Helping young people THRIVE: Implementing a person-centred model of care for young people’s mental health Tavistock and Portman NHS Foundation Trust

Around 10% of children and young people have a mental health problem. This has a negative effect on their physical health and quality of life, making them vulnerable to poor relationships, violence and substance abuse.

Child and adolescent mental health services (CAMHS) face a range of problems, including difficulties with access to care and long waits. Children and young people are not always included in decisions about their care, and the things that matter most to them are often not taken into account. There is an urgent need to improve the quality of services by making them person-centred, equitable, efficient and more effective.

THRIVE is an integrated, person-centred and needs-led approach to delivering mental health services for children, young people and families which conceptualises need in five categories or needs based groups: Thriving, Getting Advice, Getting Help, Getting More Help and Getting Risk Support.

Following successful development in Camden, a core set of THRIVE principles has been identified and translated across four localities in NELFT, using an evidence-based approach to implementation called i-THRIVE. Improvements have included redesign of assessment, advice and signposting services, development of new care pathways, and trialling multi-agency approaches to support high-risk young people.

The project has led to increased access, with 100% of referrals now receiving advice and signposting. Waiting times between assessment and first treatment have reduced by 72%, and breaches of the 18-week target to first treatment have reduced by 60%. 

Main enablers of implementation include dynamic local leadership and national support of i-THRIVE, and using a structured approach to implementation. Barriers include unprecedented strain on services, and lack of capacity in terms of time, experience and expertise.