Specialist CAMHS
- The
extent to which new (and/or reconfigured) services are helping to
reduce waiting times in specialist CAMHS. Whether the improvements
in waiting times Welsh Government expected from CAMHS have been
met.
- What
the data tells us about the variations in practice (equity of
access) across Wales.
- The
extent to which changes have addressed the over-referral of
children and young people to CAMHS.
- Referrals and access to CAMHS by individual Health Board,
including the restrictions and thresholds imposed by
CAMHS
- Whether the changes have helped to improve specialist
CAMHS’ ability to respond out of hours and at times of
crisis; whether out of hours care is working effectively, and
specifically looking at the needs of those children and young
people who present and are assessed at hospital A&E
departments.
- Whether there is sufficient in-patient capacity in
Wales.
1.
Comments:
The Society believes that the above terms of
reference could also:
-
Include multi-agency work that supports/facilitates
CAHMS referrals and as a result, assessment and support might be
helping to reduce CAMHS referrals.
-
Include an explanation of at what point/level of
need, referrals are most effectively made.
-
Additionally, the Society believes that the scope of
the investigation should include paediatric/Child Health Psychology
services. As these services are not always included under
specialist CAMHS but deal with the mental health of children and
adolescents, it is essential that they are included within the
inquiry.
Funding
-
Annual expenditure on CAMHS in cash terms and as a
percentage of the overall spending on mental health, by local
Health Board.
-
The extent to which access to psychological therapies
for young people has improved. Whether there has been a subsequent
reduction in the use of medication for young people.
-
How the additional funding has been used to improve
provision for children and young people in local primary mental
health support services
-
The extent to which the funding has been used to meet
the needs of vulnerable children and young people, for example,
children who are in care, children and young people with ADHD and
autistic spectrum disorders, and those who are already in or at
risk of entering the youth justice system, including those who are
detained under section 136 of the Mental Health Act
1983.
-
The effectiveness of current planning and
commissioning arrangements to address the needs of young people who
have early onset of a severe mental illness, such as
psychosis.
2.
Comments:
The Society believes that the following should be
included:
-
The type(s) of psychological therapies that are
accessed most and least but also those perceived the
easiest/hardest to access, by children, young people, parents and
professionals.
-
A clear definition of the type(s) of psychological
therapies that are most effective in supporting areas of need.
Also, the psychological therapies that are considered to be most
effective at each level of intervention, for example-
universal, administered to every member of a
population, targeted and specialist interventions, designed for
at-risk groups, delivered to individuals and groups that require
higher levels of support from professionals with greater expertise.
Intervention is considered to be necessary at each of these levels
to be effective (Dunsmuir and Hardy, 2016)
-
A definition of how psychological therapies are being
individualised and tailored to the specific needs of a person, a
central aspect of the current Welsh Additional Learning Needs
Reform.
-
Clarification on whether a more complex level
intervention at an earlier stage can save money in the long
term.
-
The inquiry may also wish to add ‘children and
young people with long-term physical health problems’ in to
the section on vulnerable children (fourth bullet
point)
Transition to Adult Services
-
How well planned and managed transitions to adult
mental health services are.
3.
Comments:
The Society believes that the terms of reference
should also consider:
-
How outcomes in regards to transitions to adult
mental health services are best monitored/measured.
-
Specific areas of support/barriers for effective
transition.
-
The transition of care from paediatric psychology to
adult health psychology services
Links with Education (emotional intelligence and healthy
coping mechanisms)
-
The work being done to ensure children and young
people are more resilient and better able to tackle poor mental
well-being when it occurs including:
-
The development of the Health and Wellbeing Area of
Learning and Experience as part of the new curriculum.
-
Children’s access to school nurses and the role
schools nurses can play in building resilience and supporting
emotional wellbeing.
-
The extent to which health, education and social care
services are working together.
-
The take up and current provision of lower level
support and early intervention services, for example, school
counselling services.
4.
Comments:
In addition to the above, The Society believes that
the terms of reference should specifically include:
-
Children and young people’s access to and
involvement of educational psychologists in supporting mental
health in schools; and joint working between educational
psychologists and CAMHS. There is an
increasing consensus that Educational Psychologists can play a
positive role in supporting wellbeing (Squires, 2010; Squires &
Caddick, 2012).
-
The extent to which school staff feel
‘ready’ and ‘able’ to support change for
children and young people. The
application of psychology in support of the work of
teachers can support teachers’ well-being and
resilience and yield cost-effective beneficial outcomes for staff and children. (Gibbs &
Miller, 2014)
References
Gibbs, S., Miller, A. (2014) Teachers’ resilience and
well-being: a role for educational psychology. Teachers and
Teaching: Theory and Practice, 20(5), 609-621.
Hardy, J., Dunsmuir, S., (2016) Delivering Psychological
Therapies in Schools and Communities. BPS.
Leicester.
Squires, G. (2010). Countering the argument that
educational psychologists need specific training to use cognitive
behavioural therapy. Emotional & Behavioural Difficulties,
15(4), 279–294.
doi:10.1080/13632752.2010.523211
Squires, G., Caddick, K. (2012). Using group cognitive
behavioural therapy intervention in school settings with pupils who
have externalising behavioural difficulties: An unexpected result.
Emotional & Behavioural Difficulties, 17(1),
25–45.doi:10.1080/13632752.2012.652423
End.