CAMHS TRANSFORMATION PLANNING WORKSHOP 01/10/2015
IN ATTENDANCE
Sue Lightfoot
Sam Dunlop
John Doherty
Sophie Tait
Michelle Jones
Jackie Boxx
Rosie Turner
Rachael Amos
Kim Fry
Shelley Weir
Joan Brown
Eileen Monks
Sue Jones
Lorraine Shotter
Sue Morris
Eleanor Bell
Joanne Smith
Darren Poplett
Rosie Campbell
Julie Davies
Sue McRae-Samuel
Emma Corina
Emma Meek
Judith Moore
Connor Dyer
IW NHS CCG
Hampshire Police
Adult MH IW NHS Trust
Medina High School
IW NHS CCG
Education
Youth Trust
School Nursing Team IW NHS Trust
Disabled Children’s Intervention Team
IAPT
CCAMHS IW NHS Trust
Youth Trust
IW NHS CCG
Parents Voice
CCAMHS IW NHS Trust
Public Health IW LA
Healthwatch
Youth Offer IW LA
IW NHS CCG
Early Help IW LA
Health Visiting Team IW NHS Trust
YMCA
Barnardo’s
GP/IW NHS CCG
Youth MP
FEEDBACK SCENARIO ONE – EATING DISORDER
Questions:
- Where is the CAF and multiagency working?
- What other agencies are involved?
- Did school notice anything?
- Why did they go to the GP?
- Did they ask about diet, eating behaviours?
- Community CAMHS and specialist CAMHS what is the distinction?
Gaps/Needs:
- IW LA Autism Ambassador Scheme
- Awareness raising
- Disabled children’s intervention team work with young people and families to
understand diagnosis and behaviours
- Lack of specialist support within the IW NHS Trust
- Interagency co-operation and communication
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Support post diagnosis
Support for young people at school
ASD pathway not clear
Schools have a captive audience need to utilise this
Hard to get money out of schools
Target those most susceptible in year 6/7
Whole peer group involved in cycle of misinterpretation, skewed healthy eating
message– supervision in schools group work “JET” program with celebrity
Previous year 6 health appraisal:
 School nurse will see ongoing
 School/charity counselling
 CAMHS
Need more dietician input earlier
Parent might identify quite early but concerns not recognised
Specialist bays on paediatric ward 1:1
Funding and training – bank sessional nurses trained for 1:1 crisis intervention
Support from Community nurse team?
Support school nurse team
Adaptations quiet place in school to eat e.g. nurture area
CYP IAPT
11 year old health check including MH and Physical health – school nurses
Psychometric tests to compliment physical health check
Wellbeing clinic for Young people at key ages e.g. yr 6/7 transition
Recognition of indicators
PSHE:
 Identifying fixations
 Education around healthy living
 Enabling young person to make healthy choices and understand how they
can adapt behaviours
 Positive thinking as a way of solving problems
 Understanding their feelings and being ok with them
Sports curriculum – incorporating healthy body image
Raising teachers awareness
Guidance for parents, health check report (like school report) questionnaire and
signposting
“Joining up the Jigsaw”
Single care pathway needed
Use of third sector providers e.g. AQP
High functioning Autism can be hidden, reluctance to identify because achieving
Greater awareness of autism and ability to recognise, coping/managing
strategies
Need to understand the trigger,
Provision of:
 schools emotional first aid
 Parenting support
 Wider community support from locality centres/Hubs
It doesn’t have to be a medical professional that diagnoses it – NICE Guidance
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Early intervention:
 0-5 service developed for children with the greatest need in terms of MH
and emotional resilience
 Neurosciences
 Perinatal MH/PNH – 12% of 1400 births
 Infant mental health – baby massage
 Emotional and MH resilience
Primary School:
 Mindfulness
 Healthy eating/self esteem/bullying yr6 52% yr8 61% yr10 53%
 Emotional/ mental wellbeing/ resilience
SATS:
 Nurture
Secondary School:
 Mindfulness
 Key people – teacher, familiarity
 Specialist – self referral
 Exam pre and post stressors
 Support for families
 Healthy eating? stats – family patterns
 PHSE – exam pre and post support
 Family support
 Earlier referral
 School nursing
 Need to be aware of warning signs with insight into students
personality/characteristics
FEEDBACK SCENARIO TWO – COMPLEX BEHAVIOUR
Questions:
- Who is monitoring the outcomes?
