Setting Up and Sustaining a Comprehensive Multi-agency Service for Young People with Problematic or Sexually Harmful Behaviours

Research in Practice Conference, Birmingham March 2014

Dr Nick Hindley, Child and Adolescent Forensic Psychiatrist, Thames Valley Young People’s Forensic Service, Boundary Brook House, Headington, Oxford OX3 7LQ

Email: nick.hindley@oxfordhealth.nhs.uk

Introduction• The problem

• Getting started• General attributes of a service• A service model• Stages in service development

• Sustaining a service

• An example of an initial evaluation

The Problem

• whose problem?

• what should be done?

• can we be sure we are doing the right thing?

• one agency or everyone?

• high risk cases?

• commissioned or ‘virtual’ team?

Getting Started

• outline of the problem in your area

• who knows about it?

• who elsewhere can help you get started?

• is there a local champion (s)?

• Safeguarding Boards

• persistence

Attributes of a Service

• accessible and inclusive

• responds to concern

• authoritative but pragmatic

• flexible

• contains and injects anxiety as needed

• accountable

• safeguarding at its centre

A Service Model

• built on staged intervention• advice, consultation, assessment and

intervention

• robust governance • probably needs to be based in one agency

used to high risk services

• built around a theoretical model but open to other modalities

• experienced team with liaison ethic

Integrated Liaison Model for a SHB Service for Young people

Service for SHB

Police

“Looked after” sector

Social care assessment and family

support teams

CAMHSEducation

Courts and CPS

Substance Misuse

Services

Specialist residential and custody

Youth Offending

Teams (YOTs)

Sustaining a service

• the importance of good communication and evaluation

• maintaining contact with strategic supporters

• involving young people and their families

• continual development

Principles of Evaluation

• better to evaluate than not to do so

• evaluate as part of overall project

• accept initial evaluation may be basic

• include quantitative and qualitative data

• include different stakeholders including family

CAHBS Evaluation(156 Cases Oxon and Bucks, March 2012- 2013)

• good age range (4-18yrs)• high numbers of formal SSD, SEN and mental

health issues• referrals from range of agencies• multiple agency involvement high• after CAHBS no agency involvement in 11% cases• CAHBS still involved in 7% cases after 1 year• 43% cases: consultation only; 57%: assessment +/-

intervention• qualitative data: positive response from strategic

stakeholders and referrers; very positive response from families

What Other Agencies Should Expect From a SHB Team

• accessibility

• good communication

• clarity relating to function and responsibilities

• specialist knowledge of:• relevant institutions

- custody, community agencies, placements, courts • practice (assessment and intervention)• strategic planning• education and information dissemination

• good collaborative relationships and joint working where possible

Reference for CAHBS Evaluation

http://www.sph.nhs.uk/what-we-do/service-review-and-evaluation/helping-commissioners-plan-for-the-future