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Children and Young Peoples Mental Health Training PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Children and Young People’s Mental Health Training" by Ed Fisher, PhD and Patrick Tang, MPH. 1. Develop an understanding of common mental health difficulties in children and young people. 2. Explore the different scenarios where you support children and young people who may be experiencing mental health difficulties. 3. Understand the experiences of children and young people with mental health difficulties. 4. Explore and understand how to communicate effectively with children and young people with mental health difficulties. 5. Explore and understand key approaches to supporting children and young people with mental health difficulties

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Published on : Mar 15, 2023 | Views : 1655 | Downloads : 0

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Slide 1-

Children and Young People’s Mental Health Training
Slide 2-

Welcome Before we start, please take a few minutes to complete the pre-course questionnaire by visiting www.wecantalk.online/pre Open in a web browser and type the full address. You must complete the pre- and post-course questionnaires to receive your certificate!
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Welcome Housekeeping
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Welcome Introductions
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Background Healthcare workers often report that they feel they lack the knowledge, skills and confidence to support young people with mental health problem This training has been developed directly in response to the views, experiences and needs of young people and staff working in acute hospital settings. We Can Talk was developed with funding by Health Education England at Barts Health NHS Trust and has now expanded to work with hospitals across England in collaboration with the Common Room, Healthy Teen Minds and the Child Outcomes Research Consortium (CORC). It has been developed by a partnership between young people and adults with lived experience of mental health difficulties, health care professionals and mental health professionals.
Slide 6-

Training overview The aims of today are to: Develop an understanding of common mental health difficulties in children and young people Explore the different scenarios where you support children and young people who may be experiencing mental health difficulties Understand the experiences of children and young people with mental health difficulties Explore and understand how to communicate effectively with children and young people with mental health difficulties Explore and understand key approaches to supporting children and young people with mental health difficulties
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Things to keep in mind Mental health can be an emotive topic. If you need to take time out please do so. We want to learn from experience, but please try not to use names or personal details. Today is focussed on building on your existing skills and experience Today is all about learning together, sharing practice, ideas and experiences. Sometimes, the best way to learn is to share and reflect on examples where things haven’t gone so well. Please be respectful if people do share examples. Don’t worry if you’re not sure the correct terminology to use about mental health. It’s better to say something than stay quiet. It’s important to explore, discuss and debate, but try to challenge the idea not the person.
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Understanding: Your Role How do you support and care for children young people who present to hospital in general? Thinking about your job role: What do you see as your main responsibilities towards children and young people? What do you practically do to care for young people? What support do you provide to meet their needs? Write your ideas down on the flipchart paper. Try to be as specific as you can and focus on all presentations (not just mental health).
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Understanding: Your Role Now think about the times when you have supported children and young people with mental health difficulties in your role or service Now think about the times when you have supported children and young people with mental health difficulties in your role or service: Describe some of the common situations where you support children and young people with mental health difficulties. What do you see or notice about the young person? How do they act or behave? What do you currently do to support them? What do you find difficult, challenging or feel uncertain about? What are these experiences like for you?
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Understanding mental wellbeing, mental health and mental health difficulties
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“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” World Health Organization, 2014
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“Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” World Health Organization, 2014
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Mental Health Overview
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“One in four people, like me, have a mental health problem. Many more people have a problem with that” Stephen Fry
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Adult Psychiatric Morbidity Survey, HSCIC, 2009 Adult statistics
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Early identification
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Defining: Depression
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Defining: Depression When we get “stuck” feeling down
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Defining: Depression
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Defining: Anxiety
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Defining: Anxiety When our worries get in the way of our life
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Defining: Anxiety
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Defining: Anxiety
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Defining: Bipolar Disorder
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Defining: Bipolar Disorder Unusual extremes of mood for no apparent reason
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Defining: Bipolar Disorder
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Defining: Psychosis
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Defining: Psychosis An altered state of perception, thoughts, mood and behaviour
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Defining: Psychosis
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Defining: Medically unexplained symptoms
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Defining: Medically unexplained symptoms Physical symptoms we don’t understand
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Defining: Eating Disorders
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Defining: Eating Disorders Dysfunctional relationship with food
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Defining: Eating Disorders
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Defining: Everything else
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When should I worry? Impact on every day functioning Rapid deterioration (in any area) Disengagement Significant change in behaviour Risk to self/others Bizarre behaviours/beliefs/statements
Slide 37-

