Search results

This paper provides initial findings from a pilot to introduce graduate mental health workers into primary care, child and adolescent mental health services (CAMHS) across three localities in the north west of England in the UK. The progress of the pilot was monitored by gathering information from students, managers, supervisors and mentors regularly throughout the 12 month period, during which the pilot cohort were being formally trained. The potential of the new role of primary care graduate mental health workers to address problems of volume and access to services, particularly how the role might contribute to developing nonspecialist primary care services, is considered.

Pilot mental health link workers have been working in schools in West Lothian since 2002. This article reports initial findings from semi‐structured interviews with pupil support staff in 11 secondary schools receiving this service. School staff reported an improvement in referral systems for children at the early stages of mental illness, including quicker access to specialist services, and an improvement in their own knowledge and skills. These benefits were associated more strongly with frequency of contact with the mental health link workers than with the physical location of the worker within the school. Link workers with a social work background were more likely than those with a nursing background to be asked to deal with children presenting with behaviour problems.

Primary mental health workers have been based in West Lothian schools since 2003 to act as links between the community and hospital‐based services. The research programme this paper describes aimed to examine how this model worked and its impact for children and their families.

This paper reports on interviews with secondary school staff, the link workers and comparative post‐holders. The research study was qualitative and the research question was “What is the perceived impact of Mental Health Link Workers in West Lothian schools?”.

The paper finds that Primary mental health workers felt that their main contribution was building capacity in the community to support children with mental health problems, and identified four strands to this: space, relationships, skills and containment. Two described direct access for children and their families as the main gain. Secondary school staff considered that the greatest impact was for children at the onset of mental illness, and their own knowledge and skills.

Primary mental health work in the community is fairly new in Scotland. This study suggested that it speeded up and improved access to services for children in need of mental health assessments and services. It was based on temporary contracts and short‐term funding. Sustainability within schools may only take place when the work becomes well resourced.

The paper is a detailed look at the views of Primary Mental Health Workers based in schools and school staff.

It is estimated that approximately 10% of children and young people in Scotland have mental health problems (Scottish Government, 2008), resulting in a rapidly increasing need for child and adolescent mental health services (CAMHS). Primary mental health workers (PMHW) have been identified as one of the key professional groups within a multidisciplinary CAMHS team to progress the agenda of early intervention and identification of mental health problems among children and young people. One discrete aspect of the PMHW role is the facilitation and delivery of consultation services to a wide range of agencies. Consultation, in this context, is understood as a community activity for disseminating knowledge, creating understanding and facilitating non‐CAMH professionals to support children and young people with psychological difficulties (Scottish Executive, 2005). This paper discusses a smallscale study that aims to deconstruct the concept of consultation and explore the professional expertise and service requirements necessary for effective delivery. It concludes that complex and multifaceted skills are required if a consultation is to be meaningful and effective. Consequently, and despite competing discourse, there remains a strong debate for retaining the role of the PMHW, specifically for the delivery of early intervention and health promotion activities, such as consultation. The study took place in Scotland, but UK‐wide data is drawn on to provide a more comprehensive picture.

The role of the primary mental health worker (PMHW) is relatively new within child and adolescent mental health services (CAMHS). Different organisational structures have emerged and it is important to study the advantages and disadvantages associated with different PMHW practice models. The current study uses a large, representative sample of PMHWs and operationalises practice models according to the PMHWs' self‐reported location and team alignment thus identifying three models (namely CAMHS outreach, primary care based, and dedicated PMHW team). Comparisons between the models are made in relation to organisation and management, inter‐agency links, and job satisfaction with the aim of exploring the strengths and weaknesses of each model. The results suggest that each model meets the aims of the role and there is greater similarity than dissimilarity between models. However, it also indicates that attention should be paid to improving the working environments and training and development opportunities for all PMHWs irrespective of model, but with particular consideration given to improving the support available to PMHWs working in primary care based models.

