www.wheres-your-head-at.com
Adolescence and early adulthood is critical period in the
development of long term mental health problems
The ‘Future Vision Coalition’ (www.newvisionformentalhealth.org.uk)
and a number of initiatives under the previous government (‘New
Horizons’, Darzi, the Foresight report) brought a welcome focus on
realising the concept of prevention in mental health and highlighted the
transition from adolescence to adulthood as a critical time in young
peoples’ intellectual and social development and emerging personal
autonomy. With their future in front of them, the stakes are particularly
high because, inadequately treated, the impact may persist a lifetime.
Moreover, as the Dunedin longitudinal cohort [1] and other key research
reveals, we know that most young adults with a psychiatric disorder had
diagnosable problems much earlier in life:


Of those with mental health problems at age 26 years, 50% had
first met the criteria for disorder by age 15 years; by the late teens,
that figure approached 75%. Only a minority of these individuals
seek help or are treated at this critical phase [2].
The emergence of disability from the more severe end of the
spectrum of mental disorders is at its peak in adolescence and
young adulthood.
However historically the care pathways of young people with mental
illness have been poor, reflecting difficulties in negotiating traditional
interfaces between primary and specialist care, as well as inter-specialist
interfaces e.g. between CAMHS and Adult Mental Health Services (3).
These traditional boundaries in service provision are coming under
increasing scrutiny in the face of increasing evidence for the importance of
the early phase of illness and its treatment (4). In particular mood
disorders, neurodevelopment disorders and emerging personality
disorders are most likely to fall through the ‘care gap’ between CAMHS
and adult services. Building on the pioneering work in early intervention in
psychosis, there is strong evidence that the rationale and efficacy of
intervention can be realised across the spectrum of mental health
difficulty [5]
Aims:
This conference will focus on the mental health of adolescence and emerging
adulthood and will explore the following questions:
 What is the evidence base for an early intervention approach across the
spectrum of mental health difficulty?
 What are the opportunities for early detection and intervention in mood,
eating, neurodevelopment and emergent personality disorders?
 What are the universal and indicated prevention strategies that would inform
an effective public mental health policy?
 Would formal collaboration or integration between CAMHS and AMHS to
provide a youth mental health service (eg. up to 25ys) be an appropriate
vehicle to deliver care over such a critical period for young people with
mental health problems and to overcome the well documented problems
associated with transition? What other models are there?
 How might health, social care and the third sector work together to improve
continuity and effectiveness of services?
 What are the potential health-economic gains?
Target Audience
This conference will bring together leading figures in public health, NHS
CAMHS and Adult mental health services, youth mental health,
campaigning groups, local authority and the third sector. It will be of
particular interest to a wide group of clinicians, PCT and LA
commissioners, consumers, public health leads and academics who are
interested in making the concept of prevention in mental health a reality.
This conference will mark an important milestone in the future
development of mental health services for young people and make
comprehensive and preventive mental health services for young
people a reality.
Audience, Venue and Costs
2 day conference for c. 200 people.
This is a free event for attendees and we will attempt to target key people
to attend, reflecting the wide constituency defined above.
Organising team:
Prof Max Birchwood (chair), Birmingham University and Birmingham
YouthSpace
Prof Swaran Singh, University of Warwick and Birmingham YouthSpace
Claire Rigby, Manager, Fairbridge West Midlands
Dr Clare Lamb, North Wales, Adolescent Service
Kathryn Pugh, Children and Young People's Workstream, NMHDU
Dr David Shiers, Primary Care lead NMHDU
Dr Mike Clark, NMHDU
Fran Tummey, NHS West Midlands Regional Development Centre
and National CAMHS Support Service
Kate Phipps, Divisional Director, Birmingham and Solihull Mental Health
Trust
PROGRAMME
Day 1: The Science and Practice of Prevention in Youth
Mental Health.
9:15
Welcome: Max Birchwood
Welcome presentation: Bruce Calderwood: Director of Mental
Health and Learning Disabilities, Department of Health New
Horizons in Mental Health Services (tbc)
Morning
Chairs : Swaran Singh, University of Warwick & Birmingham
YouthSpace & Dawn Rees, National CAMHS Support Service
(NCSS)
9-45 to10-30am
Keynote: Early intervention in mental health? Pat McGorry,
ORYGEN, and University of Melbourne
10-30 to 11-15pm
Special Plenary : Adult mental health problems begin in adolescence:
The new epidemiology of mental health and well-being. Peter Jones,
University of Cambridge.
