Take a moment to think about this problem, which I’m sure you’ve heard many times before: 2.6 million UK citizens currently have an open referral within the mental health services. 560,000 of these citizens are under the age of 18 and 75% of those aren’t receiving any treatment at all. This is leading to over 6,000 under 18’s committing suicide every year. The chances are that 25% of your friends/associates have children with mental health issues, whether that be Depression, Anxiety, Bipolar, Bulimia, Anorexia, PTSD etc.
Is this growing level of despair in young people acceptable to us? And it is us, not someone else's problem.
Underfunded and squeezed to breaking point, the NHS is struggling to provide mental health care to everyone that needs it. In the UK mental health conditions make up around 28 per cent of the total burden of disease, the largest single health issue, but they receive just 13 per cent of the total NHS budget. At the same time, the budget for adult social care, which provides ongoing mental health support, has been cut in real terms by 13.5 per cent in England over the last eight years. There is a need for national reform, which must include a diversion of spend, particularly to address the needs of the more than 420,000 children and young people that are deprived of the urgent mental health care they so desperately need each year.
Children spend 9000 days waiting to be discharged from hospital a year due to the lack of subsequent support in the community. That equates to a yearly cost of £3.8 million, funds that can be used to successfully treat over 5,000 children and young people without regression, without a wait for outpatient services and without a demand to travel hundreds of miles for care.
But you can’t rob Peter to pay Paul. What’s needed therefore is a new approach that brings in partnership to form a public / private solution. A solution that drives out fundamental cost in ways that free up monies to be spent more effectively in areas including mental health. To divert spend from safeguarding and bed occupancy to prevention and efficient treatment.
Youngkind has been set up in direct response to this growing need for national reform with the specific intent of unlocking the resources of over 10,000 counsellors, social workers and psychologists that provide private treatment in a patch work fashion today. If you’ve ever tried to find a therapist it’s hard. Do they have the experience and skills you need? Are they local? Are they available? Are they someone who the young person can bond with, trust? It’s a maze, it’s foreign, it’s often beyond the confidence and skills of those in need or their families to struggle through. And that’s before we think about cost.
Youngkind, a charity established to deliver positive change to young people suffering with mental health issues, believes that it can help reduce the cost of NHS admissions. Today that cost which averages £429 per day per patient, could treat one person in need of professional intervention for 8 weeks. Safeguarding versus a real solution. But we understand that moving monies around in the NHS won’t be easy, not least because there is so much demand in all areas. We want to therefore help meet a significant part of that funding gap too through external sources.
We see three distinct phases. Stage one is to build a digital experience that makes finding the appropriate care easy, fast and completely unique to the UK through an app and a web site that the target demographics will embrace and understand. This platform will help unlock the vast network of private care specialists that are inefficiently used and difficult to find today. We’ll have video’s, and guides, search based upon location, availability, specialisation and so on, Q&As and case studies. It will be a portal to help access this community. All we’ll need is a referral and we can save a life.
In stage 2 we want to ‘negotiate’ lower fees for the services delivered. By enabling those in need to efficiently find those that can help, soaking up all that unused capacity, we believe that we can negotiate a 20 – 30% “discount” passed to those referred through Youngkind. Stage 3 will then be to raise external monies to deliver those services at no charge to those that do not have the capacity to pay, based upon a pledge that monies will be repaid to whatever level and rate achievable when the young person is better, is back at work and in the community.
Youngkind will offer professional mental health services in partnership with the NHS. The current pathway typically has long wait times for treatment, an average of 13 weeks to a first appointment. We plan to cut this through the following measures:
- Unlock private sector services: The Youngkind app/website will include a directory of professional Psychologists, Counsellors, Social Workers, Psychotherapists.
- Make finding professional help easy: With pictures, qualifications, accreditation, location, availability, video’s, areas of specialisation, reviews, charges, contact details etc., all to enable a qualified search and selection process.
