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In 2001, The Social Care Act outlined the increased focus on user participation by setting out requirements for all NHS organisations. These requirements were to ensure active participation in treatment decision-making, as well as the planning and evaluation of services, (Department of Health, 2011). More recently the local government has continued to make changes in the structure of the NHS, emphasising strategies which may give people more choice and control over how their support needs are met.
Central and North West London, Westminster’s Children’s Well-being Practitioner’s (CWP) programme is a progressive service that shares an ethos with Westminster CAMHS.
A team of professionals who are committed to develop and maintain quality services that enable children and young people to thrive. In a collaborative approach these two services form an alliance for an integrative and inclusive model to meet the needs of the community, families and young people. In the last three years commissioners have increased emphasis on service user involvement and its role in the planning and improvement of mental health services, (Crawford et al 2003).
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Proficient in: Organization
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“ Very organized ,I enjoyed and Loved every bit of our professional interaction ”
In this essay I aim to demonstrate how the CWP programme integrates participation principles into the organisation and wider community that is essential to successful service development and service user satisfaction. The CWP programme has been instrumental in highlighting the role of universal services, such as: schools, communities, youth clubs etc. that are inclusive of mental health and emotional well-being of children and young people. Last year’s CWP programme paved way for the importance of service user feedback and participation in the progress and career professional development of a mental health practitioner.
It is more important however that participation can be integrated in meaningful and successful ways for young people, parents and practitioners.
I actively set out to increase awareness of my role as a CWP and encourage young people and their families to participate in non-therapeutic participation groups to have fun, improve the service, improve therapeutic relationships and advocate for themselves. Working within Westminster CAMHS, I liaised with the participation worker and schools worker to gain understanding of the current participation within the service. On interviewing clinicians, the participation worker and supporting staff it was clear there was little active participation outside of therapeutic environments. The CWP programme relies on the active participation of children, young people and parents, therefore participation events are best informed by the service users. In order to promote participation within CAMHS and introduce the CWP’s to children, young people and families we planned a ‘CAMHS fun day’. The fun day was open to current CAMHS service users, CWP clients (clients based at CAMHS) and their families. The aim of the fun day was to increase service user participation, reduce stigma, provide a social environment, and reduce client clinician ‘superiority’. I hoped to inform children and families of how important their active participation is for on-going therapy and intervention. I created a suggestion boxing encouraging parents and young people to provide one or more strength of the service and weakness. My rational behind this, was to allow people to remain anonymous and therefore give a more accurate comment on what they felt could be improved. The fun day activities were selected by the service user from an activity survey. There were games and activities to suit a variation of needs. There was a ‘chill area’ for the parents and adults, where they could socialise and discuss their own experience of the service if they wished.
To my surprise many of the parents and guardians shared frustrations and successes within CAMHS, and felt that they don’t have the opportunity to speak to other adults about the service and how it can be improved. I could empathise with the families as there is currently no formal participation group forum that allowed the parents to feel that they are actively making a difference to how they service is delivered. The CWP’s offered young people and parents to fill out feedback forms that asked about their experience of the fun day and what they enjoyed the most. Results showed that 82% of 32 feedback forms selected ‘strongly agree’ for. ‘This was a good place to meet new people’. A further 77% selected ‘strongly agree’ for, ‘I made a new friend’. This showed that there are many social benefits to participation. Many of the young people that have generalised or social anxiety benefited from an environment they were familiar with and felt safe. Supporting evidence suggests that increasing participation has improved the accessibility of information, co-ordination of care and the relationships between clinician and client. In accordance with positive feedback, user participation shows positive clinical outcomes such as; improved self-esteem, confidence as well as improved social interaction (Nicholls, 2003).
Reflecting on the successes of the fun day I acknowledged that many of the young people that attended were age 11 and under. The parents had great influence on them attending and participating. In order to focus on young people participation it would be beneficial to promote participation that is exclusively to children and young people. Analysing the feedback from the CAMHS fun day, 61% of young people (under 18) answered ‘strongly agree’ for, ‘I would like to be involved in planning user participation events’. This highlighted the positive impact of user involvement has on service uses. The collaboration gives the service user a sense of empowerment as they have the ability to exercise control and change (Omeni, 2014). I teamed up with the participation worker that works within Westminster CAMHS and planned a participation hub that would be led and informed by the children and young people within CAMHS. We created a poster designed to inform and encourage young people to attend a participation hub. In order to find out if young people were interested. The clinicians were asked to have a brief chat with service users after therapeutic session to provide an indication of how many young people would be interested in signing up to the hub. This proved to be very challenging as many young people were unsure how they would benefit from attending.
