The Five Year Forward View for Mental Health, published by NHS England in 2016, highlights the unprecedented challenges faced by mental health systems across the country: rising demand, growing expectations of the system, and budget constraints.

The South Devon and Torbay CCG - part of the Wider Devon STP footprint - has a complex profile of need. It includes pockets of significant economic disadvantage - particularly in the Torbay area - associated with poor outcomes across a range of domains, including lower than average life expectancies and higher than average rates of hospital admissions for alcohol, drug and mental health conditions.

In light of these challenges, the South Devon and Torbay CCG partnered with the Dartington Service Design Lab to apply system dynamics modelling techniques and undertake a comprehensive survey of children’s mental health and wellbeing. This work
was undertaken to help inform strategic decisions about the design and delivery of mental health services in the region, and in particular to help inform investments in prevention and early intervention.

Based on both the system modelling work and the survey Dartington developed the following recommendations for the CCG and partners:

1. Invest in: (a) targeted evidence-based parenting support programmes in the early years; and (b) family-oriented therapeutic programmes for those already experiencing

If implemented at high quality and at scale, these approaches have the potential to help prevent emerging difficulties escalating into more entrenched difficulties that put pressure on families, communities and the mental health system.

2. Further explore the consequences of brokerage support. Preliminary modelling work suggests that the introduction of some form of brokerage support to help navigate what is a complex mental health system, either for practitioners in schools, primary or secondary care, or directly for those requiring support, may help reduce reassessment and ensure people receive timely and appropriate service. From the wider literature, there are calls for the deployment of brokerage support or ‘navigators’ in health and mental health systems, although the empirical support is limited.

3. Further explore the consequences of the enhanced provision in the community

Charlotte Hill and Jennie Newlove founded One Big Happy to meet the need at the early intervention level to support family well-being as per the recommendations of the research by Dartington.