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1 – 10 of 499Laura Jane Wintour and Trish Joscelyne
Child and adolescent mental health services (CAMHS) has been described as “in crisis” and “not fit for purpose”. CAMHS services have undergone a multitude of changes, including…
Abstract
Purpose
Child and adolescent mental health services (CAMHS) has been described as “in crisis” and “not fit for purpose”. CAMHS services have undergone a multitude of changes, including policy initiatives, recent growth in demand, decreases in resources and increased pressure. This study aims to explore the experiences of clinical psychologists (CPs) working in CAMHS, leaving CAMHS and working independently with children and families.
Design/methodology/approach
A qualitative design with semi-structured interviews of ten participants was used. Interviews were analysed using interpretative phenomenological analysis.
Findings
Results are represented within 5 themes and 14 sub-themes. Participants felt that over time there had been undesirable changes in CAMHS, which left them reminiscing about the past. Participants felt unable to do their job in CAMHS, meet the needs of children and young people and use their psychology skills. Participants emphasised the importance of colleagues and being part of an multidisciplinary team, which had been missed since working independently, but they also highlighted difficult relationships with managers. Participants felt that working at CAMHS had negatively impacted their emotional and physical well-being and their family life. In contrast, participants felt that working independently meant they could do the job they had wanted to be doing as a CP and had a better work–life balance.
Originality/value
This study had implications for services, where it would be beneficial for the experiences of CPs to be considered in relation to current practice with the view of improving the experiences of staff. Future research would benefit from exploring the experiences of CAMHS staff further.
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The National Workforce Programme (DoH, 2004a), supported by the National Child and Adolescent Mental Health Service Workforce sub‐group, commissioned a project to look at New Ways…
Abstract
The National Workforce Programme (DoH, 2004a), supported by the National Child and Adolescent Mental Health Service Workforce sub‐group, commissioned a project to look at New Ways of Working (NWW) in Child and Adolescent Mental Health Service (CAMHS). This article provides an overview of the NWW CAMHS project using two of the 10 early implementer sites as examples. General lessons from the project are explored.
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Emily Staite, Lynne Howey, Clare Anderson and Paula Maddison
Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the…
Abstract
Purpose
Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the current global pandemic. There is mixed evidence for the effectiveness of crisis teams in improving adult functioning, and none, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from child and adolescent mental health services (CAMHS) crisis teams in the UK. Therefore, the purpose of this paper is to use CAMHS Crisis Team data, from an NHS trust that supports 1.4 million people in the North East of England, to examine a young person's functioning following a crisis.
Design/methodology/approach
This service evaluation compared functioning, as measured by the Outcome Rating Scale (ORS), pre- and post-treatment for young people accessing the CAMHS Crisis Team between December 2018 and December 2019.
Findings
There were 109 participants included in the analysis. ORS scores were significantly higher at the end of treatment (t(108) = −4.2046, p < 0.001) with a small effect size (d = −0.36). Sixteen (15%) patients exhibited significant and reliable change (i.e. functioning improved). A further four (4%) patients exhibited no change (i.e. functioning did not deteriorate despite being in crisis). No patients significantly deteriorated in functioning after accessing the crisis service.
Practical implications
Despite a possibly overly conservative analysis, 15% of patients not only significantly improved functioning but were able to return to a “healthy” level of functioning after a mental health crisis following intervention from a CAMHS Crisis Team. Intervention(s) from a CAMHS Crisis Team are also stabilising as some young people’s functioning did not deteriorate following a mental health crisis. However, improvements also need to be made to increase the number of patients whose functioning did not significantly improve following intervention from a CAMHS Crisis Team.
Originality/value
This paper evaluates a young person’s functioning following a mental health crisis and intervention from a CAMHS Crisis Team in the North East of England.
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This paper provides an overview of the national child and adolescent mental health service (CAMHS) mapping exercise, the workforce data reported in the mapping between 2003 and…
Abstract
This paper provides an overview of the national child and adolescent mental health service (CAMHS) mapping exercise, the workforce data reported in the mapping between 2003 and 2006, and how this data relates to current policy. The paper will first outline key issues within current CAMHS workforce policy and provide an introduction to the mapping process itself in order to establish the context in which the findings from the mapping exercises are being presented. The mapping is carried out by Durham University on behalf of the Department of Health. Core trend data is provided on the growth and development of the specialist CAMHS.
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Yvonne Anderson and Barry Nixon
This article will provide an overview of the national child and adolescent mental health service (CAMHS) workforce planning programme 2006‐7, which used early implementer sites in…
Abstract
This article will provide an overview of the national child and adolescent mental health service (CAMHS) workforce planning programme 2006‐7, which used early implementer sites in each of the eight English regions to produce a specialist CAMHS workforce plan and explores the potential transferable learning from the CAMHS experience to workforce planning across a range of other settings.
