scholarly journals WARRN – a formulation-based risk assessment procedure for Child and Adolescent Mental Health Services (CAMHS): the view of clinicians

2019 ◽  
Vol 21 (4) ◽  
pp. 228-239 ◽  
Author(s):  
Nicola S. Gray ◽  
Jacqui Tiller ◽  
Robert J. Snowden
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Well Being ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Research Network ◽  
Assessment Procedure ◽  
Evaluation Instrument ◽  
Content Type

Purpose Wales Applied Risk Research Network (WARRN) is a formulation-based technique for the assessment and management of serious risk (e.g. violence to others, suicide, etc.) for users of mental health services which has been adopted across most Child and Adolescent Mental Health Services (CAMHS) across Wales. The paper aims to discuss this issue. Design/methodology/approach An online survey was disseminated to National Health Service clinicians in CAMHS to evaluate their perceptions of the use and effectiveness of WARRN. Data from 88 clinicians were analysed with both quantitative and qualitative methods. Findings Clinicians reported increased clinical skills, increased confidence in their assessment and management of risk and in safety planning, the increased safety of service users and the general public, and a belief that WARRN had saved lives. The qualitative data showed that clinicians thought a common risk evaluation instrument across Wales and different agencies had created a common language and understanding that improved communication. Practical implications WARRN appears well accepted in CAMHS services with the view that it is having a very positive effect on service user well-being and safety and could be implemented in other services. Originality/value This is the first report of a formulation-based approach to the management of serious problem behaviours in CAMHS services.

scholarly journals Mentally disordered young offenders in transition from child and adolescent to adult mental health services across England and Wales

2017 ◽  
Vol 19 (4) ◽  
pp. 301-308 ◽  
Author(s):  
Maria I. Livanou ◽  
Vivek Furtado ◽  
Swaran P. Singh
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Young Offenders ◽  
England And Wales ◽  
Content Type ◽  
Health And Wellbeing ◽  
The Impact

Purpose This paper provides an overview of transitions across forensic child and adolescent mental health services in England and Wales. The purpose of this paper is to delineate the national secure services system for young people in contact with the youth justice system. Design/methodology/approach This paper reviews findings from the existing literature of transitions across forensic child and adolescent mental health services, drawing attention to present facilitators and barriers to optimal transition. The authors examine the infrastructure of current services and highlight gaps between child and adult service continuity and evaluate the impact of poor transitions on young offenders’ mental health and wellbeing. Findings Young offenders experience a broad range of difficulties, from the multiple interfaces with the legal system, untreated mental health problems, and poor transition to adult services. Barriers such as long waiting lists, lack of coordination between services and lack of transition preparation impede significantly smooth transitions. Research limitations/implications The authors need to develop, test and evaluate models of transitional care that improve mental health and wellbeing of this group. Practical implications Mapping young offenders’ care pathway will help to understand their needs and also to impact current policy and practice. Key workers in forensic services should facilitate the transition process by developing sustainable relationships with the young person and creating a safe clinical environment. Originality/value Transition of care from forensic child and adolescent mental health services is a neglected area. This paper attempts to highlight the nature and magnitude of the problems at the transition interface in a forensic context.

scholarly journals Delphi study to identify key features of community-based child and adolescent mental health services in the East of England

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e022936 ◽  
Author(s):  
Emma Howarth ◽  
Maris Vainre ◽  
Ayla Humphrey ◽  
Chiara Lombardo ◽  
Ainul Nadhirah Hanafiah ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Delphi Study ◽  
Well Being ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Eastern Region ◽  
Community Based ◽  
The Public

ObjectiveTo identify priorities for the delivery of community-based Child and Adolescent Mental health Services (CAMHS).Design(1) Qualitative methods to gather public and professional opinions regarding the key principles and components of effective service delivery. (2) Two-round, two-panel adapted Delphi study. The Delphi method was adapted so professionals received additional feedback about the public panel scores. Descriptive statistics were computed. Items rated 8–10 on a scale of importance by ≥80% of both panels were identified as shared priorities.SettingEastern region of England.Participants(1) 53 members of the public; 95 professionals from the children’s workforce. (2) Two panels. Public panel: round 1,n=23; round 2,n=16. Professional panel: round 1,n=44; round 2,n=33.Results51 items met the criterion for between group consensus. Thematic grouping of these items revealed three key findings: the perceived importance of schools in mental health promotion and prevention of mental illness; an emphasis onhowspecialist mental health services are delivered rather thanwhatis delivered (ie, specific treatments/programmes), and the need to monitor and evaluate service impact against shared outcomes that reflect well-being and function, in addition to the mere absence of mental health symptoms or disorders.ConclusionsAreas of consensus represent shared priorities for service provision in the East of England. These findings help to operationalise high level plans for service transformation in line with the goals and needs of those using and working in the local system and may be particularly useful for identifying gaps in ongoing transformation efforts. More broadly, the method used here offers a blueprint that could be replicated by other areas to support the ongoing transformation of CAMHS.

