Support and Aspiration: a New Approach to Special Educational Needs and Disability Response from YoungMinds.

Transcription

1 Support and Aspiration: a New Approach to Special Educational Needs and Disability Response from YoungMinds. YoungMinds is the UK's leading charity committed to improving the emotional well being and mental health of children and young people by ensuring these issues are placed firmly on the public and political agenda. We achieve this though the provision of research, lobbying, influencing policy and campaigning. Driven by the experiences of children, young people, parents and carers we also raise awareness and provide expert knowledge through training, outreach work, and publications. We are concerned about the mental health needs of all children and young people, including those with special educational needs and disabilities. Children who are classified as having behavioural, emotional and social difficulties (BESD) are of particular concern to us, but we are also concerned about the mental health needs of other SEN categories such as disabled children, those with autistic spectrum disorders and so on. We believe that mental health consists of the following: 1. A capacity to enter into, and sustain, mutually satisfying and sustaining personal relationships 2. Continuing progression of psychological development 3. An ability to play and to learn so that attainments are appropriate for age and intellectual level 4. A developing moral sense of right and wrong 5. A degree of psychological distress and maladaptive behaviour within normal limits for the child s age and context As this definition suggests, mental health is not the same as mental illness. Mental health is something that we all have, and it is an essential component of health. Being mental healthy is important for school attainment and appropriate behaviour in the school setting, good social relationships and about having the capacity to cope with all that life throws at us. Many children who have a special educational need, particularly those who are said to have behavioural, emotional and social difficulties (BESD) will also have mental health problems. Question 2: Do you agree with our proposal to replace the statement of SEN and learning difficulty assessment for children and young people with a single statutory

2 assessment process and an Education, Health and Care Plan, bringing together all services across education, health and social care? We agree in principle, but we have concerns about who will coordinate both the assessment process, and the Plan. There is very little information in the Green paper concerning how the single assessment and Plan will work in practice. Also, it is not clear as to who is legally responsibility for the deliver and implementation of the assessment and the Plan. The consultation document states that the new Education, Health and Care Plan will give parents the same statutory protection as the SEN statement, but it doesn t clarify whether all relevant agencies have a statutory duty. The Green paper also states that all parties will give a commitment to provide their services, but it is unclear whether this is a statutory duty. We believe that there needs to be a statutory duty on all relevant agencies to contribute to the assessment, decision making processes and the planning and delivery of relevant services. Question 3: How could the new single assessment process and Education, Health and Care Plan better support children s needs, be a better process for families and represent a more cost-effective approach for services? As mentioned above we have concerns about how these proposals will be delivered. Whilst we believe that CVS organisations should be involved, we are concerned that they will not necessarily have adequate knowledge and training to carry out this role. It will be expensive to ensure that all relevant CVS organisations are adequately trained, and so is not a cost effective option. We believe that it would be more effective to improve the current decision making arrangements. The CVS along with other relevant agencies should be involved in the decision making processes, rather than it being left to an SEN Officer in the local authority. SEN covers a wide range of difficulties, so it is important that decision makers have adequate knowledge or can obtain expert advice on specific conditions. We are particularly concerned about children and young people who are classed as BESD, or who have a mental health problem. If there isn t adequate expertise to support decision making, it is possible that many children and young people will not be given the support they need. Children and young people with behavioural problems such as conduct disorders are more likely to be excluded from school and not achieve their full academic potential. It is well known that people with conduct problems are over represented in the justice system, and experience a range of negative outcomes in adulthood. So not providing a joined-up approach to meeting the full range of needs is not cost effective in the short or long-term. Question 4: What processes or assessments should be incorporated within the proposed single assessment process and Education, Health and Care Plan? Currently there is a postcode lottery, with the threshold for statements being higher in some areas than others. We would like there to be a mechanism that standardises the process and ensures that all children and young people with a similar level of need have equal access to services and support.