Coffee
11-45 to 12-30
Special Plenary : Prevention of depression in young people. Paul
Stallard, University of Bath.
12:30-1:00 Panel questions and open discussion
Afternoon special lectures
Four special lectures focusing on evidence for early intervention in
particular disorders and public health work
2:00pm-3-30pm
1. Suicide prevention
2. Early intervention and community management of eating disorders,
Christina Pourgourides, ICOS, Solihull Care trust
3-45pm-5-15pm
3. Public Mental Health Intervention in Schools. Paul Patterson and Fran
Tummey
4. ‘Intervening in Emerging Borderline Personality Disorder in
Adolescents’.
Michaela Swales, Director of British Isles Dialectical Behaviour Therapy
(DBT) Training Team, Consultant Clinical Psychologist. North Wales
Adolescent Service.
Day 2: Thinking the unthinkable about mental health services to
young people?
Chair: Lesley Hewson Vice-chair of the National Advisory Council
for Children's Mental Health and Psychological wellbeing
9:00-10-45am
Keynote: The future of mental health services for young people.
Dr. Andrew McCulloch, Chief Executive, Mental Health Foundation
Special Plenary : The CAMHS-AMHS distinction: need for change?
Dr Margaret Murphy. Chair of Child & Adolescent Faculty of Royal
College of Psychiatrists; Consultant Child & Adolescent Psychiatrist.
Cambridge.
Dr Clare Lamb. Vice Chair of Child & Adolescent Faculty of Royal
College of Paychiatrists. Consultant Child & Adolescent Psychiatrist.
North Wales Adolescent Service.
11:15-12:00
Special Plenary: Mental Health Services for young people: young
persons perspective. Sarah Brennan. Chief Executive, Young
Minds.
12:00-12-30 Panel questions and open discussion
LUNCH
Afternoon:
1:30-2:15pm Keynote: The ‘Headstrong’ youth health service. Dr Tony
Bates, CEO Headstrong, Dublin
Coffee
Four symposia focusing on new and potential service structures.
2:30pm-3-30pm
1. Primary Care and young people’s mental health: Dick Churchill;
Stephanie Lamb; Maryanne Freer.
2. NGO and NHS partnerships: Birmingham YouthSpace; Fairbridge
3-30pm-4-30pm
3. CAMHS /AMHS interface: Early findings from the SCIE Practice Enquiry
into Transitions, and The Role of Commissioning. Rebecca Goldman SCIE,
and Kieron Murphy NMHDU
4. Preventive forensic mental health pathways.
Professor Sue Bailey, ‘Improving pathways of prevention and early
intervention for young people who offend and have mental health
problems’. Professor of child and adolescent mental health policy and
consultant child and adolescent forensic psychiatrist, GMW NHS trust,
Manchester.
Dr Hilary Grant, ‘YouthFirst’: working with young people with severe
mental health problems at risk of career offending. Consultant CAMHS
Forensic Psychiatrist, Birmingham and Solihull Mental Health Foundation
Trust
Conference close and Drinks
References
[1] Kim-Cohen J, Caspi A, Moffitt T, Harrington H et al (2003) Prior Juvenile Diagnoses in Adults With Mental
Disorder Arch Gen Psychiatry; 60:709-717.
[2] Ronald C. Kessler, G. Paul Amminger, Sergio Aguilar-Gaxiola, Jordi Alonso, Sing Lee and T. Bedirhan U (2007)
Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry 20:359–364.
3 Singh SP (2009) 'Transition of care from child to adult mental health services: the great
divide' Current Opinion In Psychiatry 22 (4), 386 - 390
4. Singh SP et al (2010) Transition from CAMHS to adult mental health services (TRACK): a study of policies,
process and user & carer perspective. www.sdo.nihr.ac.uk/projdetails.php?ref=08-1613-117
[3] McGorryP (2007) Investing in youth Mental Health is a best buy (editorial) and The Specialist Youth Mental
Health Model: Strengthening the weakest link in the public mental health system In Early Intervention in Youth
Mental Health Medical Journal of Australia Supplement , Vol 187, 7, October 2007