Priority Grid Criterion Table: Children and Young people among

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Priority Grid Criterion Table: Children and Young people among 11-16yrsin Kettering, NorthamptonshireCriterionHealth Need 1Reduction of mental healthadmissions among 11-16yrsHealth Need 2Reduction of self-harmadmissions among 11-16yrsHealth Need 3Reduction of teenagepregnancy among 11-16yrsSizeIn 2011/2012 the rate of admissionsper100,000 among the under 17s inNorthamptonshire rose very sharply to 287per 100,000, more than double the Englandaverage of 91 per 100,000 (Schiller, 2014).In 2012/13, there were 260.4 per 100,000hospital admissions for Mental HealthConditions in children aged 0-17(includesthe target population of 11-16yrs). This issignificantly higher than England, where thefigure stands at 87.6(NCC JSNANorthamptonshire, 2015).Kettering has a relatively high number of 12to 16 year olds among its admissions whichwas 18 per 201 admissionsthan any otherregions between 2010-2013 inNorthamptonshire (Schiller, 2014).The Northamptonshirewith an averagetotal children and young people (C&YP)population of 1, 03,453 in which 13,949is estimated in Kettering. About1,478/13,949 children with mental disorderis prevalent in Kettering (NCC JSNANorthamptonshire, 2015).Prevalence estimates for mental disorder inchildren aged 11-16yrs is higher in boys(11.4%) rather than girls (7.8%) inNorthamptonshire (ChiMat, 2014).The estimated prevalence of mentaldisorders in Northamptonshire among 11-16yrs is 5,625(ONS, 2014). The prevalence isfurther broken down by prevalence ofconduct, emotional and hyperkineticdisorders (Green, 2004).Estimated children (11-16yrs) with conductdisorders in Northamptonshire is 3,245 inwhich 767(5-16yrs) is estimated inKettering. Estimated children (11-16yrs)with emotional disorders inNorthamptonshire is 2,480 in which 502 (5-16yrs) is in Kettering. The number ofestimated children (11-16yrs) withhyperkinetic disorders in Northamptonshireis 725 in which 209 (5-16yrs) in Kettering(NCC JSNA Northamptonshire JSNA, 2015;ChiMat, 2013)According to CAMHS, 3600 referrals weremade to CAMHS in 2013.2300 active caseswith CAMHS (19.8%) was reported.Admission rates for Northamptonshire were286.6 compared to England 91.3(Campion,2014).NCCconducted a survey to addressthe gap in service provisions and statisticalanalysis for future found that the modellingteam at Public Health Action Support Team(PHAST) projected a 16% increase onaverage in the numbers of mentally illchildren by 2021.(NCC Children’s JSNA,2016)In 2011/12 hospital admissions as a result ofself-harm (rate per 100,000 aged 0-17 years)in Northamptonshire (154.9) was above thatof England (115.5), the East Midlands (124.4)and statistical neighbours (125.1).The rate of hospital admissions as a result ofself-harm (rate per 100,000 aged 10-24years) in Northamptonshire has risen from419.3 in 2012/13 to 510.9 in 2013/14 andboth years were considered significantlyworse than England for the same timeperiods( NCC Children’s JSNA, 2016)In Northamptonshire, between 2010/11 and2012/13, there were 442.84 children andyoung people (aged between 10 and 24)admitted to hospital per 100,000 populationsas a result of self-harm. This compares with357.45 children and young people across theEast Midlands and 352.26 children andyoung people across England (NCCNorthamptonshire Children’s JSNA 2015).The majority of people who self-harm areaged between 11 and 25 years (Hagell,2015).According to National CAHMS supportNetwork 2011self-harming seems to be moreprevalent in older groups: a 2001 studybased on parental reports, suggests that therate among 13-15 year-olds is one and a halftimes that of 11-12 year-olds. Similarly, in alater study sample of 710 under 15 year oldsseen at a general hospital, most were agedbetween 12 and 14(Nixon B, 2011).While an estimate of 3590 people aged 11-16 years previously self-harmed, there were2940 admissions for self-harm in under 18year olds inNorthamptonshire(Campion,2014) Howeverit is possible that some younger children self-harm without presenting to anyservices(Nixon B, 2011). In 2012 in secondaryschools anecdotal evidence suggesteddeliberate self-harm rates