We promoted the heading ‘Tell us how we can improve your CAMHS’. We included a gift voucher, snacks and games boldly on the leaflet to outline the relaxed and non- therapeutic nature of the hub. I sat in the waiting room at peak times and handed out leaflets and briefly spoke to young people myself about how helpful the hub will be for the service and the benefits to them from improving their mental health service. Unlike CWP appointments, we had little control over the motivation of the young people to attend. The voucher seemed to gain a lot of interest as well as informing them a little about what was expected of them. My main concern was the age variation, language barriers and social anxiety. Even though the participation hub was open to all ages (under 18) it was challenging to plan age appropriate activities for all ages, account for cultural sensitivity and English as a second language was difficult to account for. Trnobranski, 1994 explains that cultural background, age, gender and previous health care experience may influence the extent to which service users are willing to be involved in participation. I reflected on positive session feedback in my own sessions with clients and how willing the young person is to attend another session. I knew that a positive experience was essential to ongoing intervention and therefore essential in participation. Culturally Westminster is device and although the hub was small, there was variation in cultural background. The young people were happy to share some interesting cultural facts and respond positively to each other.We planned neutral ice breakers, a variety of snacks and would ask the young people to name their hub group and inform us of what they would like to use the time for. We created roles within the hub giving the young people options to select a role they were interested in and wanted to find out more about. The aim of appointing roles was to actively get the young people to benefit from participating and to measure and track improvements they are putting forward for the service. I did consider possible implications this may have on the group such as self-esteem, confidence, etc. However the group had full autonomy and good add or remove agenda points.
After 3 weeks of promoting the hub, a total of 6 young people attended. Given the high number of young people that attend CAMHS I felt disappointed that we were unable to engage more than 6 young people. I wondered whether being part of a ‘CAMHS participation hub’ had its own negative stigma, and whether the young people were concerned of other young people knowing about their mental health diagnosis. I felt it appropriate to mention confidentiality within the participation group in order to combat anxieties, although I may have indirectly linked this to a group style intervention. I became pre-occupied with making the hub ‘fun’. Despite my own anxieties, the first hub was informative as we had direct experience of how the young people engaged in group participation. I was aware that some young people felt like it was a form of group therapy. In order to combat this, I and the participation worker took part in the hub as if we were a young person. We participated in coming up with a group name as well as a logo and themes for possible future participation hubs. Further limitations stemmed from the date and time of the hub. The feedback provided showed that young people gave priority to other engagements. I felt anxious that young people didn’t feel purposeful engaging in the hub and that I as a practitioner was more aware of the importance of participation than the young people. What was useful was getting the young people to write down their expectations of the hub and what they hoped for. Many of the young people expressed similar expectations as the fun day: To make new friends to have more community groups, to be less judgemental, make therapy less awkward and a place to have fun.Although very little was mentioned about the improvement of the service, this provided a guide as to what the CWP programme can do to improve participation for young people. Furthermore the feedback showed that service users were unsure about how they can help improve the mental health service in Westminster.
This led me to believe that there is lack of understanding on how important participation is for the mental health services in Westminster. The satisfaction of the young people participating stemmed from the positive social interaction rather than service improvements. In future it would be beneficial to consider how Westminster CAMHS can partner with community and youth clubs to improve participation outside of a CAMHS setting and promote the expectation of young people. In addition I hope to promote a participation hub for the CWP programme within Westminster. The young people that engage in the unique and new intervention would benefit from social interaction and autonomy on service improvement. However participation is a key CYP IAPT principle, it is vital that children and young people know how to actively use participation for their benefit rather than the service using it as a Tokenistic approach. In addition the CWP hub can be extended to Parent hubs that receive intervention from the parent lead models. This would be integral in improving access to the service and how it can benefit them.
How The Cwp Programme Integrates Participation Principles Into The Organisation. (2024, Feb 25). Retrieved from https://studymoose.com/how-the-cwp-programme-integrates-participation-principles-into-the-organisation-essay
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