Understanding behaviour and communication
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Understanding: Behaviour
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Understanding: Behaviour Choose one behaviour you encounter when supporting young people with mental health difficulties in your clinical practice Think about the young person: What do you see or notice? How does the young person act? What do they do? Try to imagine how the young person might be feeling - what could some of their underlying feelings and worries might be? What are their core needs in this situation?
Slide 40-

Understanding: Behaviour Choose one behaviour you encounter when supporting young people with mental health difficulties in your clinical practice Think about what this is like for you: How might you be acting? What might the young person see or notice? What are some of your underlying feelings and worries? What are your needs in this situation?
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Understanding: Behaviour Regardless of which mental health difficulty a young person is experiencing, they have core needs like all patients; their behaviour is not just a product of their mental health issue Behaviour is a form of communication – we need to try and understand what they are trying to express Young people are individuals – 10 young people with the same mental health difficulty will all have different underlying feelings, worries, wants. This is why it is important to understand and respond to underlying feelings, core needs, rather than the visible behaviours (or assumptions about behaviour) All children and young people have the same core needs - which is exactly what healthcare workers are skilled and experienced at supporting. You don’t have to be an expert in mental health to help.
Slide 42-

PHEW
Slide 43-

Hands up for harm! Listen to the following scenarios: If you think the behaviour or situation described is an example of self harm, raise your hand.
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Defining: Self Harm
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Understanding: Self Harm Are these the only types of self harm? Cutting Burning / scalding Head banging Breaking bones Punching body Inserting/swallowing objects/poisons Throwing self against something
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Understanding: Self Harm What about? Smoking Tattooing Risk Taking Behaviours Body Piercing Eating Disorders Alcohol use Drug Use
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“Self harm is a way of expressing very deep distress” MIND, 2012
Slide 48-

Understanding:Experience
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Understanding:Experience Why do children and young people come to hospital in mental health crisis? Hospital isn’t the first choice for young people experiencing mental health difficulties. They need professional care to stay safe, just like those attending with physical needs. When forced to seek medical care, they do so with feelings of shame and unworthiness.
Slide 50-

Understanding:Experience Hearing children and young people’s voices “I will not go up there anymore, mainly because I feel like such a time waster, and I hate all the questions they ask you … I just want to get back home, hide under the duvet and die of shame … I've ended up with numerous infections however from not getting wounds treated.” “I can understand their frustration at having to stitch someone up knowing that there is a possibility of them returning the next day with a new injury or after re-opening the stitches … They are only human and have bad days just like anyone else.”
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Understanding:Experience Positive and negative experience of mental health support in acute hospitals Staff attitudes/behaviours have more impact on young people’s experience and are more important than a lack of knowledge around mental health. Negative experiences mean young people are less able to cope when they leave hospital and encourages young people to abscond when attending due to their mental health. CAMHS don’t always get this right either, and the same goes for non-healthcare organisations such as schools struggling to support young people in mental health difficulty.
Slide 52-

Understanding:Experience Hearing children and young people’s voices “The last time I had a blood transfusion the consultant said that I was wasting blood that was meant for patients after they'd had operations or accident victims. He asked whether I was proud of what I'd done…” “…they have concentrated on medically patching me up and getting me out. Never have I been asked any questions regarding whether this is the first time I have self-harmed or if I was to do it again or how I intend to deal with it.”
Slide 53-

Understanding:Experience Positive and negative experience of mental health support in acute hospitals Children and young people have a better experience if involved in decision making and if staff explain the reasons for/the goals of assessment They like being given a chance to talk about their problems Children and young people who self harm say that it is a better experience when they can talk through what led up to the event. The most positive encounters are where YP receive ‘treatment as usual’: non-discriminatory care, delivered with kindness and empathy, not just focussing on the physical aspects (if applicable).
Slide 54-

Understanding:Experience Hearing children and young people’s voices “I allowed a student nurse to observe and she was really kind and asked me why I self-harm because she said she didn't really understand it, and it was really nice … to be able to actually help someone learn about it.” “He... took great pains to suture very neatly – when I commented on this he said “I don't want it to leave any scars” to which I replied that I am covered in them. He said “not on my watch”.” “The nurse consultant who assessed me was very easy to talk to. She explained everything clearly in a non-threatening way. It felt like a friendly chat. She was great!”
Slide 55-

