Case study: JEFF (North East Lincolnshire)
Scenario: Setting the scene and who did you engage with?
Person A was referred by his head of house from school for support for anxiety, low mood, and difficulty managing his emotions when he was in year 7, repeatedly getting excluded and was constantly in isolation due to his behaviours. During this time he had attempted to harm himself and was expressing suicidal ideation.
Person A had previously had lots of support from educational psychology, occupational therapy and the specialist advisory service in primary school. Though upon entering secondary school no further support had been put in place as a result of these and Person A was struggling as a result. The family had also received support through early help, though school felt it could be mental health. He was also on the SEN register for mild cognition and learning difficulties, including SEMH. He became involved with the service for the at risk category as he had been logged on police intel as being involved with groups of young people in the community participating in antisocial behaviour. I engaged with both schools (primary & secondary), the families first practitioner (FFP), access pathway and the inclusion lead officer.
Actions: What did you do?
I carried out a mental health assessment with Person A in school and agreed to take him on for 6-8 sessions of low intensity CBT support. He shared he was no longer having suicidal ideation and that was a result of him being in trouble in school all the time. Although he was still getting in trouble at school he said that he was feeling generally better in himself. It become apparent he was struggling with low self esteem and was struggling with managing his emotions in school.
We had completed 1 further session together before Person A was placed on a step out programme to a pupil referral unit. We saw him in the local family hub when waiting for placement and he did engaged with the session, though it became apparent that A had some potentially further undiagnosed SEN needs. Due to complications with accessing support in the community, due to mum having young children she had to bring along and A not being able to make it to appointments on his own we agreed to see him when he started his new school in a few weeks time. A home visit was also not appropriate as person A has lots of young siblings and mum said there was no where suitable in the house to see him. When I conducted a further 2 sessions at the pupil referral unit Person A said that he no longer felt he needed support. He informed me that the strategies I was giving him he no longer needed as he was getting on fine in his new school. He shared how his mood had improved and he was managing better with his anger and not getting in trouble. Person A said this was due to the smaller class sized and the extra 1:1 support. He advised he also does not get punished for minor things such as forgetting his planner. This raised questions around the level of need required in school and whether the true impact on A was that he was struggling in mainstream school.
I began liaising with mum and school and obtained all the letters and assessment information from previous years from primary. Mum shared she has been requesting further support in school or assessment for many years. This became apparent with the extent of information obtained from many support services. It became apparent that when the Covid-19 pandemic had hit Person A was home schooled around the time he was being assessed by the educational psychologist and specialist advisory service. No support was put in place as Person A was being schooled from home and then returned in year 7 to secondary. I pushed this back to the school and requested the support is followed up, but with no success. The PRU shared that they had observed similar difficulties in school e.g. forgetfulness, rocking on his chair, inattention etc. I liaised with the FFP and we arranged a Team Around the Family (TAF) meeting with both schools. Unfortunately I could not attend but the feedback from mum was that she never got to speak and both schools refused to continue with the assessment. No answers where provided for the future of his schooling either and whether he would go back to mainstream where he was struggling significantly.
At this point I made contact with the lead inclusion officer, she was able to share some information around the next steps for Person A. She also liaised with school as it was clear the future for Person A was not being clearly communicated and creating some anxiety for him. It became apparent that the next steps was to go down the access pathway but both schools where refusing to complete this. There was also many other professionals involved but none would take ownership to complete an access pathway referral despite all the evidence.
In the end I met with mum and A and completed the referral with over 30 pages of letters from school with concerns around SEN, and service letters. My opinion was that this young person had been missed due to Covid and was not able to receive specialist assessment before he entered year 7 without being able to manage. Secondary school was not able to provide the same level of adapted support as primary school. This led to him being excluded in less than 6 months. I also recommended mum to contact SENDIASS for further support.
Finally I provided Person A and mum access to positive activities, one was very local to his own home and he could get there easily. He began engaging with the boxing activities at the West Marsh Community Centre on Monday evenings. This helped to get him hanging around in the community through boredom where he is at risk of exploitation and have him something fun to do.
Success: What was the impact?
The access pathway referral has now been submitted. The access pathway is for further specialist assessment when support has been tried but not been affective. The evidence from professionals who have supported through the years all suggest possibility of an attention deficit disorder. The impact has been that both mum and A feel less anxious that something further is being done before he returns to mainstream.
Mum shared her trust in professionals has been restored as she felt not listened to by some of the key staff in school. Both Mum and Person A are now hopeful that assessment and evaluation of his needs can continue so that he will be able to have something in place in the future. Not only with school and college but so he can enter working life with the right support also.
Mum has been in contact with SENDIASS who are now also supporting mum and A with navigating his schooling. Both mum and A have shared they have found it helpful having the JEFF project provide them lots of information, signposting and advice so that they have not felt left in the dark during this process. A has been given some strategies which he states he continues to use when needed, although he is thriving in the alternative provision. Though, the concerns are that he will return to mainstream and his mental health will be impacted as a result again without the correct support.
A continues to access positive activities at his local community centre now and has also shared he would like to attend another on another evening (parkour at YMCA) when it is up and running. He plans to start going on his bike.
Below is the reported outcomes using the Revised Childs Anxiety & Depression scale from assessment to the end of the intervention. A reported accessing the positive activities and being in a more supportive schooling environment has helped him to feel much happier in himself.
Issues: What barriers and challenges did you face and how did you overcome these?
The main barriers was getting responses or returned calls from school. It felt as though no one wanted to discuss the matter or take ownership of it. I overcame this by using our partnership with Aspire and made contact with the Lead Inclusion Officer who began approaching school for answers. She was able to get the responses needed to move forward.
The challenges were trying to encourage school to take ownership of the access pathway. However, to overcome this myself and mum managed to instead collate all the information, correspondence between school and professionals, letters, reports etc to move this forward ourselves. Though school have agreed to contribute when contacted as they believe A does require specialist assessment as they have been unable to effectively support him.
Further barriers were meeting with A and mum due to the home not being suitable environment due to young children and RS being out of school. He struggled getting to appointments on his own in the community. To get round this we kept in regular contact via phone calls between this time. It would have been easier if the service would allow me to use my car to have picked RS up and transported him to the sessions. In future I will attempt to use the FFP to bring him, though in this case by the time the FFP was involved he had returned to school.
Lessons Learnt: What would replicate moving forward? What would you do differently based on the learning?
I have learned that Covid is meaning we are coming across children who may have been missed during key times in their schooling with support plans being put in place. Also with the struggle for many children who had to transition to mainstream during this time who may have had SEN needs.
Moving forward as a result I have arranged for SEN training for our team. I have had supervision with the SEN specialist in compass Go to support with this case and I would utilise her for advice again regarding these cases. I would also use our links with the lead inclusion officer when school are not cooperating to obtain information for young people on the aspire or BACs process.
Now that we have a petty cash arrangement I would attempt to travel via bus with the young person to an appointment if needed.
Moving forward the local positive activities have worked great in helping this young person to be off the streets, getting into potential trouble and doing something he enjoys. In future I will always encourage and support young people in accessing these as I have see how useful this addition is to the project.