Children and Young People's Mental Health: New Normal - Same Crisis

Registration and Coffee in the Networking Area

Chair's Opening Address

• Joe Rafferty, Chief Executive, Mersey Care NHS Trust (confirmed)

This presentation will review the transferable benefits discovered by innovating in response to the coronavirus pandemic that could be carried over into the post-COVID world, both for service users - such as streamlining access to clinicians, as well as benefits to CAMHS service providers; including strengthened multidisciplinary working as a result of more regular meetings between teams, made more convenient by digital platforms. The Liverpool CAMHS Partnership is a collaboration between the NHS and third sector organisations including Barnardo's, the ADHD Foundation and Mersey Care Trust that has adapted to remote working to support children and young people with a wide range of needs, introducing a multi-stream of digital services that have been utilised by more than 800 children, young people, parents and carers since April 2020, including:

• Establishing a dedicated 24/7 access and crisis care service for children and young people up to the age of 18 years, meaning that any child or young person, parent or carer in crisis can access a mental health clinician directly, at any time, seven days a week via a freephone number or an email address; with the option should it be necessary to receive a more detailed mental health assessment via a video link on the same or next day. 
• Targeted individual/group support for vulnerable people living with a wide range of MH challenges including sleeping and eating disorders through video or telephone discussions, leading to face-to-face consultations (fully risk-assessed for COVID-19) when required.
• Increasing and targeting social media activity to promote the services, give advice and share links to support. Instagram has been used to engage children and young people with services, online coffee mornings have been hosted for parents/carer forums to understand their needs.   

• Dr Bernadka Dubicka, Chair of Child and Adolescent Faculty, Royal College of Psychiatrists (RCP) (confirmed)

The Royal College of Psychiatrists have published a new report Technology Use and the Mental Health of Children and Young People backed by the NSPCC and YoungMinds, making high-impact policy recommendations to protecting children and young people’s mental health. The study looks at diverse types of interaction(s) with online resources and possible impacts on children and young people’s mental health, including exposure to bullying, exploitation, gambling or violent/graphic imagery; whilst contextualising the negative influences of tech in balance with the positive. The report contains recommendations for young people, parents, educators, clinicians and government, including:

• Building on the suggested 2% levy on the UK revenues of major tech companies that fail to protect children online – the report recommends establishing a levy commensurate to worldwide turnover – a ‘turnover tax’ that ring fences some of the money for mental health research may be more impactful.
• Regulators should urgently review and establish a protocol for the sharing of data from social media companies with universities for research into benefits and harms on children and young people.
• Making use of programmes installed in smartphones, tablets and consoles that limit the amount of time a child can spend online.
• Enable the regulator to undertake a joint review with the UK Gambling Commission to review regulation regarding loot boxes, in line with other countries recognising loot boxes as a form of gambling.     

Headline Sponsor

Question & Answer Session

Coffee in the Networking Area

Case Study

The UK's leading children's charity commissioned YouGov to conduct a poll of 4,000 children and young people aged 8 - 24 year's old across Britain, asking them: how did you feel during lockdown? 

• 41% said they feel more lonely than they did before the lockdown
• 38% reported feeling more worried
• 68% of respondents said not seeing their friends had been one of the most difficult things about lockdown
• 37% said they felt more sad
• 47% said they would still be more isolated from their friends once things return to normal
• 33% disclosed that they had more trouble sleeping
• 34% said they felt more stressed 

The charity is warning that lockdown(s) could have an impact on the metal health of a whole generation. This presentation will outline actions that can be taken forward from Barnardo's Generation Lockdown report to improve the mental health of children and young people after lockdowns.

• Dr Wendy Sims-Schouten, Associate Head (Research and Innovation) and Reader in Childhood Studies, The University of Portsmouth (confirmed)

In this talk Dr Wendy Sims-Schouten will focus on the challenges and opportunities when it comes to spotting signs of potential mental health issues in the primary school age group; acknowledging the voice of the child and parents, as well as developmental pathways and milestones. When we talk about mental health support in schools, most of us picture a teenager, and most of the training such as Mental Health First Aid is geared towards this age group. Yet, there are signs and symptoms of specific mental health issues at primary school and earlier on, even when children are in the EYFS [the early years foundation stage].