could be as high as50%(Schiller, 2014)The greater prevalence of self-harm amongfemales was demonstrated in a studyconducted on 10-19 year-olds over a periodof 10 years, in which the majority of cases(73.1%) were women. This is echoed innational figures which show that 6.5% of girlsand 5.0% of boys reported that they hadtried to harm themselves (Nixon B, 2011).According to national CAHMS the proportionof self-harm among 11-16yrs with no mentalillness is below 2% while those with mentalproblems are higher which is more than 18%,but those with anxiety problems accounts to10% (Nixon B, 2011)As per National levels among 11-16 year olds7% have tried to harm, hurt or killthemselves (Campion, 2014). But higher withemotional (28%) and conduct disorders(21%) (Schiller, 2014). In Northamptonshirethe rates of self-harm in young womenaveraged 302 per 100,000 in 10 to 14 yearoldsand among menaveraged 67 per100,000 in 10-14 year old (Hawton, K, 2012)In 2012 teenage conceptions bythose aged 13-15 and deliveries tomothers under 18,Northamptonshire performs about30.8per 1000 population worsethan both the national average(27.7)and regional average(28.3)(NCC JSNA Northamptonshire,2015).In 2012 there were 30.4conceptions per 1,000 of femalesaged 15-17 in Kettering. Thoughbelow the Northamptonshireaverage of 30.8, Kettering is aboveboth the East Midlands (28.29)and England (27.75) rates(NCCJSNA Kettering, 2015).The overall rate of teenageconceptions in Northamptonshirehas shown a downward trend inpast years (2008-1010) from 524in 2008 to 450 in 2010. Thecounty’s teenage pregnancy ratein 2010 was 35.1 per 1,000females aged 15 to 17, which wassimilar to the national average of35.4 (NCC, 2014).Even though it shows a downwardtrend in under 18 conception ratesthan England rates, but thereducing trend in rates over thepast decade has reversed in Corby,Kettering and SouthNorthamptonshire (JSNA report,2013)The young women vulnerable tobecome teenage parents are thosein care or leaving care, those notattending school, those involved inyouth offending system, thosewho already have children andthose who underperform at school(NHS Northamptonshire, 2009).In 2010 the UK statistics revealsthat there are seven pregnanciesper 1,000 girls aged under 16(NHSCHOICES, 2012). The forecastedconception rates per 1000 femalesaged 15-17yrs in 2020 and 2015 inNorthamptonshire will be 36.6which will be higher than Englandand East Midlands average of 32.1and 31.5 respectively (JSNA report2013)Most people become sexuallyactive and start formingrelationships before 16yrs.Youngpeople in these age groups havesignificantly higher rates of poorsexual health ; figures indicate thatyoung people aged 16-24 accountfor over half of the sexuallytransmitted infections (STIs)diagnosed and, despite progressmade in tackling teenagepregnancy, 80% of under 18conceptions were 16 and 17 yearolds (PHE, 2013)
Priority Grid Criterion Table: Children and Young people among 11-16yrsin Kettering, NorthamptonshireSCORE: 5As per NHS, Kettering have a higher rate ofdeliberate self-harm admissions includingpoisoning with 199 per 100,000 C &YPpopulation which is high than local averageof 165/100,000 population (Schiller, 2014) .SCORE-5SCORE-3SeverityChildren with mentaldisorders are more likely to absent in schools(Green, H, 2004). About 14% of young peoplewho committed suicide were in contact withmental health services (ChiMat, 2016).Approximately 50% oflifetime mental health starts at the age of 14(ChiMat, 2016). Young people with mentalhealth problems result in low educationalattainment and leave school with noqualification which is evident from countyprofiles that significantly less YP attain fiveGCSEs A* to C than the England average(PHE,2015). Thus are strongly associated withbehaviours that pose a risk to their health,such as smoking drug and alcohol abuse andrisky sexual behaviours (Green, H, etal, 2004)Conduct disorder is the most commonmental disorder in childhood andadolescence affecting 5299 per 100,000child population aged 11-16 year olds inNorthamptonshire. Conduct disorder is thecause of a 34% of school exclusions.Lifetime costs of each one year cohort of11-16 year olds with conduct disorder inNorthamptonshire