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Mental Health Services and Schools Link Pilots: Evaluation report

In summer 2015, NHS England and the Department for Education (DfE) jointly launched the Mental Health Services and Schools Link Pilots. The pilot programme was developed in response to the 2015 report of the Children and Young People’s Mental Health Taskforce, Future in Mind, which outlined a number of recommendations to improve access to mental health support for children and young people.

Overview of the pilots
A total of 22 areas, incorporating 27 CCGs and 255 schools, were funded to establish named lead contacts within NHS CYPMHS and schools. They also participated in 2 joint planning workshops, involving other professionals from their local CYPMHS network. These included, but were not restricted to, school nurses, educational psychologists, counsellors and voluntary and community sector organisations (VCSOs). The local pilots were led by CCGs, often with active involvement from local authorities.

The joint planning workshops were facilitated by a consortium led by the Anna Freud National Centre for Children and Families (AFNCCF), using a framework developed specifically for the pilot programme (CASCADE) and involving a combination of reflection, action planning and review to benchmark local collaborative working.

In September 2015, Ecorys (UK) was commissioned by the DfE to undertake an independent evaluation of the pilot programme. A mixed methods design was deployed, incorporating survey research, research observations and qualitative case studies in a sample of 10 areas. The data collection took place between September 2015 and 2016.

Key findings
Overall, the evaluation found that the pilots had considerable success in strengthening communication and joint working arrangements between schools and NHS CYPMHS. This was often the case even where relationships were said to have been weak at the start of the pilot programme, although the extent of change varied between pilot areas.

At a programme level, the evaluation found quantifiable improvements to the following self-reported outcome measures, between a baseline and follow-up at +10 months:
• frequency of contact between pilot schools and NHS CYPMHS
• satisfaction with communication and working relationships between pilot schools and NHS CYPMHS
• understanding of the referral routes to specialist mental health support for children and young people in their local area among school lead contacts
• knowledge and awareness of mental health issues affecting children and young people, among school lead contacts

There was a smaller increase in the frequency of contact between school lead contacts for the pilots and other school-based mental health professionals. These varied between schools but included educational psychologists, counsellors and school nurses.

While harder to quantify, the interviews strongly suggest that the programme contributed towards improvements in the timeliness of referrals and helped to prevent inappropriate referrals within many areas. This was enabled by schools’ improved understanding of pathways and ongoing contact with NHS CYPMHS. The qualitative interviews show that many of the pilots facilitated direct referrals to the NHS service and discouraged unnecessary indirect referrals via GPs, where this local flexibility was available. They sometimes helped to improve the flow of information beyond the initial referral. In this context of improved capability in schools, closer joint working and more timely direct referrals, it was noteworthy that, at programme level, there was not an overall increase in the level of referrals, although unmet need was identified within some pilot schools.

There was also quantifiable evidence of improvements for all knowledge and awareness-related measures among other school staff. There was a strong indication that many schools had cascaded the benefits of the programme beyond the lead contact and used their pilot to complement existing funding and support for mental health and well-being.

Aims and scope of the pilot programme
The overall aim was to test the extent to which joint professional working between schools and NHS CYPMHS can improve local knowledge and identification of mental health issues and improve the quality and timeliness referrals to specialist services.