Understanding:Experience Summary Whilst there may be many perceived challenges to supporting children and young people with mental health difficulties, it is the small things that make the biggest difference: Care Compassion Empathy Validation Reassurance Time to talk All things that healthcare workers are highly skilled and experienced in doing.
Slide 56-

Communication
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Support: Communication Key areas of good communication: Talking about and acknowledging a young person’s distress and mental health difficulty Understanding and meeting their core needs as a patient Understanding risk and safety Involving young people in making choices and decisions about their care and support
Slide 58-

Support: Communication Communication about risk Always ask about: History – What’s happened and when, how long Hope – Understanding intention Suicidal Ideas - “What did you hope would happen?” “Did you think it might kill you? Suicidal Intent - “Did you want to die?” What helps them to feel safe
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Support: Communication Communication about risk Always ask the young person: What you can do to make them feel safe and supported What helps if they start to feel more distressed What you will see or notice if they start to feel worse or become more distressed (all young people show this in different ways e.g. some may become more withdrawn meaning it is hard for staff to notice Talk to the young person and agree with them how they can let you know if they are starting to feel more distressed
Slide 60-

Support: Communication Having a go!
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Support: Communication 1. Entering the room What choice is there to enter? Introductions 2. What is the conversation about? Explaining why you are there, what you want to talk about and why 3. Understanding What has brought the CYP to hospital? Validate presentation 4. Exploring risk and intention What did they hope would happen? Did they intend to harm themselves? Did they want to kill themselves ? 5. Exploring current risk Do they still want to die? Could they tell us if they did? How can we help keep you safe? 6. Informing others Choice for the young person on how? Remember to use: Validation Empathy Open/closed questions Calm, caring tone of voice
Slide 62-

Support: Communication What does it feel like to change the way we communicate? Abrines-Jaume, N., Midgley, N., Hopkins, K., Hoffman, J., Martin, K., Law, D. and Wolpert, M. (2014). 'A qualitative analysis of implementing shared decision making in Child and Adolescent Mental Health Services in the United Kingdom: Stages and facilitators'. Clinical Child Psychology and Psychiatry.
Slide 63-

Support: Communication Summary of key messages and further resources Saying something is better than saying nothing Intention is more important than getting it perfect Communication is highly valued by young people. Conversations make them feel heard, seen and valued. This alone can dramatically change their experience. Mefirst.org.uk has a host of resources to support communication with CYP in healthcare
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Support
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Support: Practical CATASTROPHE
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Support: Practical Distraction and relaxation Paper and pens are valuable tools! Listen to music Board games, cards Breathing exercises (YouTube!) Progressive muscle relaxation Mindfulness (Mindful Eating) Consider strategies specific to your clinical team or environment
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Risk and Protective Factors Support: Mental Health
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Support: Mental Health Risk factors Genetic influences Low IQ and learning disabilities Specific development delay or neuro-diversity Communication difficulties Difficult temperament Physical illness Academic failure Low self-esteem
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Support: Mental Health Impact of poor mental health Risky behaviour - smoking, alcohol and drug misuse, sexual risk, poor nutrition, lack of physical activity Physical illness, long term (physical) conditions and premature death Poor educational and employment outcomes Antisocial behaviour/offending Poor social skills Suicide and Self-Harm
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Support: Mental Health Protective factors A supportive relationship with a parent/carer or trusted adult Clear, consistent discipline and boundaries Long term relationships Support with educational difficulties Pathways for child to raise problems Secure attachment experience Good communication skills, sociability and humour Being a planner and having a belief in control Problem solving skills and a positive attitude
Slide 71-

Support: Mental Health Protective factors Experiences of success and achievement Faith or spirituality Capacity to reflect Sense of belonging Positive peer influence Community integration/network Good housing Opportunities for valued social roles (team captain, leadership) Team sports/activities
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Support: Mental Health Promoting protective factors Draw two large faces on your giant paper (one happy and one sad) What could we do in our clinical environments to promote positive mental well-being? What potential risk factors might young people experience during their stay with us?
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Support: Mental Health Protective factors Relationships are the most important factor in young people’s experience in hospital. As with all patients, their time and contact with you can make a significant impact. It’s the small things that make the biggest difference to someone’s experience.
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Understanding: CAMHS Child and Adolescent Mental Health Services (CAMHS) Work with children and young people from 0-18* *some areas up to 25 Work with families, parents, carers & other professionals
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Understanding: CAMHS CAMHS Tiers Tier 4 Highly Specialised Tier 3 Specialist Services Tier 2 Targeted Services Tier 1 Universal Services
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Understanding: CAMHS CAMHS Tiers Tier 4 Highly Specialised Tier 3 Specialist Services Tier 2 Targeted Services Tier 1 Universal Services
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Understanding: CAMHS Referral Routes Self-Referral GP School Social Care Team A&E / Urgent Care / Paediatric or Adult Wards
Slide 78-

