Chris Spark shares our learning on what’s vital in delivering the right services at the right time.
Children and adolescent mental health services (CAMHS) are under enormous pressure across the country. There has been a noticeable national increase in awareness of the importance of emotional wellbeing of children and young people. At the same time, demands on health, education and social care budgets, capacity pressures, workforce and operational challenges, combined with the drive for more integrated services have all contributed to the pressure being felt by CAMHS services and care professionals.
Critically, children and young people are not consistently receiving the mental health support they need, when they need it. So what can we do?
Time for a new model of care?
There is a clear need and drive for transformation and a tangible commitment to improving care for and safety of children and young people. In response to these challenges, national policy is evolving and new models of care are being trialled across England, with some great and interesting results.
As commissioners and providers seek to get a handle on what is going on in their local services and plan for the future, we have been engaged to undertake a number of reviews of CAMHS services across England this year.
In one geography, we have already undertaken extensive engagement across providers, commissioners, social care, CAMHS professionals, medics, the voluntary sector, schools and primary care through a series of workshops, interviews and focus groups. Through extensive analysis of provider and commissioner data, we have been able to bring a fresh perspective on the dynamics of the CAMHS system. Working alongside leaders, clinicians and staff from across the CAMHS system, we have been able to identify the wide ranging challenges facing the system and their root causes.
We have developed a set of short and longer-term recommendations to help shape the future of CAMHS, including a top level system strategy and a high-level design of a new model of care that focuses on CAMHS as a part of a wider system of emotional wellbeing support and early intervention. Finally, we have reviewed resources, identifying the funding, workforce, data and digital requirements for a transformed CAMHS system.
So, what have we learnt so far?
What are the success factors?
In our experience in conducting such reviews, there are a number of success factors that should be considered:
- Taking a system view – uniting health, local authorities, education and the wider community partnerships to share leadership of and accountability for the emotional wellbeing of children and young people is critical.
- Having an aligned care model that facilitates flow through the system and appropriate access, clear pathways and a roadmap breaks down barriers to the right services at the right place and right time.
- Balancing medicalised care with de-medicalised interventions means that services can maximise commitment from the voluntary sector, family and community resources to support children and young people.
- Investing in early intervention and primary mental health teams equips those that really know the children and young people (usually teachers, parents and GPs) to provide timely and tailored support before situations escalate.
- Partnering with parents and families to co-counsel children and young people builds resilient families.