The current focus on psychological well‐being and the treatment of people experiencing common mental disorder in primary care is of interest to health professionals and economists alike (Centre for Economic Performance Mental Health Policy Group, 2006). This brings with it an important opportunity to consider how services for people living with long term medical conditions may benefit from developments in widening access to psychological therapies. The National Service Framework for Longterm Conditions (DoH, 2005a) aims to improve the quality of life for people living with chronic medical conditions. Further to this, NICE Guidelines for the Management of Chronic Obstructive Pulmonary Disease (COPD) (NICE, 2004a) specifically focuses attention on quality of life issues for COPD sufferers and the influence of co‐morbid mental disorder on the ability of individuals to optimise selfmanagement of their condition. By examining issues relating to co‐morbidity of common mental disorders within the long‐term condition of COPD this paper concerns itself with how the agenda for widening access to psychological therapies delivered through a stepped model of care and the introduction of new mental health workforce roles such as community matrons, case managers and primary care graduate mental health workers (PCGMHWs) provides an opportunity for primary care services to integrate mental health care into chronic disease management for COPD, which in turn may provide a model for the development of services for other long‐term medical conditions.

There is an increasing emphasis on strengthening links between the primary and specialist services in order to provide more effective care for patients. The aim of this paper is to focus on a study to engage frontline, secondary care clinicians in a process of reflection on the role of link workers and to identify their view of priorities.

The paper adopts a mixed method study involving focus groups (qualitative method with deductive approach) followed by a survey (quantitative method with an interpretative approach).

The essential role of link workers in managing clinical throughput/flow and improving communication with general practitioners is highlighted. In contrast, crisis intervention and relapse prevention were identified to be of least importance, probably indicating the role of crisis teams and community teams in fulfilling these functions, respectively.

It has become apparent through this evaluation that there may be a need to strike a balance between the emphasis upon greater integration of this role with community mental health teams and closer collaboration with general practitioners.

The study is part of a service evaluation undertaken with a view to evaluating the role of link workers.

Universal workers, or Tier 1 workers, as the CAMHS service structure suggests they are called, are in excellent positions to influence the mental health of children and young people. Many government policies and guidance suggest that Tier 1 workers have a part to play in promoting mental health, early identification of problems and offering general advice about being mentally healthy. To fulfil these roles these workers need to learn about children's mental health and their roles within this field. A CD‐rom trainer's package was developed to help trainers deliver this type of training, which was later converted into an e‐learning package. The implications of developing e‐learning are considered.

This article aims to demonstrate a different approach to identify and assess adolescents experiencing mental health problems, within a school setting. Presently we rely on primary care professionals to identify mental health problems and adolescents are often reluctant to access such services. One of the benefits of utilising a mental health surveillance screening tool is to identify mental health problems in adolescents and to implement early intervention.

A cross‐sectional survey of school pupils from a secondary school was conducted, using the Paediatric Symptom Checklist for Youths (PSCY). The self‐administered questionnaire was completed and identified adolescents were then assessed by the Child and Adolescent Mental Health Services (CAMHS). Out of 247 pupils, 84 per cent of the adolescents completed the questionnaire.

From the screening tool, 25 per cent were identified for assessment. During their assessment 64 per cent of the young people were given self‐help guides and health promotion advice. The remaining 26 per cent of the adolescents were provided treatment sessions by CAMHS or by Children's Service Worker. Only 10 per cent of these adolescents had been previously seen within the CAMHS.

The PSCY is a useful tool for identifying and assessing adolescents with mental health problems. However, these results are the preliminary findings of a feasibility study. This subject area is a rich source for future research.

Findings from this project will influence wider mental health surveillance of our adolescent population.

This approach will also influence future service provision, for such a vulnerable population.

No comparative studies of this nature were found in the United Kingdom.

The European Union‐supported Child and Adolescent Mental Health in an Enlarged Europe (CAMHEE) project aimed to provide an overview of the challenges, current practice and guidelines for developing effective mental health promotion and mental illness prevention policy and practice across Europe. As part of this work, an analysis was undertaken of the situation in England, making use of a bespoke data collection instrument and protocol.Our analysis suggests that there has been significant effort and investment in research, needs assessment, policy, human resource and service developments in CAMHS over the last 20 years, leading to a more detailed understanding and availability of services. Much of the emphasis has been on assessment and management of difficulties, however in recent years attention has begun to focus on mental health promotion. National standards and programmes such as Every Child Matters (Department for Education and Skills, 2004) have acted as catalysts for a number of national initiatives.