Recommendation 8

HM Government Acknowledged

23. We recognise that children who offend are some of the most vulnerable in our society and a significant proportion who enter the youth justice system do so with concerns relating to their mental health. We are clear that addressing the needs of these children is of key importance in improving their life chances and supporting desistance from crime. 24. NHS England and NHS Improvement’s ambition is to widen NHS help and to work with partners across the whole system (education, children’s services, public health, voluntary sector, youth justice) to ensure appropriate support is available when and where children and young people need it. As outlined in the NHS Long Term Plan, services should be expanded so that by 2023/24 at least an additional 345,000 children and young people aged up to 25 will be able to access support via NHS funded mental health services and school or college-based Mental Health Support Teams. By 2028, local areas will design and implement models of care that are age appropriate, closer to home and holistic, bringing together physical and mental health services with wider local authority and NHS services, including primary care, community services, Speech and Language Therapy, school nursing, oral health, acute and specialised services. 25. Some children cannot, or will not, access mental health services as they are currently designed. There have been a number of recent national and local initiatives to improve the support, quality, and health services these children receive; however, gaps still remain. Consideration of the specific needs of autistic children and children with a learning disability is an important part of this work. 26. The Children and Young People Mental Health Transformation Programme included a specific work programme on Health and Justice. For example, the Framework for Integrated Care (known as SECURE STAIRS) aims to deliver a whole system approach within the youth secure estate. It uses a formulation-based approach and draws from evidence-based interventions like Trauma Systems Therapy, Enabling Environments and Psychologically Informed Environments. There is already positive evidence for SECURE STAIRS emerging from settings where it is fully mobilised. 27. Community Forensic Children and Young People Mental Health services (known as FCAMHS) currently provide a specialist service for high-risk young people that would not otherwise be available. The services ensure there are clear links between youth justice and welfare provision (community and custodial), secure mental health in- patients or specialist settings for high-risk young people, and core provision whether within specific children and young people mental health services or other services. 28. Supporting wider work around mental health service improvement for children and young people, this work will aid integration of services for this group who are currently falling through the gaps. The new NHS Long Term Plan commitment is an opportunity to strengthen and pull together existing provision around the child and intervene earlier in their pathways to enable better outcomes. The intention is to apply the Framework for Integrated Care into the community, to support trauma-informed care and formulation- driven, evidence-based, whole-systems approaches to create change for vulnerable children and young people with complex needs. 29. The Ministry of Justice will work with partners from across government as they take forward the work outlined here to help ensure that children have access to the support they need.