Child and Adolescent Mental Health Services
News and updates from today’s conference chaired by Paul Scates, Senior Peer Specialist, Campaigner and Ambassador.
Transforming mental health services for children and young adults
Sarah Brennan, Chief Executive, YoungMinds
Transition from children’s to adults’ services for young people using health or social care services: Implementing the 2016 Guideline
Prof Swaran Singh, Chair, Transition from children’s to adult services Guideline Committee, NICE, and Professor of Social and Community Psychiatry, Warwick Medical School
NICE Guidance available here.
The interface between child and adult mental health care has long been considered an impediment to continuity of care. Transition between these services has often been described as a problem, but till recently there was little evidence on the nature, magnitude and the consequences of the process and outcomes of good and poor transition.
The UK based TRACK project was a multisite, mixed-methods, multicomponent series of studies that explored policy, practice, outcome and experience of transition in an epidemiologically defined cohort of young people who had reached the transition boundary of their Child and Adolescent Mental Health Service (CAMHS). The findings were deeply disturbing. Many services had no clear policies; if policies existed, there was a policy-practice gap; young people felt inadequately prepared for transition; many simply dropped through the care gap; and those who made a transition experienced poor care. TRACK findings led to a serious policy rethink at the Department of Health UK. The findings also generated international attention and concern, with transition-related research reported from Europe, Canada, Australia and USA. In March 2016 NICE produced the first ever clinical guidelines for transition from child to adult care.
This lecture will summarise NICE Guidelines on transtions from child to adult caredescribe transition-related policies across Europe, report on novel youth pathways in England that are trying to overcome transition-related problems; and report emerging findings from the MILESTONE project, an EU funded eight country European project that is tested an innovative model of managed transition. It will also explore areas of uncertainty and lack of evidence in transition in the context of adolescent developmental transition.
The Green Paper and models for delivering CAMHS in schools
Dr Sally Hodges, Director of Child, Young Adults and Families, The Tavistock and Portman NHS Foundation Trust
Pre-Event Abstract: Tavistock CAMHS in Camden Schools
NHS CAMHS clinicians have been working in 55 of Camden’s schools since 2011. The area is cultural and economically diverse. Children from some of the most deprived families in Britain live in this area. The service is free to all primary, secondary and special schools and is funded by the local authority. Some schools have opted to purchase additional support.
Clinicians are based in secondary schools up to one day a week, in primary schools one day a month, and in special schools two or more days a week.
All clinicians working in our schools are active and senior members of our two multidisciplinary CAMHS teams. They have both generic and specialist skills and are encouraged to work in partnership with each school’s mental health lead to develop the bespoke service that they need.
What do they do?
Take and work with referrals through meeting with children and their families and school staff. This might include offering on site assessment or therapy with families or young people, consultation with school staff, liaison with other involved agencies such as social care or enlisting further specialist help from CAMHS, e.g. psychiatric or psychological assessment.
Up to 40% of CAMHS referrals come through our schools. There is no significant waiting list for this service.
A recent audit of the service suggested high levels of satisfaction from school staff. This was related to the easier access for hard to engage families to mental health services that CAMHS in schools provide and also the help with liaison with other services. Schools also appreciated the regular support through consultation and ‘working alongside’ with school staff that clinicians were able to offer. It is important to remember that teachers interact and work with children and their families with mental health needs on a daily basis and deserve increased support.
CAMHS clinicians offer training to staff and students and also parents in Camden’s schools on mental health themes and the promotion of well being: for instance through inset day training or regular reflective sessions with staff. We have found that capacity building is helpfully promoted through the service itself which seeks to model and encourage reflective thinking in school communities and working in partnership with school staff though regular interaction with their CAMHS clinician.
Camden CAMHS is one of the most generously funded Services in Britain. Our service in schools is costly as its hallmark is the employment of senior mental health clinicians to work regularly in the community which we see as more demanding than work in clinic.
We are in central London and all of our schools are more easily accessible from our clinical base than in other parts of the country. The audit suggested that schools that were closer to the Tavistock received a more flexible service than others further away.
Young Adults Perspectives
James Downs, Young Adult with Lived Experience
Pre-Event Abstract: Transforming Mental Health Services for Children and Young Adults: Perspectives from Lived Experience
James's personal account, whilst only reflecting the story of one individual, will aim to illustrate broader concerns about mental health services for children and young people, with an emphasis on the lessons that can be learnt to ensure everyone gets the timely and appropriate support they need when experiencing mental health problems. Themes to be covered include:
• The importance of early intervention, spotting the signs and the shared responsibility we have for detecting mental heath problems
• Responses to distress and unmet needs - fundamental principles of validation, compassion and the therapeutic relationship
• Maximising the utility of guidelines, diagnoses and the evidence base to support individual need
• Childhood and adolescence as a time of opportunity, instilling the skills needed for psychological resilience/coping with life
• Preventative measures and holistic approaches to the maintenance of wellbeing
Young People’s Community Eating Disorder Service
Dr Sandeep Ranote, Consultant Child & Adolescent Psychiatrist, Director of Clinical Networks, North West Boroughs Healthcare NHS Foundation Trust, and GM CAMHS Clinical Lead, NHSE & GMHSC Partnership
Revolution means change when it is desperately needed & it only takes small things to motivate us to join together , overcome adversity and rise up to fulfil our potential. GM pioneered our industrial revolution and we believe it can now pioneer our healthcare revolution. Dr Ranote will provide an insight into how this is being created in Children's mental health , starting with eating disorder services, moving away from a culture of illness to one of wellness as we work together to build a conurbation where our children do not just survive - they thrive!
Full PowerPoint Presentation
Future events of interest:
Masterclass: Assessment, Diagnosis, Treatment & Management of Eating Disorders
Preventing Suicide in Young People & Children
Implementing the NICE Quality Standard for Eating Disorders
Masterclass: Expert Assessment Skills for the Family Court
26 February 2018