When a young person, or anybody, experiences a mental health problem, it is vital that this is identified as rapidly as possible, so that they can be signposted to the most appropriate service.
Providing consistency and continuity of care to our patients improves their experience of mental health services and overall outcomes. That’s why we worked to develop the first collaborative single point of access service for Wandsworth CCG.
The aim is to empower health and social care professionals to be able to refer a child or young person with additional needs, or experiencing mental health difficulties, to the SPA service. GPs, social services and school nurses - among others - all have the ability to refer someone to the service if they think that young person might need support.
The SPA is essentially an assessment function, conducted by a skilled and experienced team member in consultation with the young person, and often a family member. This can take place face-to-face, on the telephone, and, increasingly, we receive requests for the service via Skype.
After the assessment has taken place, the SPA team member makes a precision referral i.e. a full assessment of the needs of the young person, and the recommended next steps. If necessary, the SPA team can ensure that the young person is fast-tracked to the multidisciplinary tier 3 teams. This means the young person gets the right intervention from the right service at the right time.
One of the Clinical Psychologists working in the SPA in Merton which was started in October 2015 gave this feedback about how the SPA helps speedy responses so young people facing mental health problems get the right intervention as quickly as possible:
I have lots of cases that led to fast track through services - one of the quickest was a referral received on 12th May. The young person was seen face to face in SPA on 19th May, moved to Tier 3 and had her first therapeutic appointment on 1st June.
This young person (16 year old girl) had an episode of depression and engaged well with therapy and has now completed many of her Recovery Goals. She is feeling much brighter and has connected with friends and started some new activities.
Introducing the service wasn’t without its challenges, but we have seen a dramatic effect on the speed in which children and young people with a mental health problem were receiving an initial assessment; most within a week.
Since the implementation of the SPA, access times to tier 3 have fallen from an average of 8-9 weeks to 3-4 weeks. Now, more than 90% of our service users access tier 3 within eight weeks of referral. Furthermore, improvements in access times have seen the numbers of young people being referred with self-harm reduce by approximately 30%.
As a result of its success, other CCGs in South West London looked to develop similar, but not identical, SPA services. Sutton adopted it in September 2015, Merton in October 2015, and we ran a pilot project for Richmond in January to June 2016. Kingston is in the process of developing its own version.
We now have five different models of SPA service in South London which have been developed with a common set of principles applied consistently within the different contexts; ‘plugging into’ the unique setting of each borough – this means we can share examples of best practice to provide timely, effective and proportionate interventions for every single young person in our constituent boroughs; seeking to achieve the maximum benefits for the local population.