Think Good Feel Good Project Ta MHS The

Think Good, Feel Good Project Ta. MHS The Shropshire Model Supporting emotional health and well being in schools Jo Robins Locum Consultant in Public Health Kay Smallbone Programme Lead 5 -19 Renee Lee Project Support Officer Shropshire council

The facts… • In 2004, 22. 8% of the total burden of disease in the UK was attributed to mental disorder, compared with 16. 2% for cardio vascular disease and 15. 9% for cancer • Mental illness is the single largest cost to the National Health Service (NHS), being £ 10. 4 billion, that’s 10. 8% of the NHS budget • The wider costs amount to £ 105 billion a year Royal College of Psychiatrists, ‘No health without public mental health’, October 2010 and February 2011

Local Context Health and Well-Being Strategy - Outcome 3: • Better Emotional and mental health and wellbeing for all – Priority – (i) Improve the emotional wellbeing and mental health of children and young people, by focussing on prevention and early support. – Priority – (ii) Making Shropshire a dementia friendly county to enable earlier diagnosis and improved outlook for people with dementia • Priority (i) listed above is to be delivered by the Children’s Trust and reported through to the Health and Well-Being Board. • In Shropshire, it is estimated that between 26% and 32% of the population have a mental health condition with the main illnesses being depression and anxiety, alcohol related mental health problems, and personality disorders. In addition to this, over 4000 people in Shropshire are known to suffer from dementia. The ageing nature of our population means that this number is increasing, and problems with diagnosis mean that this figure is already likely to be much higher.

What are the risk factors? Factors that increase the probability of a child developing an emotional health problem

• If a child has one risk factor their chance of developing an emotional health problem is 1 -2% • Three risk factors is 8% • Four or more, increases to 20%

The benefits of school engagement “… warm, caring and supportive relationships in school are a crucial factor: not only in maintaining good mental health; but to achieve high levels of performance; greater enjoyment of school; more motivation; better learning; higher attainments; improved attendance levels…” (Weare and Gray, 2002)

The Shropshire Model Shropshire Children’s Trust Health and Well Being Board CAMHS Commissioners CCG Safeguarding Board Public Health Ta. MHS Steering Group Project Manager School leads Children and Young People (3052 pupils) Families & Community Project Team Ta. MHS Administrator Whole school Lifelines practitioners CAMHS Stakeholders Group Wider Team Voluntary Sector partners Statutory partners

National Model: A Whole School Approach

Key Deliverables of Ta. MHS underpinned by Outcomes • Increase in staff confidence and skills in working with children and young people experiencing emotional and mental health problems • Increase in staff knowledge and awareness of children’s emotional and mental health needs • Programme has reached all schools • Results from the pilot showed promising results around attendance and attainment improvement in pupil attitudes, anxiety, and feelings

Knowledge and skills training Target Group Knowledge and skills based training Description Impact/Outcomes KS 1 - KS 4 Tier 1 Sociograms Project Manager and Learning & Skills Team Assessment and tracking tool To identify need and track progress of pupils KS 1 - KS 4 Tier 1 SUMO (Stop, Understand Move On) SUMO national team or Whole school resources creating Project Manager common language to positive thinking Emotionally healthy whole school culture KS 1 - KS 4 Tier 1 Loss and Bereavement Hope House Hospice Theory/ models of grief, Raise awareness and confidence in supporting pupils following grief. KS 1 - KS 4 Tier 1 Re Think Time to Change Mental ill- health awareness rising. Service user stories Raise awareness of the differences between mental health and mental ill- health and the long term impact their childhood traumas such as bullying and abuse can have on young people into adult life. KS 1 - KS 4 Tier 1 Self Harm & Introduction to STORM Project manager and Educational Psychology service or Ca. MHS Understanding and managing selfinjury. Introduction to suicide prevention. Raise awareness of prevalence, dispel myths, how to identify early signs, how to respond and support following a disclosure Staff Tier 1 Stress management Project manager Managing staff and pupil stress, in including relaxation techniques Ensure staff are in an emotionally sound place before supporting pupils emotional needs

Skills based intervention training Target Group Tier of support Intervention training Training delivered by Programme Description Impact/Outcomes KS 1 - KS 4 Tier 1 & 2 Anger Management Project Manager and Learning & Skills Team 8 week peer support (anger) Pupils to understand triggers of anger, defuse and manage more effectively KS 1 - KS 2 Tier 1 & 2 Reach for the Top Project Manager 6 week 1 -1, (attachment) Provide time and space for pupils to talk, to build trust, to feel valued, safe and belong within the school KS 1, KS 2, KS 3 Tier 2 FRIENDS for LIFE Educational Psychology Service 8 week peer support (Anxiety) Using CBT to reduce and mange anxiety KS 3, KS 4, KS 5 Tier 2 STAR Windmills and STAR champions (eg. PM, EWO, TYS, 15 -19 teams) 6 week peer support for pre NEETs To increase aspiration, motivation and pupils or those at risk of not confidence reaching their full potential KS 1 - KS 4 Tier 1 & 2 Seasons for Growth Bereavement UK 8 week peer support, using Wordens model of grief. To help pupils manage loss and significant change (e. g. bereavement or, divorce) KS 1 -KS 3 Tier 1 & 2 Lifelines 1 -1 support with grief work Enable young people to move forward following grief KS 1, KS 2, KS 3 Tier 2 Nurture Group Priorslee campus Classic and adapted nurture groups Curriculum based sessions for small groups of vulnerable pupils KS 1 -3 Tier 1 ZJT consultancy Relaxation skills that can be delivered to small groups or whole class To raise awareness of the importance of relaxation and learning strategies of how to relax. (Spence anxiety score measure) Ta. MHS team (Boxall profile measure) Relax Kids and Chill Skils

Classic nurture groups ‘The school's own nurture group provides pupils with excellent opportunities to work and play in a calm, relaxing atmosphere’

Outdoor nurture groups Outdoor Nurture Group “using the outdoor environment to stimulate pupils' interests, especially those of boys, is having a positive impact on motivating pupils to learn and raising achievement”

Relaxation garden “The excellent attention paid to children's welfare and to their personal, social and emotional development very successfully builds their confidence and self-esteem. Children are enthusiastic learners”

Year 7 boys self esteem group Positive relationships exist between staff and the students and behaviour is managed well

Moving Forward – Think Good Feel Good Self harm identified as a problem in 2013 Self harm pathway developed in consultation with parents & young people Risk assessment policy developed for schools Information for children, young people, parents and practitioners Targeted intervention programme (10 weeks) Signature Strengths Train the trainer pilot in 3 secondary schools PHSE curriculum resource developed Extending the offer to under 5’s and over 16’s