Children & Young People's Strategic Plan Consultation
MindWise welcomes this opportunity to comment on the Children and Young People’s Strategic Partnership’s Northern Ireland Children & Young People’s Plan 2011 – 2014 consultation document.
MindWise is one of the largest voluntary sector providers of mental health services in NI. We support approximately 1500 people a year and together we work to ensure that all those at risk of, and affected by severe mental illness and other mental health difficulties have choice, hope, support and the opportunity to recover a better quality of life.
The aim of MindWise Young People’s Strategy is: “To meet the mental health needs of young people aged 13 to 24 years in Northern Ireland by improving access to and partnership working between all Tiers of Children & Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) as well as the criminal justice system.”
In recognition of the fact that the detailed action plans associated with this strategy will put out for consultation at a later date, comments included in this consultation response will focus only on strategic and social policy development issues. In the absence of a formal feedback form, responses will provided with the relevant page number/s in brackets at the end of the text.
In relation to: “…without detail in relation to particular groups of children and young people or particular geographical areas. (2) (being made in this particular draft document”,“…that vulnerable children are best supported and protected when there is a process in place which supports an integrated approach to the planning of all services, from universal to those targeted to address specific needs.” (p12) and “…will oversee a number of NI wide sub groups, which will address the needs of specific groups of children and young people, and key issues” (p13)  it has to be noted that the first and second & third statements contradict each other.
MindWise would argue that the only way to ensure that the pre-existing disadvantage –referred to as “specific needs” in this document- experienced by certain groups of children and young people is addressed in any action plan is to include a commitment to this in the strategic part of any social policy. This would in line with guidance provided by the Equality Commission for Northern. Added to this would have to be identification of the groups of children and young people for whom evidence of the experience of pre-existing disadvantage is available and a proposal on how these specific needs would be identified. This would then give ample opportunity for any omission of groups with specific needs to be picked up by consultation respondents in, in particular, the community/voluntary sector. This would ensure that actions for all “specific needs” groups recognised in the draft policy document, including those additional identified by organisations providing consultation feedback, are reflected in the action plan.
The specific-needs groups MindWise would like to see included, as part of the identification process, are young people experiencing severe mental health illness requiring intervention in either CAMHS or AMHS. Another group of young people who would benefit from early intervention through joint commissioning would be young people in contact with the criminal justice system, regardless of whether or not they have (yet) been in contact with the Courts, as there is clear evidence that the level of mental health problems and pre-existing conditions is well above average among this group. MindWise delivers the NI Appropriate Adult Services Scheme which supports young people who have been arrested during police interviews and is currently developing a programme of intensive six-month support for these young people. As such we are able to identify the specific needs of this group and provide the required support to reduce further offending and address existing health and other inequalities. (Secondary research findings for this group are available from MindWise’s Young People’s Services Manager.)
The proposed regional sub-groups (p29) seem not only have been selected on a rather arbitrary basis, perhaps based on the specific backgrounds of the members of the Partnership, but also the commitment that an action plan for each of these groups (only) will be published, does not allow for other specific needs groups to be identified and added as part of the consultation as discussed above. An obvious omission is the Section 75 Group of people who are lesbian, gay or bisexual or transgendered. (Evidence of the size of this group, specific needs, including the need for increased visibility and accessible services is available from The Rainbow Project.) It would also be beneficial to include young people experiencing mental health problems separately rather than assuming that this is included under “disability”. Looked-after Children are also a group which experiences high levels of inequalities.
The “Early intervention Sub Group” might also need to be clarified further, in line with MindWise’s Young People’s Strategy, it has to be recognised that early intervention to improve outcomes for children and young people not only relates to early childhood. Early intervention by family, peers as well as teachers, youth workers and other so-called CAMHS Tier 1 professionals, when this groups starts to experience mental health issues is also essential as recognised in the Bamford report. Joint commissioning should allow for this early intervention work to be commissioned for on both a geographical basis and specific needs groups basis.

While the contents page refers to a chapter on the “Strategic Context” of the Children and Young People’s Strategic Partnership (CYPSP), the only references made in this chapter refer to some of the relevant social policies. (p7-11) For the partnership to be effective and not to duplicate work, it is essential to add to this chapter the work currently carried by the NI Children’s Commissioner (especially as the key priorities call for a Children’s Minister to be appointed at a future stage)(p15), by OFMDFM’s Equality Unit – Children and Young People’s Unit and any other statutory sector in for example the Department for Education or the Department for Justice.
In relation to social policy included in the strategic context chapter, it might be useful to clarify how the Assembly’s Ten Year Children’s Strategy and this NI Children and Young People’s Plan 2011 – 2014 would complement each other. This is particularly important as the Assembly’s Strategy aims to provide overarching strategic direction for integrated planning and while the CYPSP has “a NI-wide responsibility for integrated planning”. (p4) (Perhaps the Strategic Partnership is actually taking on this role on behalf of the Assembly? If that is the case this will need to be clarified in the document.)
For a strategic document which will inform the action plan for the CYPSP, it might be beneficial not just to list the relevant social policies (p11) but actually analyse these to see where the proposed strategy will support these policies and where there are overlaps and gaps. It might have been useful to ask respondents to the consultation to make suggestions for other relevant social policies to be added and analysed. In line with its Young People’s Strategy, MindWise would like to recommend that the Bamford reports on Child & Adolescent Mental Health Service (CAMHS), Forensic Services and Alcohol & Drug Services are included in the Strategic Context chapter. In particular the report on CAMHS includes a number of recommendations on increased working and more effective commissioning both across the Tiers of CAMHS (community/voluntary sector and statutory sector) and between different services targeted at children and young people.