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Barry Nixon, Sue Hooton and Ann Jones
Targets set in 2005 by the Department of Health in the form of a public service agreement (PSA, 2003‐2006) standard require the development of comprehensive CAMHS, which provide…
Abstract
Targets set in 2005 by the Department of Health in the form of a public service agreement (PSA, 2003‐2006) standard require the development of comprehensive CAMHS, which provide services for children and young people with learning disabilities (LD). This standard presents particular challenges to the existing national CAMHS workforce.This paper reports on a specific project to undertake a northwest regional audit regarding capacity and capability of staff working in CAMHS to care for children and young people with learning disabilities.
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Ruth Edwards, Richard Williams, Nisha Dogra, Michelle O'Reilly and Panos Vostanis
Specialist CAMHS provide skilled assessment and interventions for children, young people and their families who have mental health disorders. The training needs of the staff who…
Abstract
Specialist CAMHS provide skilled assessment and interventions for children, young people and their families who have mental health disorders. The training needs of the staff who work in specialist CAMHS are not always clear or prioritised, due to the complexities and differing contexts in which specialist CAMHS are provided. The aim of this paper was to establish stakeholders' experiences of service complexities and challenges that affect training within specialist CAMHS. The project employed interviews to gain wide‐ranging consultation with key stakeholder groups. The sample consisted of 45 participants recruited from policy departments, professional bodies, higher education providers, commissioners, service managers, and practitioners. The participants identified a number of themes that limit training, and put forward solutions on how these could be facilitated in the future. Emerging themes related to leadership and the role of service managers, strategic management of training, commissioning, levels of staff training, resources, impact of training on service users, and availability of training programmes. The findings emphasise the need for the strategic workforce planning of training to meet service delivery goals. Policy, commissioning, workforce training strategies, service needs, and delivery of training should be integrated and closely linked.
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Tim Morris, Yvonne Anderson and Barry Nixon
This paper focuses on the policy context that led to the development of the New Ways of Working in child and adolescent mental health services (NWW CAMHS) project and the future…
Abstract
This paper focuses on the policy context that led to the development of the New Ways of Working in child and adolescent mental health services (NWW CAMHS) project and the future direction of change that is its legacy. NWW CAMHS represents a merging of policy and practice across what is sometimes a divide between adult and child services. In some aspects, CAMHS had already adopted what became known as a NWW in adult mental health with multidisciplinary teams characterised by dispersed patterns of responsibility and leadership. In other areas, particularly the involvement of service users and carers, CAMHS has been less forward‐thinking. There continues to be a significant workforce challenge for children's services and a risk that innovation and development will not be fully inclusive of the full range of service users' needs. It is important that the lessons learned from the national workforce programme are kept while the usual boundaries to development across services are broken down.
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Scott Wilson, Julie Metcalfe and Stephen McLeod
The purpose of this paper is to compare NHS Greater Glasgow and Clyde (NHSGGC) Child and Adolescent Mental Health Service (CAMHS) activity data over a one-year period to the…
Abstract
Purpose
The purpose of this paper is to compare NHS Greater Glasgow and Clyde (NHSGGC) Child and Adolescent Mental Health Service (CAMHS) activity data over a one-year period to the Choice and Partnership Approach (CAPA) demand and capacity model assumptions, providing an evaluation of CAPA model implementation and its effects on actual demand and capacity of the service.
Design/methodology/approach
Three assumptions within the CAPA model are tested against activity data extracted from the patient management system. Analysis by patient record assesses the number of appointments the patients received and the patients’ journey from assessment to treatment. A combination of community CAMHS data are combined to compare actual activity against assumed capacity required to meet demand according to the CAPA model.
Findings
Tested against an audit of 2,896 patient records, CAMHS average 7.76 core appointments per patient compared to the CAPA assumption of 7.5 appointments at a 0 per cent DNA rate. The second CAPA assumption states that 66 per cent of assessments will result in treatment, compared to 73.55 per cent in NHSGGC CAMHS. Finally, the workforce model in CAMHS has clinical capacity to meet demand according to the CAPA assumption of weekly accepted referral rates not exceeding the number of clinical whole time equivalent.
Originality/value
The data allow for identification of inefficiencies within CAMHS and highlights how capacity can be increased, without increasing budgets, to meet a rising clinical demand. The results allow managers and clinicians to improve job planning to ensure more children and young people have quick access to services.
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