scholarly journals Burnout in consultants in child and adolescent mental health services (CAMHS) in Ireland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e030354 ◽  
Author(s):  
Fiona McNicholas ◽  
Sonita Sharma ◽  
Cliodhna Oconnor ◽  
Elizabeth Barrett
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Child Psychiatry ◽  
Well Being ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Medical Council ◽  
Cross Sectional ◽  
Child Psychiatrists

Physician burnout has reached epidemic levels in many countries, contributing to adverse personal, patient and service outcomes. Adverse socioeconomic conditions, such as the economic downturn in the Ireland post 2008, contribute to a situation of increased demand but inadequate resources. Given a recent unprecedented increase in referrals to Irish child and adolescent mental health services (CAMHS), coupled with a fragmented and poorly resourced service, it is important to reflect on consultant child psychiatrists’ well-being.ObjectivesTo report on the level of burnout among consultants working in CAMHS in Ireland using a cross-sectional design.SettingCommunity CAMHS in Ireland.ParticipantsAn online questionnaire was sent to all consultant child psychiatrists registered with the Irish Medical Council (n=112). Fifty-two consultants replied (46% response rate).Primary outcome measuresQuestions assessed demographic and occupational details, career satisfaction and perceived management, government and public support. The Copenhagen Burnout Inventory measured personal, work and patient-related burnout.ResultsThe prevalence of moderate or higher levels of work-related and personal burnout was 75% and 72.3%, respectively. Fewer (n=14, 26.9%) experienced patient-related burnout. There was a strong correlation between work burnout and personal (r=0.851, n=52, p<0.001) and patient-related burnout (r=0.476, n=52, p<0.001). Lack of confidence in government commitment to investment in CAMHS (p<0.001) and perceived ineffective management by health authorities (p=0.002) were associated with higher burnout scores. Few consultants (n=11, 21%) felt valued in their job. The majority (n=36, 69%) had seriously considered changing jobs, and this was positively associated with higher burnout (p<0.001). Higher burnout scores were present in those (n=15, 28.8%) who would not retrain in child psychiatry (p=0.002).ConclusionThe high level of burnout reported by respondents in this study, and ambivalence about child psychiatry as a career choice has huge professional and service implications. Urgent organisational intervention to support consultant psychiatrists’ well-being is required.

Supporting transitions in child and adolescent mental health services: a rough guide to introducing peer support

2014 ◽  
Vol 9 (4) ◽  
pp. 222-231 ◽  
Author(s):  
Marissa Lambert ◽  
Rachael Matharoo ◽  
Emma Watson ◽  
Helen Oldknow
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Peer Support ◽  
Pilot Project ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Support Worker ◽  
Content Type

Purpose – The purpose of this paper is to share the lessons learnt during the implementation of a Peer Support Worker (PSW) pilot project within Child and Adolescent Mental Health Services (CAMHS). The project aimed to reduce the barriers experienced by young people and carers during the process of transition between child and Adult Mental Health Services (AMHS). Design/methodology/approach – The paper combines reflections of staff, PSWs and trainers in order to share the lessons that may be taken from this project. This includes a rough guide for those hoping to employ PSWs to support transitions. Findings – The PSWs provided the vehicle to support the process of transition by empowering young people and their carers to use their strengths to facilitate a hopeful and timely transition. Recommendations regarding support for peers, staff and the organisation during the process of training and employing peers are discussed. Research limitations/implications – The paper provides a purely reflective account of the pilot project. These reflections may provide guidance for others wishing to develop peer support positions within CAMHS so that an evidence base for the effectiveness of peer support within transitions may continue to grow. Originality/value – Rotherham Doncaster and South Humber NHS Foundation Trust are the first NHS Trust in the UK to employ PSWs specifically to support transitions between CAMHS and AMHS. This paper builds on the work of Oldknow et al. (2014) to highlight the first attempts to use peer support to support transitions.

Making sense of child and adolescent mental health services (CAMHS): An audit of the referral journey and the use of routine outcome measures (ROMS)

2021 ◽  
pp. 135910452199970
Author(s):  
Naomi Gibbons ◽  
Emma Harrison ◽  
Paul Stallard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measures ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Completion Rates ◽  
Making Sense ◽  
North East ◽  
Over Time

Background: There is increased emphasis on the national reporting of Routine Outcome Measures (ROMS) as a way of improving Child and Adolescent Mental Health Services (CAMHS). This data needs to be viewed in context so that reasons for outcome completion rates are understood and monitored over time. Method: We undertook an in-depth prospective audit of consecutive referrals accepted into the Bath and North East Somerset, Swindon and Wiltshire (BSW) CAMHS service from November 2017 to January 2018 ( n = 1074) and April to September 2019 ( n = 1172). Results: Across both audits 90% of those offered an appointment were seen with three quarters completing baseline ROMS. One in three were not seen again with around 30% still being open to the service at the end of each audit. Of those closed to the service, paired ROMS were obtained for 46% to 60% of cases. There were few changes in referral problems or complexity factors over time. Conclusion: Understanding the referral journey and the reasons for attrition will help to put nationally collected data in context and can inform and monitor service transformation over time.

scholarly journals Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024230 ◽  
Author(s):  
Stephen Rocks ◽  
Melissa Stepney ◽  
Margaret Glogowska ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Resource Utilisation ◽  
South East England ◽  
The Impact

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

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