Case study

Making substance misuse and mental health support more inclusive

How a service for young people in North Yorkshire works with other agencies to focus on all their emotional wellbeing, substance misuse and mental health needs.

Compass REACH team logo

The service

Compass REACH is a specialist service that works with children and young people aged 9 to 19 (and up to 25 for those with special educational needs or disabilities) who have moderate or high levels of need related to their drug or alcohol misuse, or require sexual health interventions.

It also works with children and young people who could benefit from receiving early help and prevention work to support their emotional wellbeing and mental health needs. The young people who access the service can receive interventions just for substance misuse or emotional wellbeing difficulties, or for a combination of the two.

North Yorkshire County Council commissioners set up Compass REACH (as North Yorkshire Risk Taking Behaviour Service) in September 2012 to provide consistent services across the county for young people.

The service began as a substance misuse and sexual health service, based on a nurse-led staffing model which helped young people to access psychosocial support alongside clinical interventions for sexual health (such as emergency hormonal contraception) from the same practitioner.

In 2015, North Yorkshire County Council re-commissioned the school nursing service and the specialist substance misuse service under the umbrella of the healthy child service. They extended the Compass REACH service to include early help for emotional wellbeing and mental health issues. Since then, Compass REACH has provided specialist substance misuse interventions, and early help and prevention support for sexual health, emotional wellbeing and mental health issues.

What they have done

The Compass REACH service has been running for 5 years, half of which have included the emotional wellbeing and mental health work. It is now a well-established service with referrals growing by 170% from 2013 to 2017. In North Yorkshire, Compass REACH works closely with colleagues from the local authority prevention service. All services are co-located in what are known as ‘prevention hubs’. This has encouraged understanding and communication between professionals who work to support young people.

Compass REACH’s nurse-led model combines clinical elements such as emergency hormonal contraception, blood-borne virus testing, and hepatitis A and B vaccinations with psychosocial interventions, which are all provided by the same practitioner.

Compass REACH has worked with colleagues from other local services, such as the healthy child service and child and adolescent mental health services, to develop a screening tool which helps professionals find the right service to meet the young person’s needs.

This has also helped them to establish a ‘no wrong door’ approach, as recommended by PHE’s guidance on providing better care for people with co-occurring mental health and alcohol and drug use conditions, so young people are not turned away from any service they access. The service providers are able to refer the young person to a range of partner agencies, which makes support much more accessible to them.

Care pathways have been developed and improved by Compass REACH and their partners to support the overall aim of helping every child in North Yorkshire meeting their potential.

Outcomes are measured using various tools, such as Outcomes Star, Young People’s Outcome Records and a tool developed by Compass which measures how well the young person is doing by comparing how many vulnerabilities they have when they complete their interventions with the number when they first entered the service.

Main learning points

The nurse-led model, a single practitioner who is able to provide both psychosocial and clinical interventions, works well.

Locating all the young people’s services together in prevention hubs that young people routinely access for support with careers, life-skills, parenting and housing has also added to the success of the service.

Since Compass REACH covers a large predominately rural area, outreach allows more young people to access the service. The nurses have the flexibility to meet with service users anywhere that is convenient and where they feel safe and comfortable.

There is ongoing work to ensure that all partner agencies throughout the county understand the role and remit of the Compass REACH service, especially the emotional wellbeing and mental health support they provide. They believe they need more work with partners, including the specialist child and adolescent mental health services, to make sure there are no gaps between the early help and prevention interventions and specialist services.

Next steps

Compass now provide a new school mental health and wellbeing project Compass BUZZ in North Yorkshire. Wellbeing experts work with schools and other partners in North Yorkshire to increase staff skills, confidence and competence in dealing with emotional and mental health concerns. The project also helps staff to provide low-level support to young people at the earliest stage possible, allowing specialist services, practitioners and nurses to focus their resources on children and young people who need a more intensive service.

Further info

Contact Compass REACH - North Yorkshire Service for Young People.

Published 3 May 2019