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4 The Challenge

Mental illness is a frightening experience for anyone who suffers from it. For children and their families, the levels of pain and confusion they endure can be hard to imagine.

Although one in ten young people suffers from a significant mental health problem, the majority of children, adolescents and families do not get the support they deserve.

Mental illness not only has a devastating effect on a young person’s life chances – it also places a heavy burden on us as a society. As young people they are more likely to drop out of school, become involved in criminal behaviour, abuse drugs and alcohol and develop destructive relationships.

As adults, they are more likely to go on to need long-term medical care, be unable to work and have serious relationship problems. But perhaps the biggest knock-on effect of mental health problems in childhood is the level of suffering that these children and young people are left to bear.

By failing to recognise and treat mental health problems at an early age, we are wasting the talent of young minds and allowing social problems and emotional distress to build. This loss of potential is all the more tragic given that we have the tools and the expertise to make effective interventions that can really change lives.

This is what we are about at the Anna Freud Centre.

Mental illness is the most serious challenge to our children’s futures

The World Health Organization estimates that by 2020 mental disorders will become one of the five most common causes of serious ill health among children.

66 Our Approach

The difficulties faced by some of our most emotionally vulnerable young people often appear complex and hard to unravel. For over 60 years the Anna Freud Centre has focused on understanding, protecting and nurturing young minds.

Beginning with Anna Freud’s pioneering work in the Hampstead War Nurseries with children who had experienced profound emotional trauma and damage, we have worked constantly to change how young minds are understood and to transform how children with mental health problems are helped.

Our network of world-leading clinicians and researchers has shed new light on how young people’s minds develop and led to better ways of caring for them.

Our innovative clinical practice has carried research breakthroughs into the real world and changed the lives of many children and their families. Our teaching has a global reach and ensures that the impact of our works extends far beyond the Centre itself.

The exceptional wealth of experience and expertise available to us informs and fuels the work at the Centre. On the ground, this translates into remarkable levels of care and insight being brought to the children and families who come to us for help. On a wider scale, our work influences national and international policy.

The Anna Freud Centre: where young minds matter

In 1941 Anna Freud established the Hampstead War Nurseries, now the Anna Freud Centre, in response to the social and emotional upheaval faced by the children of wartime Europe. Her emphasis on innovation and high-quality care for the most vulnerable young minds remains at the heart of our work today.

88 The Centre

Finding new and better ways of understanding young minds is what drives our work at the Centre.

We bring together world-class clinicians and researchers who use psychological approaches and technologies such as brain imaging to understand how the developing mind is shaped by emotional, biological and genetic factors.

This combined expertise in clinical practice and academic research makes us unique and has enabled us to be so effective in developing new treatments.

Research at the Anna Freud Centre has shown how the brains of children exposed to family violence display the same neurological patterns as those of soldiers returning from combat, increasing their vulnerability to mental health problems. Our research has also shown how resilient and adaptable the human brain is – providing suggestions for how we might intervene to change the lives of children whose early experiences have been damaging.

Our insights lead to innovative treatment models that are tested for the first time at the Centre and in local communities. By creating new approaches and evaluating and refining treatments, we are able not only to directly affect young lives but also to ensure that our findings will go on to change the lives of those far beyond the Centre.

Transforming young lives by revealing how the mind works

Our Evidence Based Practice Unit plays a pivotal role in linking together the worlds of academic research and mental health practice. It produces and shares the latest research evidence, and develops practical and innovative tools that help professionals to provide better support and care to children and families struggling with emotional and behavioural difficulties.

1010 Family Bonds

The relationship between parent and child is at the heart of a child’s emotional world. When that bond is fractured or lost it can have a profound effect on the young person’s mental well-being.

Working to rebuild this crucial connection is at the heart of our work.

While having a baby is often a joyful experience for the mother, couple and family, it can sometimes be surprisingly difficult. Depression, other mental health problems, childhood trauma and recent bereavements can impact on both the parents’ own mood and their ability to bond with their baby.

Our Parent-Infant Project provides therapeutic support to pregnant women, parents and their babies of up to 12 months of age. Our experienced psychotherapists help the parents and infants to develop positive, sensitive relationships with each other.

The weekly parent-toddler groups we hold at the Centre and in a homeless hostel are another example of our parent-child focused approach. Parents and toddlers are encouraged to play together in a relaxed, supportive environment. Difficulties and distress as well as play, exploration and fun can be shared in the group, which is led by a skilled therapist.

A child’s relationship with their parents is the most important relationship they will ever have

An innovative approach to family-centred treatment

The crucial role of family in a child’s mental health has informed one of the Centre’s flagship theories and treatments. Mentalization Based Treatment for Families is a brief, clinic-based family therapy that helps families to recognise, understand and think about each other’s emotional needs, to see more accurately and clearly the wishes, beliefs and ideas that drive the actions of family members – what we call ‘mentalizing’.Using a range of techniques, including games and activities, the therapist helps each family member make sense of their own thoughts and feelings and find ways of understanding other family members – increasing stability and understanding and reducing damaging conflict.