Understanding: CAMHS Referrals include: What is the problem? Why is the referral happening now? What does the child/carer want? What do you think they/you need? What is making the problem worse? What is helping manage the problem? What risks are involved to the young person/carer?
Slide 79-

Understanding: CAMHS (Better) Referrals include: Current situation (location / on-going physical treatment?) Relevant historical factors Timescales Risks Professional details of those involved
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Understanding: CAMHS Who are CAMHS? Child Psychiatrists Mental Health Nurses Family Therapists Child Psychotherapists Psychologists Art/Drama/Other Therapists Counsellors OTs, Physio, ????
Slide 81-

Understanding: CAMHS Who are CAMHS? Different professional backgrounds Different clinical approaches One size does not fit all
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Final thoughts What one thing will you take away from today?
Slide 83-

Support: Online www.youngminds.org.uk www.rcpsych.ac.uk www.rethink.org www.MindEd.org.uk www.mefirst.org.uk www.opentalk.info www.wecantalk.online
Slide 84-

Support: Online Follow us online (not all the way home) Facebook.com/WeCanTalkCYPMH Twitter @WeCanTalkCYPMH #WeCanTalk
Slide 85-

Goodbye Before you leave, please complete the post-training questionnaire at www.wecantalk.online/post Open in a web browser and type the full address. Please then show the screen screen to us and we’ll give you your certificate! We’ll e-mail you all the slides in the next few days.
Slide 86-

Children and Young People’s Mental Health Training
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The We Can Talk Principles are a young people and staff accessible version of the educational framework that the training is based on. They outline the key areas that all staff should feel confident and capable in addressing with children and young people after attending the training We Can Talk and listen about your emotional and mental health needs in a clear and non-judgmental way We Can Talk about how we will look after your physical and emotional needs while in hospital We Can Talk about how to help manage the challenges of being in hospital by using distraction and relaxation techniques We Can Talk about your problems and we can find the right person to help Principles
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We Can Talk about how to keep you safe while you are staying with us in hospital We Can Talk or we can communicate in another ways that might work better for you, by writing, drawing, using signs and pictures etc. We’re flexible. We Can Talk about self harm and other big issues that might be worrying you We Can Talk in private and will always talk with you about information that needs to be shared. We Can Talk about difficult or awkward subjects in a way that is not as difficult or awkward as either of us thought it would be We Can Talk to you and your parents / carers about helpful places to access additional support or information around your mental health Principles
Slide 89-

Recommendations for A&E nurses from “A clash of cultures: A&E and mental health” J. J. Crowley, Accident and Emergency Nursing (2000) 8, 2–8. Attitudes towards clinical services among people who self-harm: systematic review” T. L. Taylor, K. Hawton, S. Fortune, N. Kapur, The British Journal of Psychiatry (2009), 194 (2) 104-110. Needs and fears of young people presenting at Accident and Emergency department following an act of self-harm: Secondary analysis of qualitative data C. Owens, L. Hansford, S. Sharkey, T. Ford, The British Journal of Psychiatry (2016), 208 (3): 286–291. Guidelines for self-harm National Insitute for Clinical Excellence (2015) Further quotes from the young volunteers of “The Mentality Project”, Off The Record (Bristol). Thanks to Newham CAMHS Participation Group for their ideas and suggestions. References
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For more information about We Can Talk please visit www.wecantalk.online, speak to your local Project Lead or e-mail the team. Robin Barker Project Lead robin@healthyteenminds.com Kate Martin Development Lead kate@commonroom.uk.com Grace Jeremy Engagement Lead & Young Advisor grace@commonroom.uk.com Martha Reilly Project Support Officer Martha.Reilly@annafreud.org Project Team