Second Edition Miranda Wolpert, Rita Harris, Sally Hodges, Peter Fuggle

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THRIVE ELABORATED: NOVEMBER 2016 

number of adverse life events, may need proactive support to ensure they get the most beneficial help available 

to them. A wide range of agencies, often usefully led by schools and social care, has a key role in outreach and 

motivational work that helps some young people’s readiness to seek support. There is a shared responsibility 

of those in contact with children and families to promote awareness and understanding of the importance 

of good child and family mental health and wellbeing, and to promote family and child mental health and 

wellbeing actively, including specific interventions, as discussed previously. 

There are many factors that may lead to the development of mental health difficulties in children and young 

people. The World Health Organisation categorises these into three broad areas:

•  Social circumstances: such as loneliness, bereavement and neglect

•  Environmental factors: such as injustice, discrimination and exposure to trauma 

•  Individual factors: such as cognitive/emotional immaturity and medical illness.

To address these factors requires an inter-governmental commitment and cross-agency strategy. 

Poverty and social inequality: There is substantial evidence that poverty is a major risk factor for developing 

mental health problems in childhood. It is important that professionals across the multi-agency network 

are made aware of this evidence so that this is held in mind when planning preventative and mental health 

promoting input. There should also be a sensitivity and awareness of multi-agency provision and a wish to 

work collaboratively across agencies, including, for example, housing, social care and youth justice. It is crucial 

to consider this evidence and to seek to reduce child poverty in order to impact positively on mental health in 

the future.   

Trauma and maltreatment: The harm caused by child maltreatment can have wide-ranging effects on the 

child or young person’s emotional, psychological, behavioural and interpersonal functioning. Child trauma 

is also likely to have a negative effect on the quality of the close relationships a child is able to make now, in 

the future, and with their own children, thus making trauma an inter-generational issue. Reducing trauma 

and maltreatment may be one of the biggest primary prevention strategies available to us. The THRIVE model 

emphasises integrated training and continuing professional development across agencies in key issues such as 

this one.

Social isolation and bullying: The importance of having friends and feeling accepted by other children or 

young people of the same age cannot be overstated. Social isolation also means that a young person will have 

fewer resources available to help them deal with difficulties in their lives, as they will not be able to turn to 

those around them for advice or support. 

Promoting system-wide resilience: Focusing on system-wide resilience is key to supporting “Thriving”. For 

example, this will involve communities (including schools) and families in developing support systems and will 

help to build resilience at a system level. 

3.  THRIVE promotes multi-agency proactive “advice” and “help” 

There is a group of young people, and their parents/carers, who identify themselves as “Thriving”, but are of 

concern to professional networks who firmly believe that areas of their lives are problematic and potentially 

harmful. From a therapeutic point of view, working with families where difficulties are minimised or denied 

is a very familiar situation; for example, when there is professional concern about abuse, neglect, domestic 

violence, poor school attendance or poor educational attainment. Such families may not be seeking help, and 

Getting Advice, Getting Help, Getting More Help or Risk Support may be proactively facilitated by specialist 

staff embedded in local authority services, such as social care or family support, where such families are often 

known. A liaison-consultation approach is often useful to get an understanding of the situation, and to advise 

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on which approaches might improve mental wellbeing. There may be an opportunity for joint home visits – 

with a social worker, for example. However, the mental health intervention in these situations may be best 

delivered by a non-health professional under supervision from a specialist mental health practitioner, with 

shared responsibility for the work. 

A similar approach may be used with young people who are experiencing the transition to adulthood and do 

not or will not identify themselves as having a mental health problem. They may have a number of significant 

wellbeing issues which put them at risk of mental health problems in the longer term; for example, they may 

not be in education, employment or training (NEET) or they may be misusing substances. A holistic approach 

where young people are encouraged to access activities, engage in social enterprise, or get help with access to 

education and employment, will clearly improve general wellbeing, as well as mental wellbeing. 

4. THRIVE supports multi-agency clarity on endings as well as beginnings

Organisations often have detailed processes for how people access their services, not least the eligibility and 

threshold criteria, referral forms or information requirements, triage processes and assessment paperwork. In 

contrast, the processes around leaving the service can lack clarity or be non-existent. THRIVE – and the Choice 

and Partnership Approach (CAPA) – emphasise the need for all agencies to consider the ending of service 

contact from the start of an intervention, including an emphasis on transparent conversations about how both 

those helping and those seeking help will know when “enough” help has been provided, and by which agencies. 

There needs to be clear consideration and an agreed understanding of what happens next. 

We hope that this foreword will help those reading the THRIVE framework appreciate how THRIVE seeks to 

stress and promote the requirement for multi-agency input, which is essential for meeting the full range of 

mental health and wellbeing needs of children and young people in our communities.

THRIVE Elaborated (2016) authors

November 2016

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