Getting involved early on with the right interventions, training and support for teachers, may mean preventing those signs from turning into diagnosable mental health issues. Moreover, Dr Sims-Schouten will highlight that if we fail to give children a method of expression, there is a danger that this will manifest itself as behavioural problems, with the child being blamed for their ‘bad behaviour’, receiving punishments rather than support. While teenagers may be able to articulate their feelings, younger children often cannot and sometimes they do not really understand what they are feeling, and it is more likely they will say they have a stomach ache or they are not feeling well. It is not the role of teachers to diagnose mental health problems or attempt to "fix" them. Yet, spotting early signs and communicating about any concerns with parents is essential. This also means a need for more training and support for teachers.

• Dr Sarah Wynick, Head of Psychiatry CAMHS, The Tavistock and Portman NHS Foundation Trust (confirmed)
• Andrew Balfour, Consultant Clinical Psychologist & Adult/Couple Psychotherapist, Tavistock Relationships (confirmed)

The acknowledgement that, where there is inter-parental conflict, whatever work is done for the child will be undone if there is significant inter-couple conflict, led to the opening of discussions between Tavistock & Portman NHS Foundation Trust and local charity Tavistock Relationships around the idea of attaching couples therapy to children and young people’s mental health services. Since 2017 the couple’s therapist has delivered more than 300 sessions to parents of children who have been referred to CYMPHS. For some of these cases, the dysfunctional parental relationship was the primary cause of the children’s presenting symptoms. For others, the child had difficulties of their own, e.g. ADHD, depression and anxiety but the parental difficulties were either getting in the way of their treatment or exacerbating the symptoms. In some cases the child’s chronic illness had caused the parental conflict, which was then keeping the child stuck in a negative cycle and impeding recovery.

Both the psychiatrist leading the multidisciplinary team and also the social worker in the service found that having a couple therapist with psychoanalytic training and perspective was invaluable in helping parents reflect on the nature and quality of their relationships, as well as enabling the service as a whole to think about couple dynamics from a psychoanalytic perspective more often and in a more thorough way. Promisingly, outcomes for children (as well as parents) were very good, with reductions in children’s mental health problems and behavioural issues, and many of the cases closed as a result of this intervention.  

Question & Answer Session

• Barnardo's, Senior Representative, Barnardo's (confirmed)
• Dr Wendy Sims-Schouten, Associate Head (Research and Innovation) and Reader in Childhood Studies, The University of Portsmouth (confirmed)
• Dr Sarah Wynick, Head of Psychiatry CAMHS, The Tavistock and Portman NHS Foundation Trust (confirmed)
• Andrew Balfour, Consultant Clinical Psychologist & Adult/Couple Psychotherapist, Tavistock Relationships (confirmed)

Lunch

We'll be working with venues to ensure lunch at our events is as delicious as ever and caters for a range of dietary preferences - whilst being served in a safe and seamless manner. Some of the new measures we will be introducing to this effect are:

• One-way queuing systems with safe distancing in operation.
• Individual snacking bags containing fruit, trail mix and sweets provided on arrival - this will prevent people mixing around snack bars during networking breaks.
• Individually portioned dishes and pre-sealed cutlery will be served at collection points.  

Where possible, we will request food is sourced locally to reduce food miles, use seasonal vegetables, red tractor certified meat and eggs from free range hens.

Chair's Afternoon Address

Afternoon Keynote Address

In response to the dramatic rise in young people disclosing struggles with problematic gambling (55,000) and more young people regularly gambling (450,000) than taking drugs, drinking alcohol or smoking according to the Gambling Commission, the NHS introduced 14 clinics delivering support to those struggling with problematic gambling and a specialist treatment centre for those addicted to gaming. Lockdown(s) have significantly increased opportunities for children and young people to engage with digital platforms that utilise 'loot boxes' - randomised prizes that can be purchased in-game - and other tools encouraging risk-taking and associating it with reward.

NHS leaders have called for restrictions on games that encourage children to purchase ‘loot boxes’, as well as introducing realistic spending limits and supporting parents by raising awareness of the risks associated with gambling and in-game purchases. Drawing from the Gambling Commission’s report that portrayed the rise in child gambling as a ‘generational scandal’, this presentation will assess the impact of lockdown on young people's interaction with problematic gambling; in the context of a new report published by OFCOM in which 3,200 young people between the ages of 3 - 15 were interviewed, demonstrating that 50% of the UK’s 10-year-olds owned a Smartphone in 2019, 21%, 71% of 12 – 15 year-olds have a social media platform and 24% of 3 – 4 year-olds own their own tablet. 

