Introduction and statement on quality from the Chief Executive
For the past thirty years, it has been Place2Be’s mission to improve the mental wellbeing of children and young people, by embedding mental health professionals directly in schools and training the wider workforce. Our work is underpinned by the belief that no child should have to face their mental health problems alone, and we know providing on-the-ground support for pupils in a familiar environment is the best way to help.
Reflecting on priorities set out in last year’s Quality Account, Place2Be has made significant progress in ensuring the effectiveness and quality of our service delivery. In light of the demand and needs of the children and young people in our schools, we have strengthened our processes around risk assessment and supporting children and young people experiencing suicide ideation and self-harm. We continue to prioritise stronger collaboration with NHS services, both at Mental Health Support Team level and more specialist CAMHS in an evolving landscape.
We have progressed our commitment to centering the child and young person’s voice and experience in our service through Goal-Based Outcomes. This will be reported alongside our other validated quantitative measures, giving a richer and more nuanced account of our work.
As part of our commitment to creating a more diverse workforce in the psychological therapies professions in order to better reflect society and our local communities, we have continued to chair a cross-sector coalition for inclusion and anti-oppressive practice. This work has included commissioning a practical resource, helping the counselling and psychotherapy training sectors better understand race and diversity. The coalition launched Race is Complicated – A Toolkit for Training Providers in October 2023.
Over the past three decades, Place2Be has continuously prioritised collecting data to evaluate our impact. Backed by research and insights from school communities, the data is used to inform our practice and develop and refine our services. We are delighted Place2Be’s recent data shows how our support continues to be effective in improving the mental health for the majority of children and young people we see.
In Place2Be’s 2024 Quality Account, we provide some highlights of our service under our framework of Safety, Effectiveness, Stakeholder Engagement, Governance and Equity. We delve into processes which help us assure the quality of our services based on evidence, and we set out goals for the year ahead.
We welcome feedback, so please don’t hesitate to get in touch with any questions, reflections or suggestions.
With my best wishes
Catherine Roche Chief Executive, Place2Be
Our mission, vision and values
We are a children and young people’s mental health charity with 30 years’ experience of providing mental health support in UK schools.
Our mission is to improve the mental wellbeing and prospects of children, their families and school communities. Our teams across the UK promote and enable good mental health and wellbeing, and support pupils to manage challenges in their lives. Place2Be’s vision is for all children and young people to have the support they need, to build lifelong coping skills and to thrive.
We believe that how we approach our work is as important as the work itself. Our values shape everything we do:
• Compassion – We bring empathy and kindness to our work, to better understand and meet the needs of children and young people, colleagues and other stakeholders;
• Integrity – We demonstrate sound ethical values in all our work, and we are honest, transparent, courageous and authentic;
• Perseverance – We have the courage to continue in the face of adversity and do this with determination to find effective solutions;
• Creativity – We bring an open-minded approach and flexibility to our thinking and actions and enable others to do the same.
An overview of Place2Be’s governance structure is available on our website .
“Place2Be has really helped my child and has made a massive difference – my child is wanting to go to school now and this has never happened before.”
Parent
1. Safety
At Place2Be, the safety of children and young people we work with is always front of mind. We have a comprehensive framework of consents, controls, policies and reviews to manage risks and act promptly if concerns are raised. As we support vulnerable children and families, our clinical and safeguarding staff work closely with our partner schools to uphold best practice in child protection and safety.
Our progress
Over the past year, based on presenting issues in our schools, a key priority for Place2Be has been improving support and guidance for our schoolbased teams working with children and young people expressing their distress through suicide ideation and self-harm.
Our Safeguarding Team has focused on supporting partner school staff in undertaking risk assessments, safety planning and managing concerns in these areas. The risk assessment and safety planning documentation can be used at any time with either children or adults, regardless of the type of risk. Place2Be’s case management system has also been updated, simplifying the process for staff providing oversight of the documentation.
Between 2022-23, 893 students presented with suicide ideation across Place2Be partner schools. This reduced by 9% the following year, with 810 unique individuals raising the issue. We also saw a 5% decrease in self-harm disclosures during this time.
We introduced training, focus and strengthened procedures, shaped in dialogue with our staff and schools. This has led to increased confidence of our own and partner school staff in managing these concerns in a calm and measured way, meaning children and young people’s low level anxiety is less likely to escalate to more worrying expressions of distress.
