes and priorities discussed on the day, via group discussions and workshops

1. Monitoring social media and communications engagement to assess spreading awareness:

These figures represent the week following the conference (Thursday-Wednesday) and demonstrate a reach significantly beyond that of the attendees on the day:
 Impressions (number of times people saw this on twitter): 2953
 Engagement (number of times people interacted with tweet e.g like, link click, profile visit) : 101
 Retweeted to a total following of 11,572
 Most impactful accounts (generating the most engagement)
 Website visits: 529 page views, 456 unique page views, average time on page – 3 minutes 48 seconds

Figure 2. Participants were encouraged to disseminate their learning to colleagues and via social media.

Improving Children and Young People’s Mental Health in Lambeth

Improving Children and Young People’s Mental Health in Lambeth

2. Pre, post and follow-up data collection from attendees to assess their learning and translation:

– The quality, format, speakers on the day were rated highly
– The goals of the day well received, in terms of building awareness and networks
– Quantitative increases to self-reported confidence and knowledge were found (see graph below)
– Qualitative themes of learning and development were identified:
awareness of services; signposting; interacting with CYP; confidence; enthusiasm; networking
– Multiple personal next steps were reported by participants for their return to the workplace:
IPE/MDT working; outreach; physical space; share with colleagues; other areas (parents, schools etc)
– Key areas identified for further work were also highlighted:
youth violence & trauma; parenting; self-referral; online and flexible learning; more training
Figure 3. Pre, post and follow up survey scores on key metrics.

Thematic analysis of qualitative feedback collected post-event and at follow up identified key themes that related to participants learning on the day and translation of this to practice, as well as other areas of development and directions for future work.

Learning themes and translation to practice:
– Increased knowledge and understanding of services available, leading to appropriate signposting, referral and subsequent support
– Improved interactions with young people, based on increased confidence, better approaches to communication and a person-centred approach
– Shared enthusiasm, passion and motivation in this area, through inspiration from others’ work and renewed optimism in the face of challenges
– Enhanced network and opportunities to collaborate across organisations and professions, built through continued contact and outreach to others

Other themes and future work:
Post-event participants had made plans for new service development activities, e.g. relating to outreach initiatives and undertaking consultation to better understand the challenges that they face. Participants reported continued learning through seeking further knowledge and learning resources, and significantly through sharing their learning with colleagues upon returning to the workplace.

The imperative for collaborative interprofessional and multi-disciplinary working was highlighted throughout the day, relating to the need to provide holistic care. This was associated with the importance of working with parents, carers, school staff and other community setting in which CYP can be engaged with. Similarly the necessity to engage in outreach activities to support CYP was highlighted, alongside the potentially crucial role of creating physical spaces to engage with CYP. Priorities for future learning included on youth violence, trauma, gangs and parenting, delivered through experiential learning methods including online and flexible resources
Figure 4. Youth violence was a key topic of conversation and future direction.

Improving Children and Young People’s Mental Health in Lambeth

Improving Children and Young People’s Mental Health in Lambeth

Key follow up findings:
– Quantitative improvements to self-reported knowledge and confidence remained after 3 months
– Participants reported improved knowledge of services and learning from multi-disciplinary colleagues
– The most commonly reported action post-event was sharing information with colleagues
– 100% of respondents fed back that they now felt more part of the mental health workforce
– Respondents requested more events and learning, improved self-referral for CYP, better multi-agency collaboration, and more support for junior staff and colleagues

3. Feedback from speakers and key stakeholders to assess the day and inform next steps:

Positive feedback was provided by stakeholders in three key areas of success for the day:
– Good breadth of work presented, notable enthusiasm and passion, active networking opportunities
– Broad attendance, but could go further (e.g. schools, primary care) and particularly focus on schools
– Helped to inform thinking about key areas for future work, including outreach services

“Thanks so much for organising the event, it was brilliant and made me as a commissioner really proud and pleased with the provision in Lambeth! It is great to see all different elements of a workstream or pathway come together and know what the other is doing, so this was great today. The enthusiasm came across from everyone and showed that all of the work links together well.”
Head of Children’s Commissioning, London Borough of Lambeth & Lambeth CCG

4. Collation of themes and priorities discussed on the day, via group discussions and workshops:

Sessions, documents and outputs were observed and collated to determine key themes and priorities:
– Collaboration between services, organisations, and people can be tough, but very worthwhile
– There is a huge amount going on around CYPMH, which must be brought together often
– Youth violence is a key issue, closely related to mental health, which people must be aware of
– You don’t need to be a mental health professional to talk about mental health!
– Young people are best engaged in conversations about things that matter to them first
– Cross-borough working can be beneficial to the system
– Training is often a forgotten tool, supporting people to work in new ways, particularly junior staff
– Connecting with others is key to developing better mental health!
– Self-referral can be helpful for engaging CYP

Key learning, a ‘how to’ guide:

The experience of organising, running and evaluating this event has provided useful learning to share with other organisations looking to encourage or run such events across the health and social care system. Key areas of activity are outlined below with a brief explanation of each.

