A Day in the Life of CAMHS

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The Child and Adolescent Mental Health Service
(CAMHS)/Primary Mental Health Service Kirklees
WHO ARE WE AND WHAT DO WE DO?
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What is CAMHS?

• CAMHS provides a comprehensive resource for
  children, young people, and their families (up to
  their 17th birthday) who are experiencing
  emotional, behavioural and other psychological
  difficulties
• The service is staffed by a multi-disciplinary
  team including child psychiatrists, clinical
  psychologists, clinical nurse specialists,
  primary mental health workers and a variety of
  other professionals

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Referral Routes Into CAMHS

• GPs
• Medical staff (e.g. Paediatricians)
• Social Services
• Education staff

• Health Visitors
• School Nurses
• Youth Offending Team

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Referral Criteria

• CAMHS will accept a referral of any child or
  young person where the disturbance of their
  emotional and psychological well-being
  substantially impacts on their lives to such an
  extent that they require specialist mental health
  services. At present Dewsbury and Huddersfield
  CAMHS accept referrals of children and young
  people up to their 17th birthday.
• Following discussion with carer child referrals
  have to be made in writing and if urgent
  preferably following telephone discussion

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Range of Referrals Seen by CAMHS

• Children presenting with
• Emotional difficulties (e.g anxiety, low mood,
  phobias)
• Behavioural difficulties
• Pervasive Developmental Disorders (e.g. Autism)
• Difficulties in relating to peers
• School refusal
• Psychosomatic problems
• Eating difficulties
• Deliberate self- harm
• Bereavement
• Psychosis

• Parental concerns about
• Childs development
• Relationships in family
• Behaviour of their child
• Childs emotional state
• Agencies concerns about
• Parenting skills
• Abusive family relationships
• Child protection issues
• Legal proceedings

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What Makes a Good Referral?

• Background Info
• Name, consent of person with PR, date of birth,
  gender, GPs name, home address, name and address
  of parents if different, ethnic background,
  language spoken, family structure, fostered or
  other substitute care, school and frequency of
  attendance, statement or school action, behaviour
  at school, social service involvement, legal
  proceedings, other agencies involved

• Relevant Issues
• What are the areas of concern / difficulty that
  require specialist input? Does the family and/or
  young person want to be referred?
• Onset, duration, frequency, getting worse or
  stable etc, whats been tried so far and by whom,
  medical issues, family functioning, social
  relationships, support structures.
• Illustrates a clear link between the reported
  difficulties and the need for specialist CAMHS.

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What We Do With Referrals?

• Urgent -
• Acute psychosis
• Serious suicide risk
• Admission to hospital following deliberate
  self-harm
• Priority
• Significant, persistent low mood
• Evidence of possible onset of an eating disorder
• Severe, enduring emotional and/or behavioural
  difficulties which are having a significant
  impact on individual/family functioning
• Routine
• all others meeting referral criteria

• Discussed at weekly team meeting.
• Referrals are allocated on the basis of
  urgency-.
• Urgent within 1 working day.
• Priority within 6 weeks.
• Routine when reaching the top of the waiting
  list (target 13 weeks).

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What Do CAMHS Do?

• Assessments.
• Interventions with the young person and/or carers
  and family, using a variety of therapeutic
  models.
• Group interventions (e.g. parent groups, anxiety
  groups).
• Pharmacological interventions. .
• Joint working with other involved professions.

