Beacon of hope

While recognition of the importance of the mental health of young
people is improving, access to services largely relies on a degree
of stability, such as a permanent address or a regular school. But
what about the less rooted? Homeless children, for example, who are
often victims of domestic or community abuse? Or those who offend,
who have chaotic lives? Who is to mind these service gaps?

The Leicestershire Partnership Trust’s young people’s team – now a
beacon NHS service – was set up to work positively with these
difficult-to-engage and vulnerable groups.

The team has an impressive mix of specialisms, recognising that
young people don’t always fit neatly into labelled compartments. It
includes six full-time primary mental health worker posts (two for
looked-after children, four from the youth offending team), two
clinical psychologists, a psychiatrist, a specialist psychiatrist
registrar, four family support workers specialising in housing, and
a project manager.

The health, justice and housing funding is equally impressive. “We
are all NHS employees,” says Panos Vostanis, consultant child and
adolescent psychiatrist, “but the YOT members, for example, are
funded partly by health and the Youth Justice Board. And I’m
proudest of the housing money for homeless work.”

And the balance of work? “I do work with young people but 20 per
cent of my work is training and 70 per cent providing consultation
to foster carers, residential staff, link workers and social
workers,” says Daniela Gravili, primary mental health worker
(looked-after children). Having concentrated on children’s homes,
Gravili and her colleague, Anita Kelly, are now focusing on
fostering. “I think if you help the foster carer understand the
issues around the child, when that child leaves, that training and
experience remains with that carer – so they are more equipped next
time,” says Kelly.

Consistency of worker and approach coupled with clarity of purpose
power the team’s practice. “Young people sometimes have many
workers and obviously this can be pretty scary for them,” says
Madaleine Baker, primary mental health worker (youth offending
team). “They can definitely get confused as to who’s doing what. So
we need to be very clear right from the start who they will see on
what day, who these people are and why they are seeing them.”

On the importance of consistency, Vostanis adds: “If kids move out
of care services don’t normally follow them. But we try to do that
and make sure they still see the same person. That’s when they get
to trust you.”

Having psychologists and psychiatrists as full-time team members is
an enormous boost, not least for their colleagues: “It’s
brilliant,” they chorus. Veronica Bilson, primary mental health
worker (YOT) recently attended Youth Justice Board mental health
training: “People from all over the country were surprised to hear
about our team and the access we have to psychologists and
psychiatrists. They were talking about at times having a nine-month
waiting list.”

The team’s target response time is two weeks. Any longer a wait is
pointless, according to Vostanis. “With this group you need to see
them straightaway or not at all. Even after a couple of months so
much will have changed in their lives,” he says.

Interestingly, the team also works with young people up to the age
of 18. This means services can follow the young person through the
transition into adulthood. For example, a young person had social
phobia, and was living at home causing difficulties for his
family.

“After a theft he was assessed and referred to me,” says Baker. “I
was concerned and now a psychiatrist is working with him. Had he
not been picked up he would have gone into adult life living the
same way.”

This imaginative model of service, well-funded, integrated and
targeted, show how things needn’t be the same way again.

For more information contact Beacon co-ordinator Jenny
Ruane: jr33@le.ac.uk  see www.le.ac.uk/greenwood

BACKGROUND

Scheme: Young people’s team

Location: Leicester, Leicestershire and Rutland

staffing: 16 full-time posts. One part time

Inspiration: To meet needs of traditionally difficult to engage
groups – young people who are looked-after, homeless or
offending.

cost: £500,000