Merton Risk and Resilience: Annual report 2020-2021

Specialist substance misuse

Catch22 worked with a total of 84 young people aged 12 to 24 years on a care planned psychosocial intervention as defined by Public Health England, of which 59 were under 18 years old and 25 were 18–24 years old.

• 86% of young people (who completed treatment)had reduced their substance use and/or were drug free and met care planned goals at exit
• 33 parents/carers received one-to-one tailored support for their young person’s substance misuse and/or for exploitation.

Due to the COVID-19 pandemic there has been a significant drop in young people (under 18) accessing specialist treatment this year, a 32% reduction from last year. Nationally the same measurement has dropped 30%. The number of 18-25 year olds has increased slightly (8%) compared to the previous year.

Missing from home

Over this reporting period the Missing from Home service received 449 notifications, pertaining to 167 individuals, a 17% increase on the previous year. There was a marked increase in the number of young people who had multiple missing episodes – 27 young people had more than 5 missing episodes this year.

• 268 return home interviews (RHI) were completed. This was a slight percentage decrease from last year, primarily due to the number of young people with multiple missing episodes. Many of these young people go missing again before Catch22 can get out to do the return home interview and many refuse to have multiple return home interviews completed.
• 48 missing from home follow-on interventions were carried out to young people RAG rated ‘Red’ or ‘Amber’ over the last year, and 170 reports of advice and information giving were recorded by the team.
• 100% of return home interviews were offered within 24 hours of receiving the notification and 98% of them were conducted within 72 hours where the young people consented and were available.

Exploitation and follow up support

Across this reporting year Catch22 worked with a total of 63 young people (10 were brought forward on care plans and 53 were new referrals that engaged). The bulk of the new referrals were identified via the return home interviews and picked up for additional support to reduce their risks of further missing episodes and reduce the risk of exploitation.

100% of those young people worked with demonstrated reduced risk at the end of the intervention.

The number of young people referred over this period for exploitation and child sexual exploitation saw a reduction, primarily due to lower numbers being identified during the lockdown periods and the Borough’s MOPAC-funded exploitation team being allocated young people by social workers.

Of the 7 cases referred over this reporting period, 6 young people were engaged on a one-to-one intervention during this time period. The one young person who did not engage was referred onto Catch22’s Wimbledon Foundation school counsellor due to her risks being predominately emotional health with CSE risks RAG rated low.

Targeted services

Over this reporting period the targeted services delivered by detached, school/youth-based education workshops and via drop-ins at Merton Campus were severely impacted on due to the pandemic. Catch22 were proud to support the borough in the diversionary COVID-19 scheme during this time.

• 624 young people accessed the COVID-19 detached outreach provision providing reassurance and support young people to maintain social distancing and observe government guidelines re remaining at home during the lockdown.
• 17 professionals received substance misuse/CSE training over this period
• 65 young people aged 12-24 were accessed for a brief substance misuse intervention (56% of all referrals for substance misuse), an increase on previous year.
• 31 C-Card registrations were achieved – a significant drop due to not being able to deliver targeted face-to-face interventions across this reporting period due to the pandemic. Colleges and Community sites closed and took services online.
• 60 young people/adults accessed for repeat condoms – this was predominately delivered via APC Pharmacy and young people on substance misuse/exploitation interventions.

To ensure there was an accessible service to children and young people across pandemic lockdowns, Catch22 partnered up with METRO Sexual Health Services to provide an online postal provision of free condoms via the ‘Getting It On’ website thus ensuring children and young people across the London Borough of Merton have access to registering for a C-Card and to receive condoms from the 1st April 2021.

Wimbledon Foundation counselling

Over this reporting period, the Wimbledon Foundation Emotional Health Counsellor accessed students from Rickards Lodge, Raynes Park High School, Harris Academy Morden and St Marks Academy (after the service received an additional piece of funding to increase to the reach of the service across the London Borough of Merton in recognition of the impact of COVID-19 on the mental well-being of children and young people). The counselling interventions were offered between 6 to 12 weeks dependent on identified need.