- Helping find that match: Our platform will develop ground-breaking technology that helps the individuals to understand the specific problem, before searching and presenting matches to appropriate treatment options locally.
- Reduce wait times: With tens of thousands of professionals available in the private sector, we aim to have a person referred to us and receiving treatment within a maximum of one week by marshalling these resources.
- Support schools: Youngkind will enable schools to interact directly with our services, refer (with the individuals consent) to us for advice and possible referral for treatment. We will promote positive mental health within the education sector and offer ambassadors to educate and promote across student bodies.
- Support and compliment the NHS: Youngkind will work with the NHS mental health services so that we can free up occupied beds. The first step is preventative care, the second step is supporting patients while admitted to hospital, the third step is to offer treatment services to patients that have been discharged and on the road to recovery.
- Reduce cost all the way to free: We don’t want cost to be a barrier to treatment. Evidence shows that such costs can easily exceed £1000 for a course of treatment, which prohibits most. Through the Youngkind Pledge either the individual will pay a reduced fee for treatment once the necessary appropriate professional specialist has been identified, or they will receive the treatment at no charge, covered by Youngkind.
The current patient pathway is hampered and constrained leading to long waiting times. From as little as 4 weeks to as long as 4 months in some areas. Patients admitted to hospital are often stuck as there is no support available in the community for long periods of time and therefore they are forced to remain in hospital on the waiting list until community treatments become available.
This clearly is a massive burden on the NHS but also can be disastrous for patients. In a survey of 2,000 patients, one in six said they had attempted suicide while waiting for treatment, four in 10 said they had self-harmed, and two thirds said their condition had deteriorated before they had a chance to see a mental health professional.
The graphic below outlines the current mental health patient pathway:
We do not seek to replace the Crisis team or emergency services, but rather work alongside them to help young people in emergency care. We will also support outpatient services by offering a fall-back option if outpatient therapy isn’t immediately available. And we will work with any Home Treatment or Community Teams to support patients that have been discharged from hospital and awaiting professional therapy.
Our vision to compliment and alleviate the current resources and pathway can be represented as:
Refer: The client is referred to Youngkind by their GP, school, workplace, family or will find us directly themselves. Contact is made with the individual as a first triage point. The client will input responses from queries and grant a consent in order for the website to work through its algorithms.
Match: Each professional member in the Youngkind database will have completed their profile to match tags, queries and confirm accreditation. The website will search through queries that consider distance, area of expertise, previous working history, success rate, treatment demographics and availability. The patient will be presented with results so that they are able to make a more informed selection of who to reach out to with the intent of selecting them as their treatment provider, guided by the Youngkind team.
Assess: The selected treatment provider will assess and confirm the needs of the client and agree a treatment plan. A diagnosis report typically will have already been completed by the GP, or other medical professional, and will be shared with the chosen therapist with the individual client’s consent.
Treat: The selected provider will commence the treatment plan, posting an hourly log of therapy sessions conducted, a progress update of the client and will confirm the next appointment agreed with the client.
Discharge: Once a course of treatment has been completed and the provider is happy to discharge the client, they remain on our database for regular follow up communication to assess and prevent any regression in symptoms.
We need to go much broader to achieve any level of success. For that we will need the right help from appropriate partners to get the visibility and support to reach the network of young people in need. Our aim is to become the first point of call for patients that aren’t in an immediate risk of life, working with GPs, Schools, Councils, Government, Mental Health Units and CRHTTs.
The NHS Five Year Forward Target is aimed at helping an extra 70,000 patients receive treatment per year. If Youngkind could help meet a proportion of this, then the benefits to young people would be compelling.
We would then be looking at our pledge policy, trusts, media donations, charities and the NHS to increase the funding gap to enable us to accept as many additional ongoing referrals as possible.
We need one referral to save a life, it only takes 60 seconds.
Youngkind website: http://youngkind.org.uk
Youngkind Twitter: twitter.com/Youngkind_
You can see my JustGiving page here: https://www.justgiving.com/crowdfunding/youngkind