2024-25 Safety Priorities
1.1 Clinical focus on distress and despair
We have introduced a programme of bi-termly ‘clinical spotlights’ on different practice topics. Our aim is to integrate theory into practice by cascading practice session programmes, which can be delivered in local area teams by clinical supervisors. This means staff across the UK are all focussed on the same topic, helping keep the energy and focus alive in one specific area. Our first clinical spotlight covered the use of goalbased outcomes, and our upcoming spotlight will look at distress and despair. The sessions, which build on training delivered by Papyrus and Harmless, will run through the 2024 summer and autumn terms. It will cover thinking around supporting children and young people presenting with self-harm and suicidality from assessment through targeted intervention to discharge. We hope to see improved outcomes for these young people, with the area team practice and discussion sessions continuing to build an even more knowledgeable and confident workforce.
1.2 Skilling up partner school support staff on use of risk assessment and safety plans
In addition to our embedded training for our own staff, we are working to create additional resources for partner schools on the risk assessment and safety plan documentation. This includes a supporting video developed for schools covering how to effectively utilise the documentation and meeting with school safeguarding leads and support staff as needed. The aim is to continue to build and strengthen capacity in schools, identifying and supporting young people as early as possible.
2. Effectiveness
Every year, it is our overarching priority to improve the mental health of children and young people in our partner schools. Measuring impact plays a vital role in this – helping us improve our therapeutic work, evaluate our effectiveness, and inform the clinical decision-making of the service.
Our progress
Place2Be measures the impact on the mental health of children and young people after therapeutic interventions, such as one-to-one counselling. To do this, we use two main validated measures: The Strengths and Difficulties Questionnaire (SDQ) and the Young Person CORE. Using these measures, we can assess the mental health needs of the children and young people referred to our service before and after Place2Be intervention.
Our data shows Place2Be’s support continues to be effective in improving the mental health for the majority of 4 to 11 year old children who have one-to-one counselling and Personalised Individual Parenting Training (PIPT).
Academic Year 2022/23:
77% of children had improved mental health after one to one counselling on one or more mental health measures 1
86% of children were a bit or much better after PIPT, according to parents 2
We also continue to be effective in improving the mental health of young people aged 11 to 18.
In 2022/23:
The mental health of 89% of young people improved after one to one counselling on one or more measures 3
To read more about Place2Be’s outcomes and impact, please see our 2023 Impact Report .
2024-25 Priorities around Effectiveness
At Place2Be, we pride ourselves on prioritising quality data collection ensuring reliability of the data and findings. Our school-based teams work hard to gather clinical measures from all parents and carers, children and young people and school staff as part of assessing mental health needs and outcomes at the end of service.
2.1 Data Completion Rates
In 2022/23 our clinical teams successfully gathered paired measures, where children and young people had completed their intervention, for:
• 85% of 4-11 year olds and 79% of 11-18 year olds (teacher SDQ)
• 84% of 11-18 year olds (YP CORE) and 79% of this age group (Young Person SDQ)
• 59% of 4-11 year olds and 46% of 11-18 year olds (parent SDQ).
These completion rates allow us to be confident that our outcomes reflect the majority of those who have accessed our service. As accuracy is so important to us, we continue to strive to further improve these rates, particularly for parent SDQ. This will be done through focused monitoring of completion rates as part of our monthly monitoring reports to our teams. We will then identify areas where completion rates are high and share tips for successful collection to other areas as part of a UK wide push for improvement.
2.2 KIT Trial in collaboration with Anna Freud
Our trial of the CBT informed intervention KIT will further enhance our understanding and insight into the effectiveness of our interventions. The trial uses a randomised multiple baseline design. After young people are assessed as appropriate for KIT, they are randomly assigned to different short wait times, during which their wellbeing is measured weekly, before starting the intervention. In this way we can ascertain whether or not it is KIT that has an impact on young people or whether there is no difference in impact between those waiting and those receiving KIT. We will progress the trial in 2024/25, with results due in 2026.
2.3 Assessment and Formulation (A&F) quality review
We have worked hard to upskill clinical staff in good use of assessments, ensuring each child or young person is offered the right support and intervention based on their needs and presenting issues. This has involved training everyone in assessment and formulation and improving the quality of this process. We now have a 93% completion rate for initial assessments.
In the year ahead we will focus on reviewing the quality of the thinking and clinical decisionmaking based on the data. We have established a quality framework which uses both qualitative and quantitative criteria to examine sample assessments and their formulations and recommendations. The framework will be used by Clinical Supervisors during the 2024 summer
term. They will look at a number of cases for each of their supervisees, in turn reporting to their Clinical Leads on strengths, areas for development and training needs. This will allow our Senior Clinical Team to form an action plan for their area team based on the findings.