3 We suggest that the assessment and the Plan should include a standardised approach to mental health assessment. This is particularly important for the BESD category. There are well-known measures such as the Strengths and Difficulties Questionnaire (SDQ) or sociometric testing. Question 6: What role should the voluntary and community sector play in the statutory assessment of children and young people with SEN or who are disabled? How could this help to give parents greater confidence in the statutory assessment process? As already mentioned, we believe that CVS organisations should be involved in the assessment, especially as they bring independence and potentially specialist knowledge of one or more SEN category. However, we are concerned about CVS co-ordinating the assessment process unless they can demonstrate expert knowledge of this area. Question 10: What should be the key components of a locally published offer of available support for parents? The local offer should relate to the four SEN categories, and this should include BESD. Also, the local offer needs to include information about the full range of local child and adolescent mental health services (CAMHS). This is particularly important for those children who are classified as having BESD, but other children such as those with disabilities, autism and so on may also be in need of appropriate emotional wellbeing and mental health support. The local offer should also include information about what services and support are available to help children and young people who may not meet the threshold for a statement, but who do have significant problems that impact on their education and on their life generally. The support on offer needs to be based on local need and be flexible. Question 11: What information should schools be required to provide to parents on SEN? This section of the consultation only refers to information about what the school provides. We are concerned about how other agencies will provide information about their services. Question 13: In what ways do you think the option of a personal budget for services identified in the proposed Education, Health and Care Plan will support parents to get a package of support for their child that meets their needs? Personal budgets can be a great way to empower children, young people and their parents, and enable them to have a say in what services and support they need. However, we are concerned that parents who have language problems, or who are illiterate etc, may not access the help that is available for their child. Therefore, parents should have access to an advocate to help ensure that all parents take up support on behalf of their child. Question 21: What is the best way to identify and develop the potential of teachers and staff to best support disabled children or children with a wide range of SEN?

4 There needs to be a whole school approach to understanding and accepting that children and young people have additional educational needs. These additional needs include difficulties such as those covered by the BESD category. It is important that teachers and staff have adequate knowledge of all SEN categories. Young people repeatedly tell us that teachers lack of knowledge and training in mental health makes it difficult for them to get the help and support they need. Therefore, teachers and school staff need to have adequate training, access to online resources, and information about evidence based interventions. The CVS can play a key role in providing training and developing resources. The YoungMinds in Schools project is a good example of how the CVS can help develop teachers and staff s ability to support children with SEN, especially those with BESD. Question 24: How helpful is the current category of BESD in identifying the underlying needs of children with emotional and social difficulties? It is essential that the BESD category is retained. We suggest that the name of the category is changed to ensure that there is more focus on emotions rather than behaviours. The reason for this being that behaviour is a manifestation of emotional or social difficulties, but the focus is usually on the behaviour rather than the causes. So the category could change to emotional, behavioural and social difficulties or emotional and behavioural difficulties. Question 25: Is the BESD label overused in terms of describing behaviour problems rather than leading to an assessment of underlying difficulties? We are concerned that many children do not have their underlying difficulties effectively assessed. As mentioned earlier we suggest that children should be assessed using established measures such as SDQ or sociometrics. So unless there is an effective assessment process, it is impossible to know whether the label is overused. It seems that there is a lack of support for children and young people with BESD. Young people from our Very Important Kids (VIK) group have told us that in their experience there is very little support for young people who have BESD. Often the only support is for children with learning difficulties. One young person, who had experienced mental health problems and was out of school, said that she would have gone to school if there was adequate provision. Also, there is a lot of stigma associated with the SEN unit, so there needs to a whole school understanding of SEN and disabilities, and the provision needs to be more integrated to reduce the stigma. Question 32: What information would help parents, governors and others, including Ofsted, assess how effectively schools support disabled children and children with SEN? As mentioned earlier there needs to be a clear assessment process and standardised measures used for every SEN category. If the assessment is repeated, then data can be analysed to indicate how well schools are doing to help individual children. This information can be communicated to various audiences.