is £795 million(Campion, 2014)The children from 11-16yrs with conductdisorders are 30% likely to indulge in riskbehaviours like smoking and 28% in druguse as well as 21% had tried to suicide(Campion, 2014; Green ,H, 2004).Among young people of 11-16yrs with anemotional disorder, 23% were smokers and20% had taken drugs at some time and 28%said that they had tried to harm or killthemselves (Green, H 2004).Poor mental health in childhood andadolescence also leads to a broad range ofpoor adult health outcomes which leads tohigher rates of adult mental disorder like;1.Depression2.Schizophrenia and mania3.Substance misuse4.Suicidal behaviour5.Personality disorder: 40–70% ofchildren with conduct disorderdevelop antisocial personalitydisorder as adults(Campion,2014)Mental health problemNational Institute for Clinical Excellence(NICE) indicates that those who haveself-harmed are 100 times more likelydie by suicide in the following year(Nixon, B, 2011)Recent statisticsconclude that rates have increased inthe UK and are now among the highestin Europe.According to the NationalInstitute for Care and Excellence, the riskof suicide has also increased (NICE2013).Self-harm also include deliberate self-harm, self-mutilation, self-injury, self-poisoning, self-cutting, overdosing andattempted suicide. (Mitchell, J 2015).A national survey of more than 10,000children of11-15 year-olds, with the prevalence of self-harmat 1.2% among were children without anymentalhealth issues, but 9.4% among thosediagnosedwith an anxiety disorder, and 18.8% if thediagnosis is depression or kind of mentaldisorder(Nixon B, 2011).About 14 % of children andyoungpeople who deliberately attempt self-harmarewith mental problems(ChiMat, 2013).There was 36,423 admissions of 10-24 yearoldsfor self-poisoning in 2014 and a total of41,921hospitalisations for self-harm among 10-24yearolds in England in 2014.In 2013 the rates foryoung women who committed suicide were1.6per 100,000 for 15-19year olds(Hagell ,2015).Repetition of self-harm was frequent andabout17.7 % repeated within a year (Hawton, K,2012).The characteristics of adolescents who self-harmare similar to the characteristics of thosewhocommit suicide.After a deliberate self-harm“Childbirth is the number onekiller of teenagers’.Worldwidearound 50,000 teenage girls andyoung women die duringpregnancy and childbirth everyyear (NHS CHOICES, 2012).Babiesborn to young mothers are also atgreater riseand about 1 millionbabies born to adolescent girls diebefore their first birthday(NHSCHOICES, 2012). One third of theyoung women are less likely tobreast feed, and are 3 times athigher risk of smoking leading to13% of still birth, 21% high risk forprematurity and low birthweightbabies and 56% of infant mortality(PHE, 2013)Teenage pregnancy is a serioussocial problem.Having children ata young age can damage youngwomen’s health and well-beingand severely limit their educationand career prospects.Teenagemothers have 3 times the rate ofpost-natal depression (DES, 2013).The cost of teenage pregnancy tothe NHS alone is estimated to be£63m a year which placessignificant burdens on the NHSand wider public services(DES,2013).Along with the teenage pregnancythe young women riskier sexualpractises lead to other sexuallytransmitted diseases likechlamydia gonorrhoea and otherSTIs at 131.6, 29, 680 per 1000population in Northamptonshire(JSNA report, 2013)Young women with a child oftenleads to low educationalattainment which pave way tobringing up a child incredibledifficult situation and often resultsin poor outcomes for both theteenage parent and the child, inthe interim leading to long-termpoverty in both child and teenagemother ( DH, 2010). Children bornto teenage mothers have a 63%higher risk of living in poverty
