1 / 18

EU Milestones study Signorini EJCAP 2018

0-25 models and transitions: the scale of need Dr Bernadka Dubicka chair faculty C&A psychiatry RCPsych honorary reader University of Manchester consultant Pennine Care Foundation Trust, Manchester London 2019. EU Milestones study Signorini EJCAP 2018.

elle
Télécharger la présentation

EU Milestones study Signorini EJCAP 2018

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 0-25 models and transitions:the scale of needDr Bernadka Dubickachair faculty C&A psychiatry RCPsychhonorary reader University of Manchesterconsultant Pennine Care Foundation Trust, ManchesterLondon 2019

  2. EU Milestones studySignorini EJCAP 2018 • 25-49% CAMHS YP will need transitioning • ~1/3 AMHS users under 30 yrs with previous contact with CAMHS • Only Denmark & UK have transition policies/guidelines • UK YP concerns: eligibility, culture, lack connections between CAMHS/AMH, AMH competencies

  3. Preschool children (2 to 4 year olds) • One in eighteen (5.5%) preschool children had a mental disorder. The prevalence of mental disorders for two to four year-olds in England has been surveyed for the first time so these figures are experimental statistics. Source: NHS Digital. 2 to 4 year olds identified with any mental disorder, England.

  4. Learning disability: importance of early detection • 4.5x more likely to have MH disorder • EU: neurodevelopmental disorders most frequent diagnostic group (up to 81%) in CAMHS (Signorini, 2017, Lancet Psych) Institute Health Equity 2018: • 40% LD not diagnosed in childhood • Die 15-20 years before general population

  5. NHS Digital prevalence survey 2018Emotional disorders, 1999 to 2017 Source: NHS Digital. 5 to 15 year olds identified with a mental disorder, England.

  6. Prince’s Trust Macquarie Youth Index 2018 • 2,194 respondents,16 to 25 years • happiness & confidence dropped to lowest levels since 2009 • 61% regularly feel stressed • 1/4 regularly feel hopeless • those who don’t feel in control of their lives increased from 28% (2017) to 39%

  7. 15.4% of 17 to 19 year olds had ever self-harmed or attempted suicide

  8. Differences between boys and girls Source: NHS Digital. 2 to 19 year olds identified with any mental disorder, England.

  9. Sexual Identity (14 to 19 year olds) Young people who identified as lesbian, gay, bisexual or as another non-heterosexual sexual identity were more likely to have a mental disorder Source: NHS Digital. 14 to 19 year olds identified with any mental disorder, England.

  10. Social and Family Context (5 to 19 year olds) Children with a mental disorder were more likely to live in a family that struggles to function well, as well as where a parent struggles with poor mental health. Source: NHS Digital. 5 to 19 year olds identified with any mental disorder, England.

  11. Exclusion from school • One boy in ten with a disorder had been excluded from school • One child in twenty with a hyperactivity or behavioural disorder had been excluded on three or more occasions.

  12. Prevalence of Neurodisability for YP in custodyHughes, Williams and Chitsabesan, 2012

  13. 76% suicides male male to female ratio: 2.6:1 in those aged 15-19 3.7:1 in those aged 20 and over Source: Suicide by Children and Young People (2017) National Confidential Inquiry into Suicide and Homicide by People with Mental Illness

  14. Recruitment and Retention • Only 1/4 CYP with MH disorder treated in UK (NHS digital 2018) • 10 yr plan: 100% of those in need 0-25 yrs • Green paper requires doubling workforce • If aim to treat 100% disorder, 6-fold increase needed (based on past figures and to 18) CAP all grades, incl trainees, England 2009-18

  15. RCPsych activitiesTraining, values, recruitment, QI

  16. 0-25 RCPsych position paperin progress • No one model • Services need to be age appropriate with staff trained in the developmental needs of each age group (infants, children, adolescents, young adults), & training on developmental disorders • CYP centred, accessible, values driven with patient choice and shared decision making • ‘think family’ • ‘think systems’ • Quality, evidence and outcomes driven • Build on good current practice with considered implementation, lessons learned • Flexible • Needs must be matched by resource

  17. Where next?Build on recent progress • NHSE Long Term Plan: 18-25 services & offer for 0-25 yr olds: integrated approach (‘iThrive’); student mental health services • Trained, supported workforce + resource + values + meaningful participation • Levers e.g. CQUIN • STPs/LTPs: incl service users • Peer reviews and outcomes e.g. Benchmarking Network, RCPsych Quality Improvement Network • Research e.g. EU MILESTONES study (Singh)

  18. Thank you: Questions Bernadka.Dubicka@manchester.ac.uk

More Related