Keeping Bexley’s young people in mind

Good mental health helps children and young people develop resilience to cope with whatever life throws at them and grow into well-adjusted adults.

Poor mental health is a big problem nationally and, specifically for the NHS in Bexley, where I am based. According to the Mental Health Foundation, poor mental health affects about one in 10 children and young people. Unfortunately, as many as seven in ten of these young people they don’t receive an appropriate intervention at a sufficiently early age.

Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults, and it is considered as important as physical health.

But increasingly, and compared to 30 years ago, teenagers suffer more mental health issues such as depression, self-harm, eating disorders, and anxiety and conduct problems, and may experiment more with alcohol, drugs or other substances that can affect mental health.

As a GP and a mum, I worry about this professionally and personally. According to the MHF, that’s probably because of changes in the way we live now and how that affects the experience of growing up.

In 2016, Bexley estimated that an additional 867 children and young people will need mental health support by 2020. This equates to 35 per cent of the borough’s children and young people.

For me, the growing burden of mental health issues for local children and young people is all too real, and for this reason I wholly endorse the considerable investment in young people’s mental health made by NHS Bexley CCG.

In September 2016 this resulted in the launch of a Community Health and Wellbeing Service (CHeWS). Based in the community, including schools, the service aims to provide children and young people with the help they need to nip mental health issues ‘in the bud’; through early identification and support, problems will be treated before they become habitual and entrenched, when they become harder and more costly to treat.

By linking trained mental health professionals with other professionals looking after children and young people, for example the school nurse, care becomes more coordinated, continuous and more proactive.

The aim is to reduce the number of young people who ‘fall through the cracks’ in the system, or who are put off from seeking help due to difficulties with accessing treatment.

So how have we done?

Between September 2016 and May 2017 an evaluation showed that the number of children’s issues raised by schools during a CHeWs consultation reached 492 with 16 per cent of these (79) then referred on for a specialist intervention. In a review of those people who set mental health goals as part of using the service, 89 per cent felt their mental health had improved as a result, and none had got worse.

For the NHS, the investment in the service is already reaping rewards by yielding clinical capacity savings that can then be rechanneled into other mental health services and service enhancements for patients. A specific example is that since starting the CHeWs service, waiting times for the CAMHS service have reduced by nine days.

Young people and their families tell us that they now have renewed confidence in NHS child and adolescent mental health services and they have rated their experience of using the service as high.

As a result of the successes, plans are now in hand to further enhance the service and, I hope, make further improvements to the mental health of Bexley’s children and young people.

Dr Nikita Kanani

Dr Nikita Kanani is a GP in south-east London and chief clinical officer for NHS Bexley Clinical Commissioning Group (CCG), where she is responsible for leadership of the governing body and strategic development of healthcare locally.

Dr Kanani has held a range of portfolio positions within the CCG to support the development of mental health services, integrated care, primary care, clinical leadership and patient/public engagement. She is passionate about improving service provision and population health within the NHS and has managed and taken the lead on numerous projects that reflect this. Among her many responsibilities, Dr Kanani is the senior responsible officer for the new models of care work stream as part of the south-east London Sustainability and Transformation Partnership (STP).