• 38 students aged 13 – 17 years accessed the school-based counselling service
• 4 secondary schools received 1 day a week counselling support for students that did not meet the CAMHS criteria for their mental well being
• 9 students received an extension past 12 weeks and received counselling up to 20 weeks recognising their complex needs

This year the service saw a significant increase in the range of complexities that young people referred faced, the level of suicidal ideation and/or those dealing with a parental suicide. The service also saw an increase in severe eating disorders which required intensive partnership working.

Young people from within this service strand told us:

• “Counselling has really helped when everything in my life was turned upside down I knew I could talk about things my friends wouldn’t understand or would be embarrassed talking about. I now no longer feel bad or suicidal and have strategies in place if I become overwhelmed again.”
• “Counselling has helped me to believe that I can achieve what I want to do despite my background, I now feel that I can get to university to follow my dream, my counselling mantra is now the only limits are the ones we set ourselves. Thank you for helping me realise this.”
• “Counselling helped me when everyone else was telling me what I should do, you gave me the space and time to help me deal with my feelings and start to love myself again.”

The schools we work with told us:

• “The service during the last year has been more crucial than ever. The flexibility of the referral criteria for the school counselling service has enabled us to support students in a variety of different circumstances e.g. homelessness, parental mental health and addiction, concerns around our student’s mental health, high anxiety levels, low mood and suicidal thoughts.”
• “The service has enabled us to get our students support without a long waiting list especially during a time that CAMHS is inundated with referrals and unable to provide timely support.”

Impact

Young people have told us about the impact Catch22 has had on them via exit surveys they complete, it is wonderful to see that young people can see the impact the service has had on them despite the challenges faced by all this year.

• Young people are also asked if they would recommend our service to a friend, this year 88% of them said that they would.
• 100% of young people who received a follow on, or exploitation intervention form the service demonstrated reduced risk at intervention exit.
• 90% of parents provided with one-to-one packages reported positive changes in their young people and 98% reported positive change in themselves as a result of Catch22’s intervention.

The Merton Risk and Resilience service was designed to ensure young people don’t move from worker to worker, and to provide a holistic, seamless intervention dealing with all their presenting needs.

“I don’t want to be passed around different professionals or go to different organisations/buildings when I have built trust with my keyworker and feel safe within the environment where I’m seen.”

Despite the challenges with mobilisation of the new service model this year, the number of young people that presented with a missing/exploitation and/or substance misuse increased, with 37 young people who benefited from having one practitioner that worked across all three elements.

Similarly, this year we have seen a significant increase in the Missing from Home young people reporting substance misuse and the practitioner identifying exploitation at the point of undertaking a return home interview. From this, we were able to fast track these vulnerable young people into specialist care planned interventions and, where necessary, into the weekly Missing from Home meeting. We also supported undertaking the Contextualised Screening Tool with social workers as part of supporting referrals into the MARVE Panel.

“I had the space to talk about what goes on in my life without being told what to do or feel or think.”

Challenges

The higher level of vulnerability and complexities has again increased this year which has created additional work for practitioners prior to engaging clients and whilst on interventions. The need to ensure effective communication and documentation especially where there has been safeguarding concerns with partners has significantly increased staff’s client recordings which has impacted on the number of face-to-face hours available.

The lockdowns across the year has impacted on the young people the service works with and this in turn has meant practitioners needed to work creatively to engage young people and support these young people through difficult periods especially for those where there was conflict within the family home.

Increasingly the service has seen a significant rise in referrals for targeted interventions and counselling for emotional health, many were using substances which are just below the threshold for a specialist PHE NTA psychosocial intervention. This year 56% of the referrals into the service were for a targeted substance misuse intervention.

The targeted work undertaken with the YOT has increased this number significantly as the Out of Court Diversionary Project young people tend not to meet a specialist threshold but do require a targeted intervention to support diverting these young people from further contact with the criminal justice system.