• Consultation
• Supervision
• Teaching / training / education
• Research
• Audit
• CPD

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NSF Children, Young People, and Maternity
Services ( Standard 9 )

• All staff working directly with children and
  young people have sufficient knowledge, training
  and support to promote the psychological
  well-being of children, young people and their
  families and to identify early indicators of
  difficulty
• There is increasing evidence of the effectiveness
  of interventions to improve children's
  resilience, promote mental health and treat
  mental health problems
• Numbers of children with less serious mental
  health problems will need some help. In most
  cases, this will be provided by services in
  primary health care, social care, education and
  the voluntary sector

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Cont

• It is important to remember that supporting
  children and young people is not just the
  responsibility of specialist CAMHS. In many
  cases, the intervention that makes a difference
  will come from another service. Partnership
  working is an essential requirement of high
  quality service provision
• CAMHS Workers for Primary Care (Primary Mental
  Health Workers) are a key resource for work in
  the interface between specialist CAMHS and Tier
  1, to support staff in primary health care,
  education, social services and other agencies in
  ensuring early intervention and promoting good
  mental health.

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Primary Mental Health ServiceVision Statement

• To promote the emotional and psychological
  well-being of all children and young people
  within Kirklees

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Role of the Primary Mental Health Worker within
CAMHS

• PMHW role is a result of Together We Stand
  report (HAS, 1995) which identified
• A gap in the interface between Tiers 1 and 2/3
  resulting in duplication of work, fragmentation
  of services and limited access for vulnerable
  groups of the population
• Front-line professionals frequently encounter
  children who may be experiencing mental health
  problems
• Uncertainty about what constitutes appropriate
  referral to CAMHS

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• Primary Mental Health Team
• Who are we?
• Paul Tipper
• Lead for PMHW
• Linda Moon
• Senior PMHW (Kirklees)

Louise Todd Nina Hodgson Richard Shaw Lindsey
Bates Lorraine Perry
North Kirklees South Kirklees
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Primary Mental Health TeamA Multi skilled Team!

• Specialist skills/experience
• Registered Mental Health Nurses
• Registered Childrens Nurses
• Youth Workers
• Learning Mentors
• School Nurses

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Definition of 4 tier Model of Service
4 tier model of provision for Child and
Adolescent Mental Health
Tier 4
Specialist Units
Tier 3
Specialist Teams
Child Mental Health Professionals working in
isolation
Tier 2
Tier 1
Professionals not primarily employed to deal with
child mental health
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Objectives

• To increase professionals understanding of
  emotional and psychological well-being of
  children and young people
• To up skill and empower tier 1 professionals
• To be an accessible point of contact to offer
  advice, consultation and support to tier one
  professionals

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Cont

• To ensure children/young people, parents and
  carers access appropriate services by use of
  signposting
• To offer brief interventions for cases considered
  appropriate for PMHW either alone or jointly with
  tier one professionals
• To look at promoting positive mental health, de-
  stigmatising CAMHS and allaying fears of service
  users and professionals
• To ensure tier 3 receive appropriate referrals

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Primary Mental Health
Education Training We provide a broad range of
training initiatives development opportunities
relating to camhs. We are happy to discuss your
individual/organisation needs and provide bespoke
packages
Consultation We provide consultation/advice with
the support of core camhs, to agencies about the
service and individual concerns. Both formally
and informally
Joint working Via the process of consultation and
with consent from the family, a PMHW may work
with you on an individual case basis. Providing
advice guidance around appropriate strategies
or offer intervention on a short term basis
Parenting We can provide information about
parenting initiative and availability. We also
offer advice support with the help of the
Kirklees parenting forum
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No Further Action
Record Outcome
Support Professionals in working with
Child/Family or Joint Work as Appropriate
Consultation with Referrer
If More Work Needed
Written
Referral to PMHW
Joint Assessment
Refer to core CAMHS Team
Oral/Phone
Advice/Support Given
Record Outcome
Primary Mental Health Worker Pathway
No Further Action
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• CHILD MENTAL HEALTH IS EVERYBODYS BUSINESS !

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Contact Details

• Dewsbury Team 01924 512011
• CAMHS
• Dewsbury and District Hospital
• Halifax Road
• Dewsbury
• WF13 4HS
• Huddersfield Team 01484 342141
• Glen Acre House Child and Family Service
• 21 Acre House Avenue
• Lindley
• Huddersfield HD3 3BB