NEST framework implementation update 2024: children and young people's version

The NYTH/NEST framework is a plan to help organisations and leaders talk about mental health and wellbeing. The Welsh Government wants to make sure that babies, children, young people, and their families get the best mental health and wellbeing services.

The NYTH/NEST framework helps different services work together to be more:

• nurturing
• empowering
• safe
• trusted

This report shows how well the NYTH/NEST framework is being used in Wales.

In February 2024, we started using the NYTH/NEST self-assessment tool which asks services how well their NYTH/NEST work is going. This tool was made with help from young people, workers, and leaders. We tested it in different places before sharing it with everyone. We had a big event to show people how to use the tool, and over 300 people came. We also have a monthly meeting to help people use the tool.

NYTH/NEST in Welsh Government

NYTH/NEST is now included in lots of parts of Welsh Government work:

• the NYTH/NEST framework is a big part of the new mental health and wellbeing strategy
• the national framework for care and support in Wales says that people who plan services should use the NYTH/NEST framework
• the NYTH/NEST framework is part of the new plan for children with learning disabilities
• the children and communities grant now includes NYTH/NEST for support, play and childcare
  projects for families
• the neurodivergence improvement programme works with NYTH/NEST to help families of children who are neurodivergent
• our NYTH/NEST community of practice is a group of people with different jobs who meet to talk about children’s mental health and wellbeing
• youth workers and playworkers are working with NYTH/NEST because we know youth work and play is important to children and young people’s mental health

NYTH/NEST and children’s rights training

In February 2024, we started a new training course about NYTH/NEST and children’s rights. This course was made with help from young people and the Children’s Commissioner for Wales. By October 2024, 147 people had signed up for the course, and 70 had finished it.

Feedback included:

• people liked the real-life examples of how the NYTH/NEST framework is used
• they thought hearing children’s voices and real stories made the training interesting
• people wanted more video stories and examples of the NYTH/NEST framework in action

One person said:

I found the voices of the young people being part of the training helpful, and all the information of the work being done by them and with them.

Regional Partnership Boards (RPBs) are groups of people who work together to make the care and help that people get in their area better.

In October 2024, all RPBs told us how well they thought their NYTH/NEST work was going, this was called a NYTH/NEST self-assessment.

To make their self-assessments, RPBs talked to workers and leaders and listened to children, young people, and families.

NEST has 6 important ideas for children’s mental health called principles. We asked RPBs to give themselves a score from 1 to 4 on how well they were doing for each idea and you will see these scores in the report.

The NYTH/NEST score for all regions is 2.3.

In many places in Wales, they are trying to make sure there are trusted adults for children. Services want staff to stay in their jobs for a long time so children can build trust with them. But sometimes, short contracts and not enough money make this hard.

Training trusted adults about trauma (experiences that are unpleasant and can cause us distress or anxiety) is very important.

Regions also said it’s important for trusted adults to work well with each other. This helps make sure children get the right help when they need it.

The NYTH/NEST score for all regions is 2.1.

All regions know that mental health and wellbeing support in schools is very important. But many places found it hard to get education workers to join their groups. They are working on fixing this.

There is support for schools for learner’s mental health and wellbeing from the whole school approach to emotional health and wellbeing and from CAMHS in-reach.

Many regions want to teach schools more about mental health services and connect schools with these services.

Some regions are working on giving children who are homeschooled or in special units extra support.

Regions also said that childcare, colleges and universities should be part of the NYTH/NEST plan.

The NYTH/NEST score for all regions is 2.1.

All groups doing the NYTH/NEST self-assessment need to listen to children and families. Some places did a good job of this, but not everywhere. Where children’s voices were missing, regions had plans to start listening.

Many regions had good examples of working with children and families to plan and deliver services. Although, not all regions had a plan for involving children and families in larger, important decisions. Regions are working to do better at this.

Regions are planning to include more voices from children who might be left out, like homeless young people, children with serious illnesses, and children who don’t speak. They also want to hear more from parents and carers.

Listening to babies and very young children was mostly missing from the self-assessments, but regions know they need to work on this.

The NYTH/NEST score for all regions is 2.1.

Regions talked about the problems people face when trying to get help. Some of these problems are:

• living in rural areas
• bad transport links
• poverty

North Wales said they need services in Welsh, and other regions said they need services in different languages too.

Regions are working on websites that give information about mental health and services.

People said that services work better together when they are funded by the Regional Integration Fund. The biggest problem is long waiting lists to get help.

The NYTH/NEST score for all regions is 1.8 (the lowest).

Regions said there is a lot of work to do. Problems include living in rural areas, bad transport links and projects being run only in big towns instead of small villages.

Many regions also worry about not having enough green spaces and places for children to play, which are important for mental health.

Regions are planning to work with Public Services Boards on wellbeing issues. They want to include things like youth work, play work, and housing in their NYTH/NEST plans.

Regions know that youth activities and community events are very important. Some regions also talked about “social prescribing,” which means connecting people to community activities and services to help them feel better.

The NYTH/NEST score for all regions is 2.3.

Regions are spending a lot of time and effort to make sure there is “no wrong door” for getting help. This means that no matter where you go for help, you will be guided to the right place. This is one of the best-rated principles.

All regions are creating single points of access or making their “no wrong door” systems better by learning from others. These changes take a long time and involve working together, sharing information, and changing how people think.

Some regions want to include help for neurodiversity and crisis situations in their “no wrong door” systems.

This year, NYTH/NEST has made a lot of progress with a new self-assessment tool and training. This helps everyone in Wales use the same plan, with local support.

People want to use NYTH/NEST, and things are going well. But properly doing NEST will take a long time and everyone needs to work together.

We will make sure childcare and early years are included in NYTH/NEST because young children’s mental health is very important. We will also connect NYTH/NEST with mental health work in schools.

We will keep making “no wrong door” procedures better to make sure everyone can get help easily.

Lastly, we will keep listening to everyone involved in NYTH/NEST to make sure we meet the needs of babies, children, young people, and families.