Development of Schools Self-Harm Pathway Buckinghamshire Team

Transcription

1 Development of Schools Self-Harm Pathway Buckinghamshire Team Dal Sahota- Clinical Commissioning Director, Maternity & Children s Services. Chiltern CCG Kerry Allen- Clinical Team Manager OSCA Daniela Raffio- Paediatric Urgent Care Project Manager

2 Self-Harm: The Facts Self-harm statistics (Stallard et al 2013) 27% of year olds sampled had thought about self-harming 15% of year olds had self-harmed over the last year Self harm is an important signal of distress and increases the likelihood that person will die by suicide between fold above the rest of the population. ( Hawton et al 2012)

3 Bucks Picture The Young Foundation Report, 2012 Being Seen, Being Heard Report- researching emotional resilience in Bucks ( lack of support to universal settings e.g. schools YP tell a friend or care provider e.g. Teacher not necessarily GP Multi-disciplinary events across Bucks showed a lack of support and training for school staff and school nurses Last two years a number of serious case reviews in Bucks involving self-harm Self-harm 1/3 highest reason that a CYP admitted to SM Hospital

4 What we wanted to do? Provide support and training to school staff Improve the self harm urgent care pathway Work with all partners Simplifying systems and processes Raise the profile of emotional resilience in schools Children s mental health is everybody's business

5 How we did it? Interested ST4 GP- Nick Smith with a project for health and education integration. He received mentorship with Kerry Allen (CAMHS) The project was managed by jointly chaired Overview Group including representation for schools, health, LA Nick had access to senior leadership and was able to influence at appropriate Board level Whole systems approach to managing self harm

6 Nick Smith CAMHS Public Health Project Management Schools Chiltern CCG

7 Loosing the driver Nick is happily off to Uganda

8 The work continues... Excellent handover Momentum had been built- Communications Strategy & Plan Timeline developed Dedicated Project Management Clear commitment from relevant agencies: Wycombe High Deputy Head- Sally Jarrett, CAMHS (Oxford Health)- Kerry Allen, Public Health- Jen Beer, CCG s Clinician s- Dal Sahota & Steven Murphy and Project Management- Daniela Raffio Clear lines of governance

9 Governance Multi-agency Self Harm Overview Group jointly chaired by a secondary school and the Chiltern Clinical Commissioning Group Preventing Self- Harm (PH) Emotional Resilience Project Managing self-harm better in universal settings Schools Self Harm Working Group Improving urgent care Secondary Care Pathways Group

10 A day in the life. Schools Self Harm Working Group Getting everyone around the table e.g. meeting within a school at lunchtime Giving real life examples- Lucy & Sam Not reinventing the wheel- does it already exist? Hearing the patients experience Pushing & Persuasion Being flexible and inclusive - adapted model to include school nurses Sense checking tools (Self-harm guidelines, e-learning) Schools offered free locations- and it included schools into a ownership of process

11 Tools to support training Guidelines and resources for schools, may also be appropriate for other settings Developed by a multiagency working group. Chaired by Wycombe High School

12 Schools Self-Harm Resource Pack Basic information about self harm e.g. what it is, why CYP self-harm, do s and don ts Flow diagram for dealing with self harm in schools Appendices to support flow diagram e.g. circle of support, list of support agencies, leaflets that can be given out to help young people that self harm, friends and family etc

13 The Plan The self-harm pack was piloted with 9 secondary schools with excellent feedback-summer 2014 It was rolled out to all secondary schools including school nurses Autumn 2014-Dec 2015 To date only three secondary schools including independent schools have not been trained in Bucks.

14 Training Agenda Item Time Subject Speaker pm Arrival, Registration and Refreshments pm Welcome, Introduction and Case Studies Sally Jarrett Dal Sahota pm An Overview of Self-Harm Kerry Allen pm Part 1: Self-Harm Schools Resource Pack and Group Activities Sally Jarrett pm Break pm Part 2: Self-Harm Schools Resource Pack and Group Activities Sally Jarrett pm Role of CAMHS & A&E Pathway Kerry Allen pm Building Emotional Resilience Jen Beer, Public Health Practitioner pm Conclusion and Training Evaluation All

15 Who we trained Total Trained: Pilot: 10 school staff Rollout: 128 staff HEALTH SCHOOL STAFF School/ Community Nurse DH/Pastoral Lead School Counsellor SEN Safeguarding Head of Year Total secondary schools/colleges trained= 42

16 Evaluation To date Pilot feedback- helped us to develop the full training Training feedback- 100% excellent or good Next steps Impact evaluation from both staff and young people

17 The missing link Improved process/pathway in A&E: In response to feedback from young people and an SCR, part of the self-harm pathway work was to look at the experience of the YP if they attend A+E following any form of self harm the paediatric staff team, A+E and CAMHS created a clear pathway and guidance for triage, assessment and follow up of any YP attending This is in line with NICE guidance around admittance and liaising with other agencies It links in clearly with the protocol of jointly assessing with social care where the young person is known to them, and alerting them if not, thus safeguarding is considered immediately. A Triage form was designed for use of staff to aid initial assessment and experience of the young person As part of this, training on mental health screening and young people who self- harm has been offered to SMH A+E and paediatric staff by Bucks CAMHS. Better trained staff helps to reduce stigma of self-harm and thus the experience of the patient.

18 Next Steps Evaluate impact of training and urgent care pathway on practice through both school staff and young people Develop Primary School programme Develop Special School Programme CAMHS Link Worker into every secondary school. Sharing our learning with others Raising the profile within primary care (GP s, Ambulance service etc)

19 Any Questions? Dal Sahota Kerry Allen CAMHS Daniela Raffio (Project Manager)