3. Stakeholder engagement
Collaborative assessment and formulation underpin our therapeutic work with children, families and schools – ensuring the client’s needs always remain the priority. Over the past year, a key focus for Place2Be has been highlighting the child voice and experience, while also monitoring progress towards goals that young people wish to focus on.
Our progress
We have implemented ‘Goal-Based Outcomes’ (GBO) for children and young people in one-toone counselling, while also developing a ‘Child Voice’ form. These measures enable us to collect views of children and young people before and after counselling. As part of this, we ask children and young people to set goals for their counselling, and score how worried they were about the issue before and afterwards. This approach was developed in 2022 through adopting the GBO measure. As it is a standardised measure used across many different organisations, we can compare our progress made with other providers. Place2Be clinicians review the goals with children young people at the end of the intervention, supporting them in looking at progress that has been made.
Stakeholder engagement 2024-25 priorities
3.1 Monitoring the goals of children and young people
In August 2024, the GBO method will have been in use for a full academic year for our one to one and parenting interventions. Following this, our
Research and Evaluation Team will conduct an analysis of the goals, and the progress made by the children and young people towards achieving them. Once completed, this will be an indicator of the effectiveness of our interventions from a child or young person’s perspective. Based on findings we will assess what learning or further action is needed to strengthen our practice.
3.2 Children and young people’s voices in our research
We have two major research studies ongoing with children’s voices at the heart. The first is a longitudinal study (across Greater London) looking at the long-term effects of individual counselling, aiming to support the case for early intervention in mental health. This involves contacting children and young people, along with their parents one and two years after the end of one to one counselling and collecting follow-up data using validated measures. Children and young people are helping us to shape the study through consultation groups. They have helped us to develop qualitative questions to guide our focus groups. In the year ahead we will ask children and young people who volunteer to participate in semi structured research interviews to share their experience of counselling from Place2Be and its effect on their wellbeing. This will add to the quantitative findings and support better interpretation of the results.
The second is a three-year research study in 20 primary schools (Salford), which aims to assess the impact of Place2Be’s ‘whole school approach’. This evaluation will not only explore outcomes for individuals who have directly accessed Place2Be’s services but also the wider school community. As part of this research programme, we are conducting 10 annual focus groups with pupils in years 4, 5 and 6. These focus groups aim to supplement surveys, to provide a more detailed insight into pupils’ experiences with Place2Be and any impacts they have experienced.
4.
Governance
We are deeply committed to using a range of evidence-based interventions at Place2Be, helping achieve the best possible outcomes for children, young people and families. Our schoolbased staff will continue to make best use of the resources available, ensuring our service users are provided with the right support.
Our progress
Improving integration of local systems has been front of mind for Place2Be, particularly in an evolving landscape over the past year. In turn, we have published and disseminated a Good Practice Guide for our school-based teams working with NHS services. This includes both Mental Health Support Teams and Children and Young People’s Mental Health Services (CYPMHS).
Our 2024-25 governance priorities
4.1 Implementation of working with NHS and good practice guidelines
The surveys and focus groups which informed our Good Practice Guide also raised awareness across Place2Be about statutory provision in each area. The guide has been welcomed as a concise checklist for staff around maximising collaboration and communication with CYPMHS
and Mental Health Support Teams. The focus in the coming year will be on strengthening connections with services and commissioners in areas where Place2Be is well established in schools. Collectively, this will help deliver an effective net of support for children, young people and families.
4.2 Increased take up and more even distribution of the 4 targeted interventions
Place2Be now offers an extensive range of universal and targeted support for children and young people, parents and carers, and school staff. Our four targeted interventions include one-to-one counselling, Journey of Hope group work, CBT-informed intervention KIT for secondary students, and PIPT delivered in primary schools. Work has been done to ensure staff are trained and confident in delivering our newer services. Uptake of all interventions is monitored monthly and clinical leads will be targeting support at areas where uptake of any intervention seems lower than we would expect in terms of the presenting issues recorded. Currently 79% of all targeted interventions are one to one counselling.
4.3 Introduce a ‘Customer Survey’ across our partner school base
To support good governance across our client and partner school base and to have a Place2Be-wide overview of customer satisfaction, service quality and trends, we will introduce an annual ‘Customer Survey’ across our schools. This will build on our established mechanisms, such as our local ‘school review’ process and guidance from our Headteacher Advisory Group. The aim is to ensure that our whole school services are meeting the needs of our key stakeholder schools and in turn their school communities.
5. Equity
We are continuing to prioritise Equity, Diversity, and Inclusion (EDI) across all areas of Place2Be. This has included focusing on removing barriers to accessing our services, ensuring we are meeting the needs of diverse groups, reaching as many children and young people as possible, and maintaining a clinical focus on anti-oppressive practice.
