Young boy being carried

Supporting the mental health needs of the under fives

By early 2020 NHSE/I recognised a comprehensive 0-25 mental health offer was needed if it was to meet the expectations of the LTP. We worked alongside NHSE/I to deliver a national under-fives mental health services report that would inform service change and policy development.

The challenge

Clinicians working with children in the 0-5 age range are reluctant to diagnose or medicalise, and this presents issues in benchmarking service quality. But the 0-5 group remains important, with a significant crossover with adult mental health (MH) and it is an active area of best practice research.

Following a competitive tender SCW began working with NHSE/I to review 0-5 provision in nine regions across England. This review would inform service change and further policy development to deliver NHSE/I’s LTP commitments.

It was important to recognise straight away that models of Under 5 MH service provision differ by region - some have multiple services while others have only one. Some services are in pilot phases, others well-established and even at the point of conducting original research. Service purposes differ in focus and specialty. For example, some are targeted at children with specific parental MH difficulties.

Our solution

  • We designed a template with our in-house clinical, data, and workforce subject matter experts – this allowed us to be fair in our questioning while still interrogating the detail.
  • Careful calibration of the questions meant we could highlight good, consistent practice across data systems, therapeutic intervention methods, and priority ordering.
  • From May 2020 onwards we worked with regional service leads to capture and prioritise the most relevant insights.
  • Nine detailed, extensively researched and curated case studies were submitted to NHSE/I in October 2020.

Next steps

  • There remains further identified work to be completed on equality and diversity.
  • The final report will form an integral element of a wider review of MH services nationally and will go on to inform the development of national policy.

Added value

  • Clear understanding of the wider Children's and Young Persons (CYP) policy context and rationale for this scoping and service review
  • Adapted and flexed the offer to include additional key areas of relevance i.e. equalities, digital
  • Rigorous iterative planning of report structure to ensure most effective presentation and usability

'SCW appears to be as equally passionate about the needs of under-fives as we are…We very much applaud the work of the team and feel it will be a crucially valuable contribution to us locally and hopefully to others nationally

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