Perspectives: keeping children & young people’s mental health in mind

Dr Duncan Law and Helena Miles explain the progress they’ve made with improving access to psychological therapies for children and young people.

It is widely quoted that at any one time at least 1 in 10 children in the UK will have a serious mental health issue; less well reported is that three quarters of these young people will not get the help they need from a trained mental health professional. Behind these figures are real people — we are both people who experienced mental health issues before adulthood and neither of us received the help needed first time. It is these personal experiences that have driven both of us to dedicate our time and passion to improving service for children and young people who experience mental health issues and why we are involved in the Children and Young People’s Improving Access to Psychological Therapies Programme (CYP IAPT).

CYP IAPT is an NHS England and Health Education England funded programme to transform existing Children’s and Adolescent Mental Health Services (CAMHS) and facilitate service improvement through embedding the key principles of quality services:

  1. More evidence-based practice
  2. Better collaborative practice and shared decision making
  3. Authentic participation
  4. Rigorous use of clinical outcome monitoring

Over the past five years, NHS, social care, the voluntary sector and higher education institutions (HEIs) across London and the rest of the country, have been coming together to form learning collaboratives to implement the CYP IAPT principles and share learning to improve mental health services for children and young people. The London and South East collaborative is the largest in the country and it has been making impressive progress already reaching the government target of 100% coverage across the capital. The London and South East learning collaborative, hosted by the Anna Freud Centre, Kings College and University College London, encompasses over 100 provider organisations across London and the South and East of England.

Training is a substantial part of the programme with well over 500 therapists, supervisors and service leaders have been trained in evidence-based therapies and underlying CYP IAPT principles. These courses are driving the change in services as a result.

“I really feel like it’s helped me in my role… and I’ve taken a lot from it” — CYP IAPT Supervision course student

Greater participation of children and young people in co-producing services and training allows their voices to shape the services that they use. Young advisors co-produce training sessions on all of the CYP IAPT training and are involved in a range of activities to increase participation in the collaborative, such as filming videos for resources and visiting other services to talk with participation groups. Young advisors also extend their roles to participating in a Hackathon, in which apps aimed at improving services and young people’s mental wellbeing were created in 48 hours — you’ll find out more about this in Alex Goforth’s blog — and co-chairing the Executive meeting. The collaborative also hosts regular participation groups where learning and practice can be shared.

“It’s been so great to use my expertise to help shape and mould the future of CYP IAPT” — CYP IAPT Young Advisor

Services are using outcome measures as a tool to work collaboratively, track progress and improve transparency and accountability of services. This means that we will be able to have a much clearer, more accurate view of what is actually happening in services, how effective they are, and where they can improve. However, good quality data in CAMHS remains a challenge.

An audit of partnerships in CYP IAPT has shown large steps forward in access, with a reduction of assessment waiting times by 73% and increases in self-referral, outreach and out of hours appointments.

This is just the beginning. The collaborative continues to expand and deepen working closely with Healthy London Partnership Children and Young People’s Programme to make sure that what we do complements all the other work that is ongoing to deliver the wider CAMHS transformation agenda set out in Future in Mind. New CYP IAPT training courses will be out later this month to cover: counselling, looked after children, children with learning disabilities and autism, under 5s and training on interventions that blend psychological and drug treatments. We know, from our personal and professional experience, that mental health issues can have huge costs for children and young people, their families and society as a whole and yet effective mental health interventions with children and young people is the most efficient and cost effective way to deal with mental health across the whole lifespan.

It is therefore vitally important to give children and young people the help that they need, when they need it. The CYP IAPT programme is giving more children and young people than ever before the chance to access effective, acceptable and accountable services.

If you want to know more about CYP IAPT or are interested in taking up one of the training places please contact Charlotte Barrett at charlotte.barrett@annafreud.org

Thanks to Natasha Byrne for help with this blog.


Dr Duncan Law and Helena Miles are the co-chairs of the CYP IAPT Executive group for London and the South East

Helena, is employed by the London and South East CYP IAPT Learning Collaborative as a Young Advisor to the programme. She has been involved with participation work for children and young people’s mental health services for three years, first with Lewisham CAMHS and then at the Anna Freud Centre.

Duncan, is Clinical Lead for the London and South East CYP IAPT Learning Collaborative. He is a Consultant Clinical Psychologist, at the Anna Freud Centre and Honorary Senior Lecturer at University College London. He has over 25 years experience working across the NHS, higher education, and third sectors. He is a board member of ACAMH, a founder member of the Child Outcomes Research Consortium (CORC), and was a project executive of the MindEd learning e-portal and former Chair of the Division of Clinical Psychology’s Faculty for children, young people and their families.

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