5 Question 37: How do you think joint working across children s and adult health services for young people aged 16 to 25 could be improved? We are particularly concerned about the transition from CAMHS to adult mental health services (AMHS). It is well known that CAMHS and AMHS often do not work effectively together to manage a young person s transition. The Track study shows that very few young people receive a good transition, and many disengage with services and only come into contact again when their problems reach a crisis. We recommend that there needs to be a multi-agency approach to care planning, with young people being fully involved in the process. CAMHS and AMHS need to work together with the young person to ensure that the transition is seamless and is as stress free as possible. AMHS generally focuses on seriously mentally ill adults, and so young adults are often overlooked because many do not meet the clinical threshold for these services. If young adults make the transition to AMHS, they are often reassessed and given a different diagnosis. We would like to see the AMHS budgets being shifted to focus more on the18-25 year s age group with a distinct set of services tailored to their specific needs. Question 40: We have identified three core features of the role of local authorities in supporting children and young people with SEN or who are disabled and their families: strategic planning for services, securing a range of high quality provision, and enabling families to make informed choices and exercise greater control over services. Do you agree that these are the three core features of the role of local authorities in supporting children and young people with SEN or who are disabled and their families, or are there others? As already mentioned, the local authority should retain a key role in the assessment process. This is because training up the CVS to take on this role will not be cost effective. Question 42: What would be the best way to provide advice to GP consortia to support their commissioning of services for children and young people with SEN or who are disabled and their families? GP Consortia, should ensure that the commissioning of relevant services are based on local needs, so the JSNA needs to highlight the needs of children and young people with SEN, and feed into the Joint Health and Wellbeing Strategy. GP Consortia need to listen to what children and young people with SEN say concerning the support they need. Young people from our Very Important Kids (VIK) project tell us that they want easy access to counselling services and other talking therapies. Question 43: What would be the most appropriate indicators to include in the NHS and public health outcomes frameworks in the future to allow us to measure outcomes for children and young people with SEN or who are disabled?

6 We asked the young people from our Very Important Kids (VIK) project about what a good outcome would be for them. They said: easy access to help and support and getting regular support when they need it; having a real choice of treatment and not just being given medication; having good quality information and advice about their condition, treatments, and ways to help themselves; being able to access high quality mental health services regardless of where they live; and being able to continue with their education, even if they can't actually get to school. As well as the above indicators, we would suggest that the following indicators would be useful to measure the mental health and emotional wellbeing of children and young people: The prevalence of children and young people s mental health we already have the CAMH survey. So we suggest that this survey is repeated to measure changes in prevalence over time. Subjective reports of children and young people s wellbeing there is work in progress to develop a measure of wellbeing, but we are concerned that this will not adequately cover children and young people s wellbeing. It has been shown that children and young people in some respects have a different concept of wellbeing to adults. There are existing measures such as the Children s Society/Uni of York s Good Childhood Index - Parental Mental health especially maternal mental health. This is important as parental mental health is a risk factor for mental health problems in their children. Behavioural, social and emotional development at age three this is important to estimate how well children are developing and pick-up on problems early on. Question 44: What are the ways in which the bureaucratic burdens on frontline professionals, schools and services can be reduced? It is important that the SENCO is not overburdened and receives adequate administration support. The role needs to be properly financed, resourced and equipped. These professionals need to be given adequate time to carry out the role. Adequate administrative support will help to remove some of burden from them. There needs to be a whole school approach towards providing adequate support for children and young people with SEN and disabilities, and teachers need to be encouraged and given time and support to carry out these duties. This should help to ensure that these duties are seen as an essential element of the teacher or staff s role and not as an additional burden. Question 45: In addition to community nursing, what are the other areas where greater collaboration between frontline professionals could have the greatest positive impact on children and young people with SEN or who are disabled and their families?

