Case study: Using messaging to improve access to a Mental Health Support Team (MHST)

In October 2020, the Mental Health Support Team (MHST) in Gloucestershire, known as Young Minds Matter (YMM), set up their text support service, powered by ChatHealth, for young people to get direct access to mental health support in selected schools and colleges.

Organisation: Gloucestershire Health and Care NHS Foundation Trust
Service: Young Minds Matter, Gloucestershire’s Mental Health Support Team

The Situation

Gloucestershire was one of the first 25 trailblazer areas to establish an MHST, as mandated by the Government in December 2018 as part of the NHS Long Term Plan to expand access to mental health care for young people in schools and colleges.

Delivered by Gloucestershire Health and Care NHS Foundation Trust’s (GHC) Child and Adult Mental Health Services (CAMHS), the purpose of the MHST is to develop early models of intervention to support mild to moderate health issues, such as exam stress, behavioural difficulties or friendship issues. The service is offered to 50% of senior schools in Gloucestershire covering a population of 43,000 students. Following engagement with young people and parents, who felt that the ‘Mental Health Support Team’ terminology did not resonate with young people, the service name was changed to ‘Young Minds Matter’ (YMM).

YMM recognised that mental health is a stigmatised topic amongst young people and understood that they needed to operate a discreet service to help young people feel comfortable in accessing mental health support.

Young Minds Matter, Clinical Lead, Becky Flory-Bryan explains,

“The ethos of our mental health support team is about improving accessibility to mental health support. It’s a big challenge for young people to turn to a teacher or their parents for help. We are aware of the barriers they face in getting help and we want to help to break those barriers to offer support when it’s needed.”

Initially the service trialled paper-based self-referral forms for young people to access help. However there were safety concerns around the information governance of handling referrals in this way. The team were keen to explore how digital technology could be used to improve the way young people could access the mental health service.

The solution

ChatHealth has been used by the school nursing team at GHC since May 2019. This allows young people to send a message to school nurses to get advice about a range of physical and mental health concerns.

As ChatHealth meets all NHS guidelines in relation to data protection and related compliance frameworks around confidentiality, the YMM team were encouraged to consider the use of the messaging service for young people to access mental health support from their practitioners. Becky said,

 “ChatHealth is a tried-and-tested method for engaging young people, so it made good sense to replicate this model for our service. As it was already used in school nursing, it gave us the confidence to implement a messaging service that would ensure patient data is kept safe and secure and meet our information governance requirements.”

YMM’s messaging service was launched as YMM Chat in October 2020. Like many other ChatHealth services, they have a rota system in place, with one member of staff on duty at a time to respond to messages. If a conversation needs to be continued to the following day, the next member of staff can easily pick this up within the shared inbox. Becky explains how it works,

“YMM Chat is available for anybody within our trailblazer senior schools. It’s manned by professional staff who are there waiting to support and advise young people if they have any worries or concerns around their mental health”

The YMM team are available for young people to chat via text between 9am and 4:30pm Monday to Fridays, except bank holidays, and aim to respond to messages the same day or the next working day. Young people can use the service to get advice or can self-refer themselves to get a 1:1 appointment with a mental health practitioner. If they send a message out-of-hours, a bounce-back reply advises them when to expect a response and where they can find support elsewhere.

The results

The YMM Chat text service has been welcomed by young people in the selected schools where it’s available as a more approachable way to reach out for mental health support.

  • Young people say messaging is one of the easiest ways to access the service.
  • Young people use YMM Chat for mental health support for issues such as low mood, depression, self-esteem, anxiety and emotional wellbeing worries.
  • YMM mental health practitioners have found the ChatHealth system to be user friendly and enjoy using it to respond to messages.

Feedback from service users has been positive. This is what some young people have said about using the messaging service to request support,

“[Texting is] something we use every day. It’s casual and easier than talking to someone face-to-face as there’s less commitment than getting a teacher or doctor involved.”

“A text service is a good place to start for someone who doesn’t know where to get advice from.”

Key learnings

When the COVID-19 pandemic occurred, YMM Chat had to be rolled out quicker than planned across all the selected schools to put a route in place for young people to easily request support. However, the closure of schools meant it was more difficult to make young people aware of how they could access mental health support during lockdown.

Becky explains the importance of promoting the availability of the messaging service to young people,

“It’s important that schools are well engaged in promoting our YMM Chat text service to young people. If they don’t put up the posters and show the video, then young people are not going to know how to contact us and the service is not going to get used. It needs to be kept fresh in people’s minds.”

A promotional video about YMM Chat was produced, which was shown to young people in the pilot schools via their online home learning platforms. As soon as the schools were back open, posters were displayed around the schools and business cards handed out to young people. The team also worked closely with young people’s to determine their understanding of what ‘self-referral’ meant. As a result, the posters were designed to clearly convey that young people can text for mental health support in an easy and confidential way.

Becky’s recommendations

“I would recommend that other MHST services consider setting up a messaging service. The biggest benefit for us is the infrastructure and support behind ChatHealth. We were fully supported by the project management team, which made it easier to get up and running and there’s a helpdesk available if you have any technical issues.”

Becky Flory-Bryan, Clinical Lead of Young Minds Matter

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