Priority Grid Criterion Table: Children and Young people among 11-16yrsin Kettering, Northamptonshirethat go untreated result in distress in childrenand their families, carers and communities.Within NHS its accounts for more than 12%oftotal budget.It is estimated that in 2007, thecost of mental health care across services was22.5 billion pound, taking into account loss ofemployment and other associated costs thisrises to 48.6 billion pound, which is 3.6%GDP.By 2026 it is estimated that thesecombined costs will have risen to 88.5 billionpound which is 6.6%of GDP (NHS, 2013).SCORE-5thereis30-66% increased chance of suicide(Hawton, K, 2005).Challenging behaviour can take many formsfrom self-harm, aggression, sleeplessness,risk taking behaviours, anti-social behaviourand may lead to poor outcomes such asschool and social exclusion.(YHMP, 2011).SCORE-4(PHE, 2013).Women who wereteenage mothers are 22% morelikely to be living in poverty at age30 (PHE, 2013)SCORE-3EffectiveinterventionsLocal level :According to Dr.Schiller, 2014Northamptonshire have array ofinterventions , some of theearly interventions which are found to beeffective are:1. Prevention and Early help, whichincludes the key projects*Talk Out Loud Anti Stigma Programme(Talk Out Loud Young Person’s: is designedto improve awareness of emotionalwellbeing and mental health isues insecondary schools, enabling young peopleto talk openly about their concerns.(YHMP,2014)*Ask Normen Service Gateway: Thiswebsite www.asknormen.co.uk had a £30kinvestment in 2013/14 and the input ofover 40 stakeholders to transition it from aservice directory to an information, adviceand guidance website. This websitesupports the professionals and familiesunderstand: Behaviours and Concerns,Conditions, Emotional Wellbeing themes,National and Local Policies, ChildDevelopment & Parenting Support, Links toservices, Training Directory, News storiesand newsletters, Referral pathways. Theutilisation of site has dramatically increasedwith a peak of 632 users in March 2014 andan average of 433 users a month for the lastquarter of 2013/14 (YHMP, 2014).*Building emotional resilience throughcommon language: “five to thrive”: Whichaims to give families a better start whichinclude preparing teens to become parents,In order to prevent self-harmthe main focusis on schools to train teachers in identify,intervene and refer for further support forchild.The programme also providedguidance for schools to undertake an in-school meeting with the young person aswell as carers and parents (Halls 2011).Toolkithas been developed byNorthamptonshire Multi-agency pathwaydevelopment team. The tool kit introducedin schools and other health sectors, help inintroducing school best practice policy and toprovide guidance in dealing with self-harmchildren(Sturgeon, S, 2016).The Talk Out Loud Anti Stigma programme/TaMHS work in schools to promotemindfulness is effective in Northamptonshire(Grinham, 2015).Those with some problems can be referredto NCC targeted services for counselling,specialist services like CAMHS required forthose with moderate impairment. But thosewith severe suicidal ideation or attempts canbe referred to hospital services (Grinham,2015).The new self- harm toolkits forNorthamptonshire onAsknormento sharethere questionnaires for acute self-harmers,helps to identify the specific self-harmbehaviour of the peer (Grinham, E, 2015).An emerging qualitative evidence that moreaccess to robust treatment of mental healthdisorders in adolescents who self-harmactively contributes in suicide rates of youngIn order to reduce the teenageconceptions the target shouldinclude males and females,educating them on safer sex, andgiving young people the aspirationto grow and achieve (NHSNorthamptonshire, 2009).One programme to reduceteenage pregnancy isTime2Talk.The project aims to identify, trainand support young people (16-24)to become peer educators andpromoters of safe sex with localpopulations of ‘vulnerable’ youngpeople aged 13-19 years. Thesepeer educators are to educate andsupport young people on issuesrelating to safe sex, prevention ofunwanted pregnancies andsexually transmitted diseases (NHSNorthamptonshire, 2009). This‘Time2Talk’ team which serves theyoung people aged 13-15 includingcounselling, information on drugs,sexual health, pregnancy andsexually transmitted infections. Italso encourages teenagers to talkto parents for support (DaventryExpress, 2015)Team working in partnership withyoung people under19yrs toreduce the rates of pregnancythrough sex education in schools,free advice and contraception(Daventry Express, 2015)
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