14 August 2025

 

Graeme Caul, our Chief Operating Officer, describes in this blog how CNWL are transforming young adult mental health through co-production.

It’s long been clear to those of us in mental health that the cliff edge at 18 is one of the most damaging design flaws in our care system. At precisely the moment when vulnerability spikes, our services split. Childhood ends, but adulthood does not arrive fully formed. It is a period that deserves its own thinking, its own response, and its own model of care. 

Over the last three years, Central and North West London NHS Foundation Trust (CNWL), in partnership with West London Trust and a wide network of VCSE and academic partners, has been quietly transforming this overlooked corner of the system. What sets it apart isn’t just structural reform, it’s the culture shift at its heart. Young people and their families haven’t just been consulted, they’ve been in the room shaping it, chairing it, delivering it. This feels like a significant shift from some of my past experiences earlier in my career when working in services aimed at directly helping young people were ran differently. 

The Scale of the Challenge 

The needs we are addressing are complex and overlapping. In the first 18 months of our new Young Adult Pathway, our Pathway Leads provided 1,274 consultations to staff across CAMHS, Adult Mental Health Services, Early Intervention Services, Local Authorities and voluntary sector organisations. 

Through our Young Adult Partnership (YAP) Forums, 103 young people were discussed, each with a comprehensive plan agreed. Most were referred to help prepare their transition from CAMHS to other services. Within this group: 

  • 28% were Looked After Children 

  • 19% were not in education, employment or training (NEET) 

  • 35% had diagnosed or suspected autism spectrum disorder (ASD) 

  • 25% had experience of substance misuse 

  • 86% presented with a risk of self-harm 

This is not a marginal cohort — this is the sharp end of vulnerability. 

And yet, the early outcomes are encouraging. Six months after being discussed at the YAP Forum: 

  • 90% were still engaged with appropriate services — 51% with CNWL secondary care, the rest with non-CNWL NHS, GPs, or VCSE partners 

  • Fewer than 7% disengaged 

  • Less than 2% were discharged and re-presented within six months 

  • Only one person presented in crisis 

These figures suggest that when we give young adults tailored, joined-up, co-produced support, we can dramatically reduce crisis presentations and keep engagement high. 

Discovery College: Co-Production, Not Consultation 

At the heart of this approach is Discovery College,  a ground-breaking, co-produced programme of peer-led courses designed by young adults, for young adults. 

It didn’t appear as a pre-packaged toolkit or corporate pilot. It emerged through time, trust, and lived experience. Our Young Adult Ambassadors, a dynamic group aged 16–25, scrutinised models from elsewhere, co-designed every element (from course titles to logos), and even co-delivered early pilots to CNWL staff and peers. 

The courses, from Preparing for University and Making Sense of Senses to Moving on from CAMHS, respond directly to issues that young people say matter most. Their content is not theoretical. It is rooted in lived struggle, collective resilience, and peer insight. 

As one ambassador put it: 

“From the outset, young adult ambassadors have been heavily involved in every aspect of the development, design, content, marketing and delivery of the courses – our lived experience was really able to shine through.” 

Another reflected on the importance of the offer itself: 

“Seeing it grow would be amazing because currently I don’t think there are that many offers out there that are a step down from services or just an alternative. And I think the Discovery College kind of offers that.” 

More Than a Programme — A Culture That Listens 

Discovery College sits at the meeting point of care and education, recovery and prevention. It shows what happens when we stop seeing young adults as “transitioning” and start seeing them as leading. 

For ambassadors, the role has been equally transformative: 

“Being an ambassador helped me overcome anxiety and gave me something meaningful — helping other young people like me.” 

“I’m a change champion with the Young Harrow Foundation — something I heard about through the ambassador group. These opportunities have given me real skills while making a difference.” 

“It’s a space for young people designed by young people — I’ve never felt uncomfortable in a meeting and it’s helped me overcome a lot of my anxiety.” 

These aren’t just warm anecdotes. They point to measurable gains in confidence, skills, and purpose — qualities that feed directly into education, employment, and independence. In many cases, ambassadors and peer workers are moving from receiving services to shaping them, and from shaping them to shaping their own futures.

The System We Should Build 

The NHS has rightly invested in early intervention in psychosis and increased digital access. But for young adults, we need more than clinical levers. We need cultures of belonging. The traditional split between CAMHS and adult services continues to fail this group. 

Our task now is not just to mend a broken transition, but to build services that start from the premise that this is the age that matters most. That means integrating clinical care with peer leadership, education, and community connection. 

As a father to two young children, I feel a personal warmth and encouragement that CNWL’s Discovery College offers a glimpse of that future: inclusive, co-produced, asset-based, and genuinely empowering. It’s not just a college — it’s a signal. When we trust young people not only to shape their own care, but to shape the system itself, we get something better. We get services that feel like they were made for them — because they were.