In 2017, the Department of Health and Department for Education published the ‘Transforming Children and Young People’s Mental Health’ Green Paper. The Green Paper set out proposals for improving the services and support available to children and young people with mental health problems, with a particular focus on enhancing provision for those with low-moderate needs within school and college settings. The proposals had three main elements:
- Incentivising schools and colleges to identify a Designated Senior Lead (DSL) for Mental Health to oversee the approach to mental health and wellbeing.
- The creation of Mental Health Support Teams (MHSTs), providing specific extra capacity for early intervention and ongoing help, and supporting the promotion of good mental health and wellbeing in education settings.
- Trialling a four week waiting time for access to specialist NHS children and young people’s mental health services.
The proposals are being implemented as a large-scale pilot programme in four cumulative waves of trailblazer sites, with the aim of including 20-25% of children and young people in England by 2022-23.
The first wave involves 25 trailblazer sites and the creation of 59 MHSTs to support children and young people in more than a thousand education settings (including primary and secondary schools, special schools, colleges and other settings such as pupil referral units).
MHSTs will have three functions: i) delivering evidence-based interventions to children and young people with mild-moderate mental health needs; ii) working with education settings to support a ‘whole school approach’ to mental health and wellbeing; and iii) supporting coordination and joint working with other providers in the area. Areas will have flexibility to tailor their approach to local needs and circumstances and therefore some variation in service models and how they are implemented is expected.
It is planned that the first teams will be operational in January 2020.
A two-phase evaluation is being undertaken as a collaboration between PIRU and the Birmingham, RAND and Cambridge Evaluation (BRACE) Centre. The early evaluation, July 2019-February 2021, will focus, in particular, on the first wave of trailblazer areas and two of the programme’s main components: designated senior leads for mental health; and mental health support teams. This will be followed by a summative assessment of the programme’s longer-term outcomes and impacts, including an economic evaluation.
The study protocol may be accessed here>>
The aim of the early evaluation is to examine the development, implementation and early impacts of the trailblazer programme. The evaluation will explore how service delivery models and implementation strategies differ across trailblazer areas, highlighting the factors (e.g. local contexts) that are inhibiting or promoting success and drawing out the practical implications of the findings for the development of the programme and the longer term evaluation.
The specific objectives are to:
- Contribute to wider work being undertaken by the Department of Health and Social Care (DHSC), Department for Education (DfE) and NHS England (NHSE) to assess the accessibility, quality and effectiveness of existing mental health services and support in education settings and identify gaps in current provision in the trailblazer areas.
- Describe and understand the emerging delivery models, their leadership and governance, and explore how these vary across the trailblazer areas and the potential implications of this variation for future effectiveness. This includes examining how new roles and services are working in practice, what is working well and what is not, and barriers and facilitators to successful implementation.
- Describe the experience of mental health support teams, school leads, clinical commissioning groups (CCGs), child and adolescent mental health services (CAMHS) and others of taking part in the delivery of the programme.
- Capture the progress of the trailblazers towards key milestones and objectives, early impacts and any unanticipated consequences in the initial phases of the programme.
- Identify measures and data sources of relevance to assessing programme outcomes and costs as well as appropriate comparator areas and education settings in order to assess the feasibility and develop the design of a long-term outcome and economic evaluation.
- Conduct formative and learning-oriented research, producing timely findings and highlighting their practical implications to inform future implementation as the programme progresses.
The study findings will be formally reported in interim (March 2020) and final (February 2021) reports, alongside which we will provide timely formative feedback to programme leads and trailblazer areas. A proposal for the summative evaluation will be developed in late 2020.
Dissemination activities will also include:
- Publication of findings in academic journals
- Presentations at conferences, seminars, workshops and meetings
- Tailored outputs addressing key findings and/or for particular audiences. This will include an output for children and young people, which we will be designed in collaboration with our child and youth advisors
- Blogs on the BRACE and PIRU websites
- Creating or identifying opportunities to disseminate through existing networks
- Use of social media such as Twitter.