Birmingham children's mental health services have been extended to those aged 25.

  • Young people can speak to therapists and youth workers at a city centre drop-in service
  • It is set to receive 10,000 visitors in its second year and reports high satisfaction rates


Pause is a drop-in service in Birmingham city centre. It was commissioned by Birmingham Women's and Children's NHS Foundation Trust following a shake-up of child and adolescent mental health services (CAMHS) in the city on the back of a consultation with young people and stakeholders. As a result of the consultation, the age range for services was increased from the conventional birth to 18-year-old range, up to 25.

Pause, which is run by The Children's Society, was commissioned and designed to deliver services with this wider age range in mind. The idea of extending eligibility was to avoid a cliff-edge for young people moving from child mental health services to adult mental health services.

"The transfer from one service to another [between child and adult mental health services] was poor," says Rob Willoughby, West Midlands area director at The Children's Society.

"At the age of 25 young people are more mature and able to manage the transition."

Willoughby says Pause was established due to concerns about access and engagement for young people in the city.

"Because of feedback and consultation, we were aware that it was difficult for young people to get access to support and help early and quickly enough," he says.

"We conceived the idea of a drop-in centre, a city centre space where young people and families could walk in without an appointment, talk to therapists, youth workers, volunteers, and get immediate help and support without waiting."

In order to fine tune the design, The Children's Society established a group of young people called "the hub squad".

One of the key ideas young people had was they wanted the service to feel like a mix between Costa Coffee and an Apple Store - modern, bright, with IT and self-help points, as well as being welcoming and spacious.

"They didn't want a clinical environment, a reception or check-in, so people could just walk in and out comfortably," Willoughby says.

"Most of the time they didn't want to be going into a counselling room."

At Pause, young people can join a workshop, create artwork, go somewhere quiet to think, or simply have a cup of tea and chat with someone who will listen and try to help solve problems.

Staffing for Pause is a mix of six qualified therapists, three youth workers and volunteers, of which there are currently around 25, as well as a manager overseeing the staff team, with the service running seven days a week.

For young people presenting with higher levels of need, such as suicidal thoughts, or psychosis, a referral is made to an Access Centre which reviews the situation and recommends help, such as an initial assessment at a community hub, a visit from the crisis team, or a service provided by a local partner organisation.

The number of young people escalated in this way comes to around 10 to 15 a month out of 400 to 500 visitors a month - which works out at between two and three per cent of young people who attend the centre.

"We are giving young people help to prevent higher needs developing," Willoughby explains.

He adds that there has been an associated increase in numbers of young people accessing other CAMHS in the city, putting this down to "more people coming through the front door".

"We have improved access, which has created pressure on the system at higher tiers," he says.


In its first year, Pause had 7,191 visits, from 3,595 people. This translated into 2,486 one-to-one therapeutic sessions for 1,330 individuals. Now in its second year, it is on track to reach 10,000 visits.

Willoughby says that it is quite difficult, at a clinical level, to identify the outcomes as they may see a young person once or twice but have no follow-up information on their progress.

However, the service does complete a survey with young people who visit. A total of 97 per cent of respondents said that they would recommend Pause to their family and friends. Meanwhile, 97 per cent of young people said they felt more able to cope with their presenting issue following a drop-in session. On average, each young person felt their ability to cope with their presenting need increased by four points on a scale of one to 10.

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