Local leadership, national change: Insights from Norfolk

Children and young people growing up today are facing unenviable pressures. With social media, exams, 24-hour news, a cost-of-living crisis, a global pandemic, concerns about our climate, and a war in Europe – it’s perhaps not surprising that levels of mental ill health in our young people are continuing to rise.

It’s a challenge that is made ever more difficult by our system-wide recruitment challenges and financial pressures, in addition to the growing demands across all services.

NHS data tells us that one in six children and young people aged six to 16 has a probable mental health disorder – that’s five children in every class of 30. We know that mental ill health can affect school attendance, relationships, and long-term outcomes. We also know it’s important that everyone working with children and young people is provided with the knowledge, skills and confidence to support early identification and help with mental health needs.

But I am optimistic. We can all play a part in building communities which support the holistic needs of our children and young people.

I speak to active, ambitious and impressive young people all the time, who have the language and emotional intelligence to speak about mental health in a way that was lacking in the generations before them. And this willingness to talk, understand and influence gives me every confidence that we can move to a system that is preventative, rather than crisis and diagnosis driven. It also needs to be a system that recognises children’s emerging needs – even when they don’t feel able to ask for help.

By making that shift to early recognition and help, we will create a system that works for the children and young people who we support. We know that providing help early prevents mental health from deteriorating and is essential for our children and young people to flourish. We also know that this approach will reduce pressure on specialist services, making better use of resources and ensuring that intensive support can reach – as early as possible - those who really need it. It’s a model we have used to transform children’s social care in Norfolk, and is at the heart of our system for transformation of both mental health services and support for children with special educational needs and disabilities.

It shouldn’t matter who children and young people reach out to. They should get the help and support they need, without facing endless referrals and waiting lists.

In Norfolk, children’s services, education settings, police, health services, district councils, and children, young people and their families have come together with a shared vision and outcomes framework to ensure that we are working collectively. Known as FLOURISH, our vision is built on what children and young people tell us is important to them: Family and friends, Learning, Opportunity, being Understood, Resilience; Individuality; Safety and security, and Health. This approach is underpinned by four priorities, which include mental health and emotional wellbeing, special educational needs, and prevention and early help. That means that we are all working to the same outcomes with the same priorities, and we are all committed to keeping children at the forefront of our services.

By working in this collective way, we can draw on the skills and experiences of all the professionals in our system. We can pool our data and resources, and act on the information children and young people are telling us, to build an effective and responsive child-focused system. As a collective, we can respond to emerging need and we can piece together a child’s whole story – recognising their strengths, needs, the community they live in, and the risks and opportunities. As part of this work, we’ve also developed our FLOURISH Pledge which calls on businesses, public sector bodies, voluntary and community sector partners to make a commitment to do at least one new thing each year to help children and young people to flourish. Many of these pledges are taking on a mental health theme.

It is exciting in Norfolk to see the growing work of our school based mental health support teams and our new special schools and mainstream school bases for children with social, emotional and mental health needs. Our health partners have commissioned online counselling services and we have improved the digital information available to children and young people as part of our efforts to improve access to support.

The next step is to develop ways to ensure the children’s workforce have the same shared language and understanding of mental health, to reduce the medicalisation of understandable worries and feelings experienced by children and young people. This will help increase confidence to recognise emerging needs in children and young people. It will also improve understanding of how they can help the children they work with to access support. We’re working with the Anna Freud Centre and other partners on this – so watch this space.

There is no doubt that more resource, capacity and investment are needed in prevention, early identification, and in school and community-based support. By investing in children’s mental health we improve resilience, life skills, education outcomes, reduce the risk of exploitation and crime, and we support more families to stay together. As leaders of services for children, we must continue to collaborate, champion and influence so that government can see the impact that positive mental health has on the future of children and young people, and on the future of our country.

We are in challenging times, but I am genuinely excited about the changes we are making, and the collective will to collaborate across sectors, services and local authorities so that children and young people flourish – both physically and emotionally.

Sara Tough is Executive Director for Children’s Services at Norfolk County Council and Chair of the Family, Communities and Young People’s Policy Committee for the Association of Directors of Children’s Services (ADCS).