Some of the terminology used is maybe a bit vague and non-committal. For example the use of words or phrases like “suggesting”, “seeking”, “in the longer term” and “making CYPSP trusted” do not support a strong strategic vision. This is especially an issue as one of the purposes of the Partnership is listed as: “To ensure an effective and efficient, fully mandated structure … is in place to carry out the work of the partnership”. (p6) This either needs to be addressed before the action plan is developed or included as part of the action plan itself.
As discussed below, themes in a strategic document would be far stronger if they had been developed using a community development pro-forma approach. Using this methodology issues and needs are firstly identified and evidenced; then the aims is developed which states what issues and needs are going to be addressed, followed by the strategic objectives which set out how this will be done. Only after this should the strategic themes be identified based on the objectives and desired outcomes. At the moment it is not quite clear on what the choice of the strategic themes are based upon on:
PURPOSE OF THE            STRATEGIC                         STRATEGIC THEMES (P15)
(None)                                                                                    1. Early Intervention
2. CYPSP will be informed and inform                             2. Advising Government
individual organisational business,                      
corporate and community plans
1. To put in place integrate planning and                        3. Integration of Planning
commissioning across all agencies and
(None)                                                                                   4. Optimisation of Resources
3. To ensure participation and involvement                    (None)
of children, young people … in the integrated
planning process
4. To ensure an effective…fully mandated                      (None)
structure is in place…
This is not to say that MindWise does not consider the themes currently selected non-relevant, but we would like to see a theme added for the participation of children and young people in planning and commissioning. This could perhaps replace the theme of “Optimisation of Resources” as this could be included under theme “Integration of Planning”.
The references to “Making CYPSP trusted re. about what’s going on for children and young people in NI” and “Making CYPSP the trusted partnership of leaders” is likely to raise questions about the remit of CYPSP and the buy-in of all government department/agencies. There is perhaps little use in developing an action plan before this is in place?
If the role of the CYPSP is “to improve support and services for children and young people” by “taking on the Northern Ireland wide responsibility for integrated planning” (p4), then it would be useful to provide evidence of adverse impact that the current approach to planning is having on this group. This Strategic Plan should include an analysis of this evidence followed by an identification of all issues involved followed by a consultation exercise to establish any gaps or omissions. (As discussed this could not have been done without considering the specific needs of Section 75 Groups as well as those who come from socio-economic disadvantaged backgrounds.)
While MindWise would certainly support almost all the assertions made in this document, an important question always needs to be asked when developing a strategy, namely: “What are the current issues/problems for which this solution of integrated planning and commissioning across agencies and sectors is proposed?”.
The current issues identified in relation to children and young people in the report in relation to planning and commissioning are:
-       Reduced outcomes in relation to improving wellbeing;
-       Lack of or limited participation and involvement;
-       Lack of a mandated structure representative of all key stakeholders able to advice government;
-       Lack of a common way of understanding children’s lives;
-       Lack of early intervention;
-       Use of resources not being optimised.
Rather than discussing the issues throughout the document, it would be beneficial to have them listed under one heading and to provide available (secondary) evidence of the adverse impact of the approaches currently used in planning and commissioning. This would be in particularly important in relation to the first point listed.
The reason MindWise would argue that it is essential to use this approach is that at the moment it would appear that the only reason why current planning and commissioning of services for children and young people in NI is not providing the outcomes desired is because of the lack of integrated planning. Other reasons why this commissioning is currently not as effective are:
-       The focus on commissioning on a geographical area basis only;
-       Insufficient consideration of the statutory duty to promote equality of opportunity by addressing pre-existing disadvantage. (Simply listing the Section 75 Groups only does not address pre-existing disadvantage nor address the internal and external obstacles certain groups experience when accessing general support services commissioned on a geographical basis.
These approaches to commissioning can make it nearly impossible for the voluntary/statutory sector to provide services for issue-based groups of children and young people on a NI-wide basis where statutory services do not meet their needs and thereby improve their outcomes. This can be especially be an issue for planning and supporting services meeting the needs of BME/Migrant Worker-, Disabled- and Same-sex Attracted children and young people which can meet their pre-existing disadvantage.
The current approach of commissioning many services in the community/voluntary sector on a one-year contract only –usually in practice this means nine months- severely limits the ability of the sector to work strategically. This combined with many social policy documents, and therefore strategic planning, being out of date and the lack of recognition that a full-cost recovery needs be applied when commissioning community/voluntary sector bodies, results in a disproportionally large amount of funding for children and young people’s services being allocated to one-off events (coffee morning, balloon launch etc) and training courses rather than more strategic support services.
Furthermore, the current main focus on commissioning suicide prevention work in NI, to the detriment of early intervention work with children and young people when they first start to experience mental health problems (as recognised in the Bamford report and MindWise’s Young People’s Strategy), can lead to reduced health- and life outcomes for children and young people. It would perhaps be more effective to discuss the Whole Child Model (p10) at the start of the document rather than in the “strategic context” chapter. (Other issues in relation to planning and commissioning of mental health and learning disability services for children and young people are also included in the Bamford reports.)
While MindWise recognises that the proposed integrated planning and commissioning model cannot address all these issues identified, it is essential that they are all listed as having an impact on the issues listed under paragraph 5.3 above and considered in the CYPSP action plan. It is good to note that early intervention is included in the document as one of the Strategic Themes, but as noted above it is important to emphasise that early intervention in relation to mental health also includes identification of children and young people, by parents, peers, teachers, youth workers etc., when they first start experience problems. The approach for integrated commissioning to address this issue will need to be included in the CYPSP action plan.
MindWise looks forward to responding to the CYPSP action plan in due course. In the meantime if you require further clarification of the issues raised above, please feel free to contact me.
Mirjam Bader
Youth Services Manager

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