Guiding principles: At the outset of an event there are essential considerations to guide its development and delivery. The aims of the event (i.e. why you are putting time into running it) should be clarified, as well as the learning objectives for the delegates and others involved. Similarly, the target audience of the day should be established and a list of key stakeholders should be developed and engaged with, alongside clear roles and responsibilities of those involved being drawn up.

Design: With the aims, audience and any key parameters (e.g. costs, times etc) of the event determined, the format and delivery of the event should be considered. This is the structure for the day from which the final schedule will be formed and the logistical requirements of the day will be determined. Subsequently, the core content that will be addressed within this structure should be determined and any required outreach to collaborators to provide this content can be undertaken. Learning activities and sessions can be developed based on the core content and key collaborators in a complementary way to fit into the structure and relate back to the core aims.

Logistics: Building on the key aims, parameters and format of the day, logistical requirements can then be addressed as they will likely have been raised during the activities outlined above. Event space needs and capacities can be finalised, with dates and times of the event following accordingly, again with the aims and audience in mind. Should extra input be required to understand an audience better this should be sought. Catering, housekeeping and on the day requirements should be agreed at this stage. Finally, a booking system or process should be set up – this may be a pre-existing internal system, or an openly accessible one such as eventbrite. Consider the data that you may want to collect from your delegates at this stage and how you need to store it.

Communications and marketing: Dissemination of the event can then begin, with the primary aim of recruitment and a secondary aim of spreading awareness more generally. This process benefits from a strategic approach, where communications materials, channels and audiences are mapped out in advance to give the best chance of success. This also allows you to monitor progress and determine the most effective communications activities that you undertake. Marketing activities may include hosting stalls or roadshows, email campaigns, social media posts, print flyers and materials, among others. Consider that you may need to access ‘gatekeepers’, people that hold a mailing list or newsletter that you may want to list your event in. From here recruitment should be closely monitored to guide future communications and marketing.

Evaluation: Similarly to communications, determining an evaluation strategy is important to deliver useful and robust evaluations. Again consider the aims or purpose of your evaluation, and the methods should be derived from this and factor in other logistical requirements (e.g. online versus paper surveys). Give thought to your scope and available resource and be realistic, less targeted data can be more useful than more generic data. Further guidance on evaluation is available in the KCL Evaluation Toolkit.

Preparation: Moving towards the event and again referring back to your aims and objectives, there may be some key elements of preparation to attend to. This includes the presence of key stakeholders or leaders that may support your aims and future practice, as well as ensuring that relevant organisations have been informed. Event materials must be both designed and prepared, for example printed programmes, other information to go in delegate packs such as flyers of other events, name badges or signage as required.

Final preparation: Final checks closer to the event itself will include confirmation of arrangements and requirements with the venue and any suppliers, reminder emails and event information being communicated to delegates, and confirmations and key information being shared with speakers or exhibitors.

On-the-day management: Consider the resource you will require to manage the physical space setup and any requirements of delegates, speakers and sessions. Take note of housekeeping issues that should be communicated to delegates and speakers, as well as any actions or activities that will be going on through the day. Consider the needs of speakers throughout the day (e.g. audiovisual equipment support), as well as the time keeping of the overall event, people don’t like to stay past the time listed on the event information! There may be communications opportunities throughout the day, such as social media coordination, or signing up for further events and information.

Debrief: Post-event there are elements that will require attention, such as circulating evaluations and analysing data, as well as making final financial arrangements. Consider whether you plan to provide certificates of attendance and a system for doing this, and whether you need or would like to report back to anyone on your progress. There will be an opportunity to reflect on the process and outcomes, determining any next steps that need to be taken and lessons learned from the experience. This gives you an opportunity to build on your progress with future projects.

Sustainability

This event has developed local expertise in Lambeth around event organisation, networking and collaboration relating to CYPMH. This has led to continued delivery of educational events such as this one, available via the Maudsley Learning website, including events focusing on CYPMH in schools.

Many thanks to HEE for funding and supporting such important and exciting opportunities to develop our approaches to CYPMH. For any further questions on this event please contact chris.attoe@slam.nhs.uk.

Appendix. Improving Children and Young People’s Mental Health Event programme.