Support hubs campaign gains impetus

The pandemic has shone a light on children and young people’s emotional and mental wellbeing, and the need for timely support.

However, a report published in December by the Centre for Mental Health found there continues to be “large gaps” in preventative and early intervention services.

It recommends the creation of “early support hubs” to ensure young people aged up to 25 with low-level mental health needs get help before their problems worsen.

Early support hubs provide easy-to-access, drop-in support for young people who do not meet the threshold for child and adolescent mental health services, often co-located with other services such as housing, employment advice or sexual health.

The government has previously endorsed the hub model and encouraged local areas to set them up, but the lack of a national approach means provision is patchy.

It is estimated there are currently about 60 such hubs across England “but it is a bit of a postcode lottery and funding is very ad hoc”, explains Kadra Abdinasir, associate director for children and young people’s mental health at the Centre for Mental Health.

“If a young person doesn’t want to access support at school and is not sick enough to get help from the NHS, they basically have nowhere to go,” she says.

Ahead of last autumn’s Comprehensive Spending Review (CSR), the centre joined forces with the Children and Young People’s Mental Health Coalition, Mind, The Children’s Society, YoungMinds, Youth Access and Black Thrive to launch the Fund the Hubs campaign to urge the government to invest in a national rollout of the approach in England.

The Centre for Mental Health’s Time for Action analysis suggests this would cost approximately £103m a year and help about 500,000 young people.

The fact young people do not need a referral to access support is key, as is the fact hubs are usually co-designed with young people and reflect local needs.

“The drop-in nature means you get immediate advice and support, whereas for other services you have to be referred and have to wait,” says Abdinasir.

“Each of the hubs that do exist all look and feel a bit different. What we hear from young people is it’s an informal space so very different to going to NHS services where it feels more clinical.

“Because of that, you see more young people from marginalised backgrounds using these services.”

Long-term funding

The Local Government Association, which represents councils in England and Wales, has also called on the government to provide long-term funding for hubs to help prevent a looming mental health crisis and reduce pressure on other services.

“Councils are concerned that mental health issues will continue to rise significantly, which could lead to increasing numbers of young people developing serious mental health issues and a rise in clinical interventions,” said Anntoinette Bramble, chair of the LGA’s children and young people board.

“It is crucial that early intervention and prevention services are able to help children avoid crisis point. Making early support hubs available for young people across the country to access mental health support without referrals will help reduce delays in receiving support.”

Areas that have already set up hubs – such as Southwark in south London (see box) – have seen the benefits, with some reporting a social return on investment of more than £3 for every £1 invested.

While campaigners were disappointed at the level of funding earmarked for mental health in the CSR, they hope hubs will feature strongly in a new government mental health strategy planned for this year.

CASE STUDY
The Nest provides early therapeutic support in a safe place for Southwark’s young people

Southwark’s early support hub – The Nest – was set up following a joint review of mental health services for children and young people from birth to 25 by the council and Southwark Clinical Commissioning Group.

This highlighted a gap in provision for those who needed extra support with their mental health, but did not meet the criteria for specialist services.

Southwark Council worked with young people and parents to develop The Nest, based in Peckham. The service is funded by the council and delivered by the charity Groundwork London.

“We were very clear from the start that young people’s voices are key in the development of this service to ensure it reflects what they need,” says Southwark Council’s director of commissioning, Genette Laws.

Young people took part in workshops to consider how the service might work, decided what the inside of the building should look like and voted on the name.

The Nest initially launched as a remote service in May 2020, but since the summer has been offering face-to-face drop-in sessions to young people, parents and carers (see picture, right).

It is staffed by a team of “wellbeing coaches” with a background in providing different types of therapy including play, art, music, psychodynamic and interpersonal therapy. The Nest also works with universities to offer placements to clinical psychologists in training.

Between May 2020 and September 2021, the service received 439 referrals and delivered more than 1,700 hours of support in person, over the phone, via video call or online chat.

A quarter of referrals were from young people themselves, with 16 per cent from schools and 11 per cent from families. Others were made by a mix of professionals including social workers, early help staff, health professionals, youth offending teams and voluntary sector organisations. Two-thirds were young people from black and minority ethnic backgrounds, reflecting the make-up of Southwark’s 0 to 18 population.

Feedback from a sample of young people who received therapeutic support for up to 12 weeks, suggests the service is making a difference.

Two-thirds said they felt more confident, 73 per cent said they felt happier, while 78 per cent reported an increased sense of wellbeing.

Early intervention is crucial when it comes to preventing mental health problems escalating, which is why Southwark is backing the Fund the Hubs campaign, says Laws.

“The mental health crisis facing young people is only going to get worse if we don’t act now,” she says. “We committed to 100 per cent of children in Southwark having access to mental health support. But our ambition – and that of Fund the Hub campaigners – needs to be met by consistent, long-term funding from government.”