Our progress
Maintaining clinical focus on anti-oppressive practice
We have made a number of positive developments this year in our commitment to anti-oppressive and inclusive clinical practice.
This includes:
• Place2Be chairing a cross-sector coalition for inclusion and anti-oppressive practice which aims to improve the diversity of the psychological therapies professions. The coalition commissioned a toolkit for training providers entitled Race is Complicated. This launched in October 2023 and has been welcomed by institutions offering psychological therapies training across the UK. Place2Be hosted an online event at the
end of June 2024 for training providers to share good practice about how they have used the toolkit and what has changed as a result on their courses.
• Clinical Supervisors across the UK have been studying Myira’s Khan’s book, ‘Working with Diversity’ and are making use of this to prompt constructive clinical conversations within their teams and with supervisees. It has proved impactful to have everyone in the organisation using the same text to galvanise awareness and action.
Increasing accessibility to online content
Work is being done to ensure our Parenting Smart, Children’s Mental Health Week and Place2Be websites are accessible as possible. We have implemented a ReciteMe tool which allows for easy translation of written content, and other accessibility options. To further improve accessibility, changes are also being made the colour and background patterns on our main website.
Increasing parental engagement
To ensure everyone in our school communities can access our services, especially where language barriers exist, Place2Be has launched a live interpreting service pilot in our five regions. The third-party supplied service, which is conducted over the phone by professional interpreters, has significantly enhanced accessibility for parents, enabling meaningful conversations. We plan to expand this service to all our school-based staff by September 2024. Additionally, we support this initiative with translated versions of our key assessment documents, available in the eleven most requested languages.
EDI Steering Group and Special Interest Groups
Established five years ago, our EDI Steering Group is comprised of staff from across the charity. The group – who meet every other month – review policies and bring in experts from outside Place2Be to speak with staff. We have more recently formed Employee Support Networks which cover hearing loss, LGBTQIA+, neurodivergence and race equity. These groups are led and managed by employees, with a representative from each regularly reporting back to the EDI Steering Group.
Our 2024-25 priorities around equity
5.1 Ensure the children and young people accessing and benefitting from our services represent the whole of the community in which they are located
We will continue to seek to understand what barriers there may be to accessing any of our services, whether self-referral or targeted, in each of our school communities. We will proactively work to address any barriers where they exist. We will work with clinical and operational colleagues and our EDI Steering Group to establish a methodology and commence a review of our clinical screening tools and assessment practices for any biases. We will continue to monitor and track progress across our service delivery.
5.2 Development of an industry-wide Apprenticeship Standard
One side of building diversity within the workforce is to increase access by removing material barriers to entry. With this in mind, Place2Be has mobilised a Trailblazer Group with representatives from other counselling employers and training organisations. The group will work towards establishing an Apprenticeship Standard for counselling, with a focus on children and young people in schools and community settings. This opens opportunities for a more representative mental health workforce by
creating paid training routes. An Apprenticeship Standard could also help address challenges faced by local Integrated Care Systems, schools, and multi academy trusts regarding access to mental health services by building a more available and accessible quality-assured workforce. We are seeking to establish a Standard over the next 18 months.
While working towards an Apprenticeship Standard, Place2Be has introduced new bursaries for all Place2Be’s qualification pathway programmes. These bursaries will support those who are passionate about working therapeutically with young people and currently find the financial requirement a barrier to entry.
The other side of building better representation into the workforce is to ensure students find an inclusive environment once they are on our programmes. Place2Be’s commitment to antioppressive practice is brought to life through our use of the Race is Complicated toolkit. We also offer training for tutors on our pathway and qualification programmes on bringing out-ofawareness biases, and understanding of working within diversity.
5.2 Supporting involuntarily dislocated families
Supported by Save The Children, we are developing a programme to improve support for families who have been involuntarily dislocated. We have focussed our energies on gaining a clear understanding from young people and parents about how schools could provide better emotional and practical support to newly arrived families. This involves collaborating with psychologist Prof Renos Papadopoulos, founder and director of the Centre for Trauma, Asylum and Refugees. Prof Papadopoulos has guided our work in consulting with families, schools and social workers. We are aiming to develop a training programme based on the findings for our own clinical staff and a good practice guide for schools, which will come to fruition in Autumn 2024.
“If you have problems or worries you get a chance to talk to a person you trust. When I grow up I want to help children like Place2Be helps children.”
Girl, 8-years-old
For further information
Readers can find out more about our impact and our data by looking at the following publications: Impact Report 2023 place2be.org.uk/impactreport
25 years’ learning from practice and evaluation bit.ly/36hmuoQ