The global pandemic has further increased the number of referrals for young people who have experienced behavioural/emotional health impacting on functionality, the spike in referrals has been as a result of schools referring a number of students that did not meet the CAMHS thresholds and there not being any other service they could refer to.

Working in partnership

Catch22 offers interventions across all levels of the Merton well-being model and service delivery is based on the principles of multi-agency working. To support this a number of joint working protocols were refreshed as part of launching the new service and supporting the improvement of referral pathways and information sharing to ensure the needs of young people are at the centre of all work undertaken.

We rely on partnerships working with Child and Adult Mental Health Services, Social Care, Youth Justice Team and a number of statutory and voluntary agencies for referrals of young people and young adults requiring substance misuse interventions. We also ensure young people participate within their own care plan to create onward support packages with our partners beyond engagement as part of exit plans when additional services are required.

We attended a number of strategic groups to ensure the most complex young people that are identified at risk and/or using substances, risk of missing and/or exploitation are referred and have a smooth transition into the service. Information sharing/updates for clients in treatment and/or referrals via; MARVE Panel, Multi-Agency Child Exploitation Panels/Strategy Meetings, Localities board meetings, and via the Multi-Agency Safeguarding Hub, Social Care Teams and Youth Justice Team (YJT) where staff sit and/or hold drop-ins.

We recognise the wealth of support that voluntary and community sector organisations can offer to clients and as part of building a team around a young person/adult Catch22 has continued to develop and maintain working relationships and referral pathways across the London Borough of Merton with; supported housing organisations, hostels, job centres, adult mental health services, Off the Record, Polish Community and faith groups across the borough.

Future plans

The Merton Risk and Resilience Service will continue to further embed the new integrated service that was launched and mobilised during the pandemic. The Service is based on the vulnerability model that encompasses all of the core service elements.

A triage and risk and resilience referral form will be launched online to further streamline the service and support simplifying the referral process for professionals referring young people; engaged in risky behaviour, at risk of exploitation, missing from home and/or misusing substances. Our on-line referral tool will focus on vulnerability indicators related to the core elements of service and will support the service to allocate to practitioners based on the vulnerability score given at the point of referral into the service.

The integrated service will be further advertised across the borough and the work of the multi-skilled staffing team will be showcased. Highlighting the Risk and Resilience Practitioners (RRPs), acting as a single point of contact for Young People (YP) referred into support. Specialist care planned interventions will be delivered through a core framework of trauma informed support and motivational interviewing techniques, to elicit engagement/trust in the service and identify and respond to the vulnerabilities identified.

To further ensure a seamless and integrated service (aligned to the Merton Early Help Model) Catch22 will, as the lockdowns ease, take the service back out into the community and provide equitable access by providing:

a local operating base – to ensure that the service is as accessible/visible as possible and that suitable facilities are accessible for discrete one-to-one interventions (when a community-based location is not appropriate).

suitable facilities across community settings – to ensure the widest coverage of practitioners will continue to deliver one-to-one interventions through co-location with statutory providers (i.e. YJT/ Inclusion units/SMART Centre) and community venues, including in some case cafés if there is a quiet space and particularly with young people who may not be eating well. To ensure partner venues are accessible/discrete, venues are risk assessed and joint working protocols are developed to ensure the rooms are suitable for one-to-one intervention. This approach allows us to not only reach out to vulnerable young people through detached engagement and diversionary activities, but also link directly with and support local and VCSE networks and communities through co-location and Art Against Knives delivering pop-up diversionary activities e.g. Nail/Braid Bars for girls at-risk of CE/CSE.

flexible access to services – practitioners will continue to offer appointments up until 7pm to young people/parents and detached initiatives will be delivered after school from 5-8pm (or up to 9pm if being delivered via the street in ‘hot spot’ areas particularly across the summer months) to ensure as wide engagement is possible.

“I think everyone should have a Catch22 worker in their life!”