1212 Early Years

There are some circumstances when it is even more critical that we protect and nurture the bond between parent and child.

Our Early Years Parenting Unit works with parents whose own mental health difficulties have resulted in their children being placed on a Child Protection Plan or at risk of being taken into care. This service offers families an intensive, long-term therapeutic programme that helps parents to understand their children’s needs and behaviour better and think more clearly about how their own actions may be experienced by their children. In doing so, they become more aware of and responsive towards their children.

Protecting the most fragile of bonds

Two years ago, Dan had recently been released from prison and was living in a one-bedroom flat. It should have been a time for him to begin getting his life back on track. Instead, he faced the devastating prospect of his three children being taken into care because their mother could no longer cope.

As determined as Dan was to give his children the family life he had never had, the children’s social worker was unsure he would be able to care for them. Even after a 13-week parenting course, Dan still had anger issues.

It was suggested that he should attend the Early Years Parenting Unit at the Anna Freud Centre. Dan agreed, “because I would do anything for my children”.

Dan was expected to attend the 18-month programme for two full days a week and he was initially overwhelmed by the commitment. But after attending the psychotherapy sessions on his own, with his children and with other families, Dan realised he wasn’t able to fully support his children’s development.

With hard work and the help of the therapists from the Anna Freud Centre, Dan learned the value of paying close attention to his children’s emotional needs. He also realised he needed to protect his children from his anger and worked hard to manage his feelings in less destructive ways. This helped him to develop a deeper attachment with his children and Dan says: “It’s the bond I always wanted to have”.

1414 Beyond the Centre

We are determined that as many young people as possible benefit from our work.

Our work begins at the Centre but its impact goes far beyond

World-class education and training

Each year we provide cutting-edge training for up to 3,000 professionals who work directly with children and young people. This includes over 30 courses covering a wide range of topics, from therapy techniques linked with mentalization to methods of evaluating the effectiveness of therapies. With University College London, we offer four master’s degree programmes, one of which is taught in collaboration with Yale University, and one PhD programme.

Through our portfolio of training courses we can ensure that the treatments we develop reach children, young people and families across the UK and the world.

Our training and the sharing of our research and toolkits have improved the skills of more than 100,000 professionals. Collectively those we train and support have served 50 million young people suffering from mental health problems.

Taking therapies into schools

We continually look for ways to take our help to the places where it is needed most. Our Schools Programme reaches out to support thousands of children, families and their teachers.

We are set to launch the first school anywhere in the world designed for young people with severe problems who are finding it difficult to fit into mainstream education. Our Family School will serve both the educational and the mental health needs of these pupils. It will focus on making sure that each young person makes progress so they can remain in full-time education and eventually return successfully to mainstream school.

As well as setting up a new school, we run weekly family groups within mainstream schools for troubled children who may be at risk of exclusion. These groups use the most up-to-date treatment techniques, which have been shown to help develop the children’s social and emotional skills, improve their behaviour and educational attainment, and encourage more positive family relationships.

We also carry out preventative work, fostering resilience and emotional wellbeing in schoolchildren so that they can cope with future challenges. An example of this is our Evidence Based Practice Unit’s “What’s Up!” – an interactive mental health e-portal for school pupils aged 11-14 years. The site allows pupils to track and learn to manage their own emotions and behaviours.

Teachers sometimes need support to deal with disruptive and challenging pupils. If ignored or poorly managed, the child’s problems can intensify and seriously affect not only their own wellbeing and chances of academic success, but also those of their friends and classmates.

At the Centre we offer direct and online training, consultations and forums to support teachers in recognising mental health problems and working with these young people.

1616 Reaching Out

Mental illness knows no boundaries and can affect anyone. We believe that everyone should receive excellent mental health care.

It is those who are hardest to help that we are most determined to reach

Using sport to unlock young minds

One in five pupils in the UK leaves school without basic skills in literacy and numeracy. These young people are usually those whose behaviour and emotional distress are so challenging that schools are simply unable to cope with them. For many, exclusion is the start of a spiral into crime and anti-social behaviour. Such young people may even lack the ability to understand their thoughts and feelings. Our SmartGym, which was developed in collaboration with a leading sports psychologist, uses biofeedback to show children how stress affects their minds and bodies. It allows them to track their heart rates, breathing rates and skin temperature while they carry out a circuit of tasks. This improves their resilience, anger management, social skills, and school performance.

Reaching young people who need us most

We also believe that it is young people with the highest risk of self-harm and suicide and those involved in drugs and crime that we should try the hardest to help. Adolescent Mentalization-Based Integrative Treatment is our radical new way of helping these hard-to-reach adolescents.

