Tools and resources

Working with young people to plan person-centred care and support for admission to and discharge from inpatient mental health settings

1. Participation and engagement with young people and families using person-centred support

1. Participation and engagement with young people and families using person-centred support

The guideline and legislation

The first recommendation, the guideline sets out, that care and support of people in transition should be person-centred and focused on recovery, (recommendation 1.1.1). Further recommendations include involving the person's family and friends throughout their admission and discharge (recommendation 1.1.5) and using their knowledge and expertise alongside the person's when planning treatment (recommendation 1.2.3). This is supported by the Section 19 principles in the Children and Families Act 2014 which set out that all children and young people with special educational needs and disabilities (SEND), including those with mental health problems, should have the opportunity to:

  • share their views, wishes and feelings;

  • be supported to participate as fully as possible in decision making; and

  • be supported to achieve the best possible educational and other outcomes.

Example

Engaging young people in planning for their futures requires skilled practitioners and allocated time. Some local areas are using the i-THRIVE model of care to achieve this. i-THRIVE is an integrated, person-centred and needs-led approach to delivering mental health services for children, young people and families.

i-THRIVE was successfully selected to be a national NHS Innovation Accelerator. Ten sites from across England are working to implement the model.

Local learning

Attendees at the workshop reported that building trust between young people, families and practitioners is key to providing good support and planning well. They identified a set of actions to support this which are set out below.

Choice and decisions

Planning ahead: many local areas now develop 'passports' with young people, so they can share information on their needs in a way they are happy with. In addition attendees reported that developing a crisis plan with young people and their families as part of wider care planning means that the often difficult admission process can be managed positively.

Formal planning: multi-agency formal meetings are often used to agree major decisions about support for young people with mental health problems. Preparation for these meetings should include working with young people and their families to ensure that:

  • they are aware of and understand all of the options available to them

  • they have the information they need to make informed choices

  • they are clear on the process for funding agreements.

Where young people, family or team members are located across a wide area, virtual meetings could be held to ensure that everyone can take part.

Information, advice and support

Young people and families may need support, particularly if the inpatient placement is unplanned or far away, or they have different views on what should happen.

Advocates, care coordinators, named practitioners and other professionals have distinct skills and can act as powerful supporters for young people and families at admission and discharge and in planning community support. They can play a crucial role in ensuring care is planned and delivered in a person-centred way.

Out-of-area placements

Out-of-area placements can be a particular challenge and need planning, support and regular review to ensure that young people can maintain local links with family, friends and their wider support network. This network includes school and any education or training they are taking part in.

Meeting the travel costs of family members, adjusting visiting times or allowing some use of social media can provide important ways for young people to maintain links to their home area and make the transition back smoother.

The guideline recommends assigning named practitioners to young people who are being admitted to inpatient care outside the area in which they live: one from their home area who knows the person and one from the ward they are being admitted to (recommendation 1.3.10). These practitioners can also liaise to support the young person's return home.


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