Waitemata DHB
Question
Please describe the systems in place in your DHB which address the
needs of children and young people with severe conduct problems.
3.
Waitemata DHB is engaged in a range of services and activities to address the
needs of children and young people with severe conduct problems.
•
A range of parenting programmes aimed at supporting and educating parents to
better manage conduct problems and to establish healthy relationships and attachments
to the children.
•
a number of assessment and treatment services delivered directly to children and
young people with severe conduct problems.
•
A number of interagency forums
Whilst there is a lot of activity in this area, a gap is that there is no overall, comprehensive
and cohesive plan to govern and monitor the activity.
Parenting Programs
a) Drivers of Crime Initiatives
WDHB is one of the pilot sites for MOH initiatives, relating to the government Drivers of
Crime strategy ( conduct and behavioral problems work stream)
There are two aspects to this service-:
•
“Specialist Interagency Response to Children and young People’s Conduct
Disorders” provides specialist Incredible years programs through CAMHS for parents
with children whose conduct disorder is at the more severe end of the spectrum ( see
attachment 1,Service Spec)
•
“Primary Care Triple P” is a less intense programme designed for delivery in
primary care/community settings. WDHB have contracted a Maori NGO provider, Te
Whanau O Waipereira Trust to deliver the programme and to support and coordinate up
to 40 practitioners per year to undertake the training, supported by the Werry Centre.
(See attachment 2,Triple P Service Spec)
b) Other Parenting Programmes delivered by DHB services or DHB funded NGO services
•
Daysprings Trust is a mental health funded NGO specializing in working with
Mothers with mental illness. They currently provide a range of services primarily
designed to meet the needs of mothers with babies/ young children including counseling
services, mental health community support work service, supported landlord service,
parenting and recovery programmes including Early Years Toolbox Parenting Course, the
Circle of Security Parenting program and Triple P.
•
Secure Beginnings is a joint Daysprings Trust/CAMHS initiative was established in
2013, for the provision of the Circle of Security, which is a parent education and
psychotherapy program designed to shift patterns of attachment-care giving interactions
in high risk care giver dyads to more appropriate developmental pathways, (see
attachment 3, Joint Service Proposal)
•
CADS Counseling and Opiate Treatment services including AOTS work with
women of child bearing age and provide education around risks of substance use to the
unborn child and provide AOD treatment to minimize harm in this area ( See attachment
4)
•
The CADS pregnancy and parental service (PPS) works to minimize substance
related harm in pregnant women and new mothers. The service works collaboratively
with obstetric services, child welfare agencies, maternal mental health services and
community agencies across the Auckland region they are actively working at minimising
the impact of biological and psychosocial developmental adversity on newborns across a
number of domains but particularly in the area of substance use ( see attachment 5)
Assessment and Treatment Services targeted to Children and Young People with Conduct
Disorders
•
B4 Schools Check Programme is a universal comprehensive screening and health
education opportunity for children turning 4 years old. It includes assessment of
behavioral and developmental status, and appropriate and timely referrals to improve
child health and well being.(see attachment 6 ,service spec)
•
The Fresh Start Programme led by the Ministry of Social Development (MSD) has
provided for courts to refer youth to community based AOD services from October 2010.
Substance abuse is a condition that leaves extensive damage in its wake through its
impacts on family and community. Early detection and treatment of alcohol and other
drug problems (AOD) affecting children and young people can prevent a lifetime of
adverse experiences for the individual and avoid substantial costs to the State( see
attachment 7,service spec)
•
The Youth Health Hub is a district wide comprehensive health service for young
people, delivered by an NGO in conjunction with a consortium of other leading NGO/DHB
providers. The service includes mental health packages of care, and sector leadership
across agencies involved in youth health. CAMHS work closely with the hub, to support
referral triage, and provide consult liaison. ( See attachment 8 ,service descriptor and link
to Q9)
•
CADS Altered High - is a regional AOD service, delivered by WDHB CADS service,
for young people aged 13-20 years. Conduct disorders are a major co-existing disorder
with substance use /mis-use ( See attachment 9, Altered High evaluation)
•
Self Management and E-Resource Suite is a comprehensive stock take of all self
management resources and e-therapies, used by CAMHS, broken down by the age group
each resource is recommended for (see Attachment 10, e-therapy Stock Take document)
•
Intensive Clinical Specialist Service/Child & Adolescent Liaison Service (ICSS and
CALS),delivered by CAMHS and has been specifically funded to provide an innovative
response to the needs of children and young people who are consumers of the Ministry of
Social Development (MSD), Child, Youth and Family (CYF) and have serious mental health
problems. ICSS has a philosophy of seamless service provision and aims to minimise the
number of professionals involved in each case, with an emphasis on utilising the strengths
of existing relationships. ICSS use the Wrap-Around Systems of Care Model (WA-SOC).
ICSS provides intensive clinical assessment and treatment services to children,
adolescents and youth who have serious mental health problems and who are under the
care of the MSD, CYF. The team is based at North Shore Hospital as a mobile community
based service with flexible hours of operation(See attachment 11,ICSS Brochure)CALS is a
small service provided to CYFS to assist them to work with children and adolescents with
mental health problems that fall outside the mandate for ICSS and CAMHS. The service
includes; liaison, consultation and some capacity for assessment and client specific
caretaker training. Following consultation clinics, which are held in CYFS offices, CAL
pathways may include; CALS assessment, referral for CAMHS partnership, or referral to
outside agencies. CALS has limited capacity to work with children and young people
whom do not meet the criteria for CAMHS (See attachment 12, CALS Referral Pathway).
•
Gateway comprehensive health and education assessments for all children/young
people in care of CYFS. CAMHS participate in the Gateway process (See attachment 13,
Gateway contract)
•
Children of Parents with Mental Illness and/or Addictions (COPMIA)-relates to
children who have parents who experience mental illness and /or addictions, who can be
at risk of neglect, disconnected and abuse. WDHB Mental Health Services Group is looking
to:
- gain an understanding of the extent of clients within the service who have children
currently living with them
- identify the awareness of clinicians for identifying children who are living with parents
with mental illness or addictions
- raise awareness of risk factors for COPMIA and consider implications for clinical
responsiveness
-Early work is focused on understanding the resources available, numbers who could be
at risk, pathways to support services and awareness raising for those working in clinical
services, child and youth, and adult services (mental health and addictions).
Interagency Forums
Joint Child Health and CAMHS monthly meetings
•
Monthly meetings held with the operations managers and clinical directors of
Child Health services and CYF Portfolio to troubleshoot interface issues and streamline
service delivery across both ( see attachment 14, interface meeting minutes)