Removing Barriers to Accessing CAMHS

Delivered in partnership between East London NHS Foundation Trust, North East London NHS Foundation Trust and three London-based football community foundations - West Ham United Foundation, Arsenal in the Community and Leyton Orient Trust - Advantage is an innovative new mentoring programme for young people aged 14-21 years whose mental health and wellbeing has been affected by the COVID-19 pandemic.

Advantage provides young people with a dedicated mentor who works with them to set goals and help them get back on track to achieve and aspire in the new normal.

Case Study

• Elaine Tabony, SCPHN Programme Lead for Health Visiting, School Nursing and Occupational Health Nursing, Brunel University (confirmed)

Elaine Tabony has a background in paediatric nursing. Transferring her skills to the community as specialist community public health school nurse, Elaine was awarded the title Queens Nurse following an innovation award introducing the Seasons for Growth Grief Education programme. Currently, Programme Lead for Specialist Community Public Health Nursing at Brunel University London, Elaine was the first person to introduce the Seasons for Growth Grief Education to schools in England. Seasons for Growth Grief Education support children and young people following any significant loss such as death, separation, and divorce. Based on the belief that grief is a normal and valuable part of life, need is recognised to provide the opportunity to examine how grief, because of significant loss has impacted on our lives. Seasons for Growth provides the opportunity for each participant to integrate the appropriate knowledge, skills, and attitudes to understand and to cope with loss and grief. This takes place in an atmosphere of like- to- like peer support rather than a ‘one-to-one’ process.

Question & Answer Session

Afternoon Refreshment Break

Case Study

This slot is reserved for organisations looking to engage delegates with services and opportunities that compliment conference presentation and discussion panel topics. If you're interested in delivering a Case Study, contact us on 0161 376 9007.

The NHS cannot meet the scale of need for CYPMH support on its own, it is crucial that more consideration is given to early interventions within our communities. Young Minds undertook the Early Intervention Review to identify the characteristics of effective early interventions and inform its recommendations to government on introducing a national, cross-departmental commitment and strategy to address childhood adversity and trauma. The review assessed existing models of early interventions in the community in the UK and abroad to identify the impact(s) of different service models, as well as working with young people and parents to develop principals of best practices. This presentation will make high-impact recommendations for the development of effective early interventions in the community.

Panel Discussion: Making Policy to Improve Children and Young People's Mental Health

This panel is where the programmes, digital adaptions and ideas discussed at conference converge with the pragmatism of making policy. Panellists will cover issues raised in the agenda as well as drawing from experiences of making policy, working with influential bodies and driving the cutting edge frontier of digital innovation in CYPHM, including:

• The Information Commissioner's Office drafted a code of conduct designed to incentivise big tech organisations to protect children and young people from harmful online content, stating: ‘There are laws to protect children in the real world. We need our laws to protect children in the digital world too’. The code sets out the standards expected of those responsible for designing, developing or providing online services like apps, connected toys, social media platforms, online games, educational websites and streaming services. It covers services likely to be accessed by children and which process their data, and includes recommendations such as requiring that privacy information provided to users, and other published terms, policies and community standards, must be concise, prominent and in clear language suited to the age of the child; as well as switching geolocation trackers/displays off by default - unless a compelling reason(s) to not do so is demonstrated, taking account of the best interests of the child.
• Digital innovators by nature dictate the future direction of policy. BfB Labs is the only provider of clinically approved digital therapeutics for young people with 24/7 access to real-time data for clinicians; uniting evidenced therapies and immersive gaming. BfB found that even if a digital therapeutic is approved by the Medicines Healthcare and Regulatory Authority (MHRA), CE marked, has demonstrated safety, efficiency and also has good economic data, it still does not guarantee widespread adoption unlike a well-studied drug. Numerous barriers exist that hinder moving from current care pathways to a pathway that fully integrates evidence-based and safe digital solutions - meeting digital natives where they are.

Chair's Closing Remarks

Conference Close