Multi-agency mental health education triage (MAMHET)

The aim of the multi-agency mental health education triage (MAMHET) is to:

• provide support and safeguarding for young people through multi-agency information sharing
• identify emerging themes, patterns and trends to inform multi-agency strategic priorities
• identify gaps in responses and resources within the multi-agency space

• Increased information sharing between schools, social care, mental health services and police.
• Improved safeguarding of young people.
• Reduction in death by suicide or death by misadventure.
• Reduction in suicide idealisation and self-harm in young people.

Following a high number of child deaths by suicide in West Sussex, a gap was identified in terms of service provision for children who were at risk of suicide or substantial self-harm. These children did not fit the category of a child safeguarding concern in terms of neglect, assault or abuse caused by others. 

MAMHET is supported by Sussex Police’s Operation Moonlight which seeks to identify children at high risk of suicidality, to allocate appropriate support and resources to them should they be brought to the force’s attention, for example, missing incidences. MAMHET was set up in September 2022 to work with schools who were found to hold information about these young people who did not fit into the normal safeguarding referrals.

MAMHET is led and chaired by the children’s mental and emotional health (CMEH) team from West Sussex County Council. Representatives from children’s social care, police, education and child and adolescent mental health services (CAMHS) are required to attend as core members. Core members are able to send a deputy if they are unable to make a meeting.

Partnership partners include:

• Sussex Police
• Sussex CAMHs
• clinical commissioning group (CCG) safeguarding teams and multi-agency safeguarding hub (MASH) health specialists
• West Sussex early help
• youth emotional support (YES) service
• YMCA Dialogue
• Thought Full (West Sussex mental health in schools team)

MAMHET invites all schools into the triage, and they can refer any at-risk child. All referrals received by the end of the day on a Thursday are screened weekly on a Friday by the mental health managers within the CMEH team, Sussex Police and CAMHS. Those children meeting the threshold are allocated slots for the following week. All actions from the previous week will be reviewed the following week. MAMHET meetings take place on Microsoft Teams on the following days:

• Tuesday Eastern – Mid Sussex and Crawley
• Wednesday Central – Horsham and Worthing/Adur
• Thursday Western – Chichester and Arun

Each school is allocated a 20-minute slot per young person. It is the school’s responsibility to feed back the actions of the MAMHET to the child or young person’s parent’s, carers or guardians.

For those referrals that do not meet the MAMHET remit, advice and guidance will be provided directly to the referrer by the mental health managers.

Confidentiality and information sharing

Parental consent is required before referrals to the MAMHET from schools. It is the school’s responsibility to discuss with parents, carers or guardians the referral and share with them the process of MAMHET in order to gain consent. Parents should be made aware that consent includes the attending agencies sharing information held on each agencies respective system. The consent also includes the appropriate planning and safeguarding for their child. Parental consent given should be indicated on the referral form. Children and young people cannot be discussed at MAMHET without parental consent.
 

Social services have a coordinator who monitors the work of MAMHET. The information monitored includes the:

• number of referrals made to MAMHET
• number of these referrals screened and heard at MAMHET meetings
• age and gender of the young people referred to MAMHET

Before MAMHET, the police would often not have any information around vulnerable young people at risk of self-harm. This meant that the police response to missing episodes was not a true reflection of the actual risk the young person displayed. Since the creation of MAMHET, information around young people and their mental health struggles, suicide ideation and self-harm is now known and shared. This process has in-turn allowed for a cross-agency safeguarding.

Over the three years that MAMHET has been running, the team has built strong working links with every secondary school in West Sussex (over 40) as well as colleges and sixth-form educational institutions. The feedback that MAMHET has received from education is that of relief and thanks.

The number of young people who have died by suicide has declined in West Sussex since the creation of MAMHET, with 469 referrals being made between September 2022 and March 2024.

For an intervention such as MAMHET to work, it is crucial to develop strong working relationships both with schools and other local partner agencies. Sussex Police has achieved this through the following.

• Initially MAMHET was launched in the North of West Sussex before being rolled out across the county. The phased roll-out ensured that MAMHET was not overwhelmed by the demand.
• Initially there was reluctance from schools to discuss suicide and self-harm. MAMHET worked with schools to create a safe space where schools could openly express concerns about at-risk children.
• It is essential to have multi-agency buy-in and have a holistic understanding of each agency role and responsibilities.