Eastern AHSN is working with NHS England (Midlands and East) and Healios to implement online CBT for children and young people in contact with the criminal justice system.

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Mental health services across the country face challenges that impact all stages of patient care. Some services have waiting lists with patients waiting up to two years to start their treatment. With extended waiting lists there is a risk that the severity of an individual’s mental health problem may increase whilst they are waiting for treatment. Furthermore, once patients have made it off the waiting list and are receiving treatment, Do Not Attend (DNA) rates are still prevalent suggesting current services may not fit patient need. The risks are likely to be even higher when working with vulnerable children and young people. The Health and Justice Commissioning Service (HJCS) explored how digital interventions could reduce these risks and improve mental health services offered to children and young people in contact with the criminal justice service. The primary goal being to offer a more flexible service with reduced waiting times.

How did the Innovation Exchange help?

HJCS selected Hertfordshire and Norfolk to trial an online Cognitive Behavioural Therapy (CBT) service through Healios, an established online CBT provider. Eligible patients will receive an online assessment with a Healios clinician and are likely to have their course of CBT with the same clinician. However, each case may vary depending on the need of the patient (for example a mix of face to face and online interventions) as agreed by the Children and Adolescent Mental Health Services (CAMHS) and Youth Offending Teams (YOT). Patients will often receive their first Helios assessment in less than a week. Engagement with clinicians is key to designing a service that responds to the need in the area and one that staff will buy into and use. Once designed, Healios will be trialled with the target group for ten months. Interventions in both locations will be evaluated looking at both how the service integrated with the CAMHS teams and reviewing the outcome to the individuals.

Impact & Outcomes

Rather than waiting for a clinician to be available in a specific location, CAMHS teams can utilise the pool of Healios clinicians from across the country. This is particularly beneficial for individuals in a remote location. The flexible nature of online CBT means patients can access services wherever they want to (meaning no travel required), and at more flexible times (for example evenings and weekends). These factors make treatment much more accessible for vulnerable children and young people. The online CBT trials in Norfolk and Hertfordshire are currently live and are scheduled to end in February 2020. The data from the trial will be analysed and evaluated to ascertain whether online CBT should be introduced to CAMHS services across the country.