7 There needs to be support for the SEN departments in schools. There should be more liaison between social workers and education. There needs to be better links between specialist services such as CAMHS and schools. This could involve primary mental health workers or other CAMHS professionals working in schools, but also linking back to the local CAMHS service. This needs to be a joined up approach with all agencies understanding how their role fits into the bigger picture of support for a child or young person. This is important to ensure that children with SEN, especially BESD receive adequate support in school, but can also be referred on if their problems are more severe or are getting worse. Local services such as CVS organisations or CAMHS can help schools to deliver PSHE lessons on emotional health and wellbeing, which promote emotional literacy and life skills such as anger management, and problem solving. This is important for all children, but can be particularly helpful for those with SEN or disabilities to help them become more resilient and emotionally healthy. It is also important that there are strong links between the school and parents. The good work that schools carry out needs to be continued by parents at home; and parents need to know how well their child is being effectively supported at school. Question 46: What more do you think could be done to encourage and facilitate local services working together to improve support for children with SEN or who are disabled? We advocate partnership working, but agencies often struggle to make it a reality. There needs to be incentives and duties to encourage partnership working. For instance, it is well known that some schools are not happy about the support they receive from CAMHS. There are a number of reasons why schools and CAMHS do not work well together. It could be that CAMHS does not have the capacity to respond, or their service structure is too rigid and based on historical provision rather than on actual need. Children spend much of their day in school and with teachers. So teachers are in a good position to identify changes in behaviours. We know that many children and young people turn to their teachers when they have problems. It is not realistic for teachers to be therapists, but we believe it s vital that teachers have a basic understanding of child development and mental health, know where to signpost children and young people to, and know who to contact if they need advice. Schools need to appreciate their role in supporting children and young people with BESD or mental health problems, and not leave it all for CAMHS. So schools need to work with CAMHS and other services and agencies to ensure that local services are based on local needs, are designed or redesigned in accordance with users views about services, in order to help support children and young people with mental health problems or BESD. Question 53: What do you think are the areas where collaboration could have the greatest positive impact on services for children, young people and families?

8 Collaboration could have a positive impact on services for children in care. It would be helpful if there was a link with foster placements both independent foster agencies and local authority. As mentioned above, greater collaboration between CAMHS, the school and other agencies would be helpful in effectively planning, commissioning and delivering the comprehensive range of CAMHS services. Question 55: What are the ways in which a Community Budget approach might help to improve the ways in which services for children and young people with SEN or who are disabled and their families are delivered? Funding issues often impede integrated working. The Community Budget approach should encourage professionals to work in an integrated way rather than silo working. Question 57: What are the areas where the voluntary and community sector could have the greatest positive impact on services for children and young people with SEN or who are disabled and their families, and what are the ways we can facilitate this? CVS organisations can have a big impact on services for children and young people with SEN or disabilities. They can provide direct support for children, young people and parents. For instance, our Parents Helpline provides free help and support for parents/carers who are concerned about their child s mental health and emotional wellbeing. In % of the calls to the helpline were connected to educational or school issues. So CVS services such as our helpline provide vital support for many parents who may otherwise be struggling. It is important that teachers and school staff receive training to help them provide the best possible environment and support for children and young people with SEN or disabilities. CVS services such as YoungMinds can help to provide training in important areas such as evidence based interventions, emotional wellbeing and cognitive development, emotional containment for pupils, and developing the knowledge base of emotional or cognitive development and their role in relationship to learning. However, good quality training is not free, so training needs to be funded in some way. Also, schools have to be able to release teachers and school staff for training. Teachers and school staff need to keep up to date. CVS organisations can help to disseminate the latest research in neuroscience regarding development and learning in an accessible way. For instance YoungMinds produces accessible booklets and leaflets on mental health issues, and our YoungMinds Magazine is aimed at a general audience. Like training, publications have a cost attached to them, so need funding.