Each young person has one dedicated and trusted worker who will meet them in a place where they feel safe, rather than them seeing a string of professionals. The intervention is based on the latest research into mentalization-based techniques and is being applied by 30 teams across the UK. It uses award-winning web-based technology to train and support the outreach workers.

The approach offers much-needed accessible, approachable and immediate support to some of the most troubled young people in our society. The result is care when it is needed most, where it is needed most.

1818 In the Community

Tom is 15 years old. His mother works hard running a cafe and his father is an alcoholic and has recently relapsed into heavy drinking, despite spending time on life support with acute liver failure nine months ago. The family tries to avoid talking about the father’s drinking. Tom is smoking large amounts of cannabis, is not attending school, and describes overwhelming feelings of hopelessness. Family life is punctuated by enormous arguments in which the mother worries someone will get hit, Tom threatens to take off into the night, and his father blames Tom for “driving him to drink”.

A worker trained in the Adolescent Mentalization-based Integrative Treatment is allocated to Tom and travels out to meet him in a local cafe, where Tom says he would rather be seen. She works hard in early meetings to give Tom the sense that, if nothing else, this person understands how hard things are for him. Tom is not used to the intense conversations that the meetings can lead to, and is initially overwhelmed by it all. But he can see that the worker recognises this and he begins to trust her.

The worker talks a lot about what she is doing with other team members, even in front of the family – modelling to them that all of us need support in avoiding reckless responses. She knows that her colleagues share a disciplined, team-based approach and see providing this support for each other as a core part of their role. They support her work not only with Tom and his family, but also with the school and the local police.

Over time, Tom and his father can remind themselves of past pleasures they shared and begin to discuss a trip to watch a cycle race together, as they did when Tom was younger. Tom develops resilience, stops smoking cannabis and starts to return to school. His father re-engages with the hospital and stops drinking again. His mother describes feeling as though more than one life has been saved.

Tom’s story

2020 How we’re funded

We have achieved so much – but there is much more we can and need to do

How we raise money

We are a charity. But every time we deliver a service we aim to attract and blend three revenue streams: a public sector commission, a grant, donation or investment to support innovation, and fees from training and research to fuel our evidence base and dissemination. This blended revenue model is our strategy for delivering the largest impact at a time of austerity.

We earn income from training courses and contracts for providing services, but we need to raise over £2.7 million a year in donations and grants just to maintain our existing projects. And we need more if we are to achieve our vision of ensuring that every young person has the mental health support they need to thrive.

Our income this year was £6,516,468 and our expenditure was £6,530,142. Every year we need to raise over £2,700,000 from grants and donations just to maintain our existing projects.

… and how we spend it

Our total expenditure for the year ending 31st August 2013 was £6,530,142.

We spent 97% of this (£6,290,327) on charitable activities.

These include our clinical and preventative services for children and families, research aiming to evaluate new treatments and improve our understanding of childhood emotional distress, and the teaching and training of current and future clinicians and academics.

The remaining 3% (£239,815) was spent on investment management, fundraising and publicity, and governance.

It can cost £10,000 to work with a vulnerable young person and their family for one year. But it costs the state £200,000 a year to place a child in residential care.

2222 The Future

Looking forward

We are incredibly grateful for all the help we have received from existing donors and supporters. It really makes a big contribution to the young people and families that we work with.

But demand for our help has never been greater and so we are greatly expanding our clinical services over the coming year. Given sufficient resources, we pledge to increase the number of children, young people and families who directly benefit from our work by 300%. This can happen only with your help.

We guarantee that donations will be used to ensure that children, young people and families locally and across the UK receive the mental health support they deserve.

Patrons’ Scheme

Many of our supporters show a long-term commitment to helping the work of the Anna Freud Centre and make a huge contribution to transforming the lives of children today and those of future generations

Our Patrons’ Scheme recognises the impact of our supporters by extending a range of benefits to them, including opportunities to attend talks and events that provide them with the chance to meet other patrons as well as experts from the Centre.

For £100 a month, you can enjoy privileges including monthly written updates, access to the Patrons’ area on our website to see the impact of your donations, and meetings with key professionals.

How you can help

Direct Debit

At the Anna Freud Centre we are reliant on donations and support from individuals just like you. Giving a regular donation will enable us to plan for the future, allowing us to continue supporting vulnerable children and families who need our help.

To sign up to be a regular giver to the Anna Freud Centre please visit: www.annafreud.org/donate-landing.php

Thank you for your generosity. Together we can make a difference.

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Anna Freud Centre12 Maresfield GardensLondonNW3 5SUTel +44 (0)20 7794 2313

www.annafreud.orginfo@annafreud.org

Registered company number: 03819888

Registered charity number: 1077106