- Who is actually doing the work?
- Who should take the lead?
- What can be accessed and what do we need to make available?
Gaps/Needs:
- School centred unit to access:
 Nurses
 3rd sector counselling
 Workshops
 Parental advisory service
- Social care focus on assessment rather than support
- Assumptions parents won’t learn from just listening, they need to be looked after
and involved
- Little actually being done with and for the child and family
- Peer model in Devon – go into schools and have open discussions about MH
- Feedback from councillors to GPs on tips on what the person can do
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Encourage environments to be more intuitive around ASD issues e.g. schools are
a prime example it should not be a surprise when a pupil with ASD traits
becomes anxious in these environments
Personal budget/direct payments for support worker and support for parent
What would help the parent feel that they could support the YP better – just ask
them!
Autism – They won’t give a monkeys what anyone else thinks of what they are
doing….. unless you are able to teach them why, small steps at a time.
Co-ordination: Ultimate responsibility when lots of agencies involved.
 Focussed on outcomes what expecting to be achieved
 Supporting parent – is not an outcome
 Measuring outcomes
 Family/parent needs help
Person centred plan
Willingness and opportunity for professionals to come together
Care co-ordinator – must not remove knowledge of what and how to deliver
Honest conversations with parent/carers –
 tell story once
 If that was me what would I want?
 Include parent/carer do not take responsibility away
Workers are risk averse because of potential consequences
What happens in the future when mum is not around?
No suitable local provision
Lack of joined up working
Funding issues
Post 18 support
Earlier referral and diagnosis
Referred to Hants – Multiagency program approach
Early CAF (raised by HV)
Early help centres / parenting programs
1:1 in education and community
Safe places
Routine/stability
Financial resources and realistic outcomes
Independence? Community capacity and independent living
Needs to be more outcomes focused with a long term plan/view
Upskilling the young person, learning positive behaviours and skills
Health, wellbeing, safeguarding & vulnerability of young person, parent, public
etc.
Parenting support, long term/review
What has been achieved
parenting programs/support
Instant advice
Respite
Community safeguarding PCSO’s
Parenting Peer support groups
Safe environment for independence
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Plans in place
Coping strategies
WHAT SHOULD WE INVEST IN?
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Prevention and early intervention especially in education and early years
Prevention and education that it is normal to be anxious
Mindfulness in schools
Parent support
Identifying Autism: Childrens centres
Diagnosis but what do you do with it?
Third sector help during summer holidays
Widen what third sector provide e.g. through AQP
Put money into schools not forgetting home educated children
Provide more counselling sessions rather than capping sessions
Peer support
Multiagency approach, pathways and training
APPs – e-technology sign posting to trusted websites
Personal 1:1 connection is best and more effective
Pathways need to be:
 condition specific
 Therapy fine tuned
 Different types of counselling which are evidence based for certain
disorders
Clear information sharing agreements.
Childrens LD liaison nurse
Self-esteem training
Anti - Bullying
Pre and post exam anxiety levels
Provision lacking in secondary schools
Tutor/student trust relationships
Referral pathway for student to approach tutor and then to MH professional/GP
Healthy eating
Early referral/self-referral pathways
Multiagency training
School holidays – abandonment - what can school do to support during this
time?
Education around anxiety
Make people with MH feel normal and supported
Consistent support
Early intervention
Specialist parenting support
Yr 6/7 health check
Local market development
Crisis support
Preventative care for children exposed to perinatal mental health
Clear referral pathways for perinatal mental health and infant MH (0-5)
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Multidisciplinary training in perinatal mental health and infant mental health
Infant massage
Perinatal group mindfulness for mums