National: Plymouth, United Kingdom
Geography type: Mixed urban/rural
Population covered: Plymouth has a population of approximately 264,200 people (ONS 2016) and has one of the most deprived wards in the country (St Peters).
For the period 2017 to 2018, the estimated number of children and young people in Plymouth aged 5 to 17 with a mental disorder was 4490. This includes emotional disorders, behavioural disorders, hyperactivity disorders and autism spectrum, eating and other less common disorders (Public Health England Mental Health of Children and Young People Survey, 2017)
Professional group/type of organisation involved e.g. acute, CAMHS, voluntary sector, primary care
Social Services and Health.
Details of initiative
YES is a street-level agency providing a range of services under one roof for young people aged 13 to 25 in Plymouth and the surrounding villages. As a service based in a shop-front setting in the centre of Plymouth on all main bus routes, YES is widely seen as an accessible, local and informal service which engages young people. It provides young people access to a variety of services eg. counselling, information and support, child advocacy, a mentoring scheme, personal development, sexual health advice and an appropriate adult scheme offered in a holistic, young person-centred framework.
The Insight-Early Intervention Service (EIS) can be accessed by any 16 to 25-year old via primary care, the YES counselling service or by a young person walking in off the street or making contact through outreach workers. The Insight-EIS benefits from YES’s ability to work with a range of needs and with young people in distress, who do not fit into the diagnosis framework.
For those young people using the Insight-EIS, Community Services NHS Trust were able to parachute in staff who could quickly and easily access health care management services across both social services and health. The Trust brought in an occupational therapist, a psychiatrist, an education and community psychologist and a community psychiatric nurse. This resulted in a multi-disciplinary team comprising voluntary and statutory staff working together in a voluntary sector agency, managed by YES and able to access statutory care services successfully.
Type of integration (vertical, horizontal, population)
Horizontal integration between health and social care.
Usually a young person’s first experience of psychosis results in them being detained under the Mental Health Act (1983). The Insight-EIS was established to provide access for young people before their first psychotic episode and to improve their long-term outcomes. The Insight-EIS has relieved a small but significant burden on mental health services by currently picking up approximately 15 to 20 young people in crisis.
Challenges, successes, lessons learned and advice
- There is little or no stigma attached to going into a service like YES.
- Transition and the age-range served has been debated
Cost benefit information
The Insight-EIS cannot be described as saving money in the short term. However, in the longer-term the potential decrease in the numbers caught up in the revolving door syndrome combined with the benefits of young people being less stigmatised by their mental ill-health may provide considerable added value.
Youth Access Breaking Down the Barriers case studies