Dr Aileen Blower
Consultant Child & Adolescent Psychiatrist
Grampian & Forensic Network, Aberdeen Oct 12
Recommended NHS provision for
Mentally Disordered YO’s
Regional medium & low
secure inpatient units
Community Forensic
CAMHS
In-reach into YOI’s &
secure schools
Youth Offending Teams
& clinician
Grampian & Forensic Network, Aberdeen Oct 12
Provision
for young
offenders
•
HM YOI
Polmont
• Secure
schools
• Youth
Justice
Grampian & Forensic Network, Aberdeen Oct 12
Provision for
Mentally
Disordered
Young
Offenders
• Regional
YPU’s x3
• Generic
CAMHS
• (Forensic
CAMHS –
GG&C)
Grampian & Forensic Network, Aberdeen Oct 12
NHS GG&C service redesign
for MDYO’s
Regional (open generic) & English (secure)
Inpatient services
Forensic CAMHS “Hub”
(psychologist & psychiatrist)
8 x Locality CAMHS
+ 2 Forensic practitioners
Therapeutic Foster Care
Multi-systemic Therapy
Parenting Interventions
Youth Justice & secure schools
+ 1 Forensic practitioner
Grampian & Forensic Network, Aberdeen Oct 12
FCAMHS Referral criteria
 age 8 – 18y (mean 15y, boys > girls)
 Resident within Greater Glasgow & Clyde
 Inpatient within national child or regional
adolescent unit
 serious mental disorder
 significant risk of serious harm
Grampian & Forensic Network, Aberdeen Oct 12
Hospital admissions
2011-12
 9 boys; 4 girls
 Mean age of admission 15y (13 – 17y)
 > 80% secure school or prison
 70% from Glasgow City
 All detained in adult locked wards
 30% admitted to secure adolescent unit
Grampian & Forensic Network, Aberdeen Oct 12
Primary Diagnosis
Grampian & Forensic Network, Aberdeen Oct 12
Forensic risk
Grampian & Forensic Network, Aberdeen Oct 12
Risks to self
Grampian & Forensic Network, Aberdeen Oct 12
Mental health strategy
2012-15: key commitments
 Faster access to CAMHS
 Faster access to psychological therapies
 Improved access to Intensive Home
Treatment & 1st episode psychosis services
 Prevention agenda – focus on early years
 Reduced admissions to adult wards
 Policy: connect with justice & children’s
services
Grampian & Forensic Network, Aberdeen Oct 12
Early detection &
intervention
Preschool
Childhood
Adolescence
• Infant mental
health
• Victims of abuse
& neglect
• Conduct Disorder
• Neurodevelopmental
Disorders
• Psychosis
• Depression
• Substance misuse
• Suicide
Grampian & Forensic Network, Aberdeen Oct 12
Workforce
 Increased CAMHS staffing since 2008
 Increased training in:
- child psychotherapy
- infant mental health awareness
- evidence-based parenting programmes
- suicide prevention
Grampian & Forensic Network, Aberdeen Oct 12
Issues
 Increased age range for CAMHS (0 – 18y)
 Increased minimum age for prosecution
 Diversion from prosecution
 Alternatives to remand / secure care
 Access to safe inpatient care in Scotland
Grampian & Forensic Network, Aberdeen Oct 12
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Forensic Child & Adolescent Mental Health Service