Child and adolescent mental health services

jess talking though her feelings The primary function of specialist child and adolescent mental health services (CAMHS) is to develop and deliver services for those children and young people (and their families and carers) who are experiencing the most serious mental health problems.
These services are provided directly by specialist CAMH teams in many cases, particularly to those children and young people whose difficulties are complex and severe. However, as is clear throughout this Framework, they also have a very important role in supporting what the SNAP report called the "mental health capacity" of the wider network of children's services. This Framework has gone into considerable detail to illustrate the steps necessary to develop that capacity. Detailed recommendations about psychiatric inpatient services for children and young people will be published in a separate report of the Child Health Support Group's Inpatient Working Group.

Practitioners who contribute to specialist CAMHS include: psychiatric nurses, child and adolescent psychiatrists, clinical psychologists, social workers, psychotherapists (including child/analytical, systemic/family, cognitive behavioural), creative therapists (including art, music and drama), play therapists, liaison teachers, speech and language therapists, occupational therapists and dieticians.

Overarching philosophy & culture

The English National Service Framework has described the key elements of a child and adolescent mental health service that "works". It suggests that services need:

  • "Strong inter-agency commitment over the medium to long-term, including a steering group or strategy group willing to tackle tricky issues, and a commitment to consulting with and acting on children's and families views.
  • Links with existing services within CAMHS, including the integration of the service within the CAMHS tiered framework and CAMHS development strategy.
  • Links with other services and initiatives outside CAMHS e.g. education, the voluntary sector and area-based initiatives.
  • An ability to attract new sources of funding.
  • Retention of a stable, multi-disciplinary staff group with opportunities for training and development.
  • Positive commitment to continued evaluation and audit; and Balance between providing a direct service to users and influencing the broader network.
  • Services should also ensure compliance with professional and other guidelines such as those produced by the Royal College of Psychiatrists.

Capacity and skill mix

The numbers and mix of specialist professions within a specialist CAMHS team will largely depend on local needs assessment and the priorities agreed within a local area. Where the configuration of services is informed by local need and developed in light of the particular patterns of strengths and weaknesses in partner services, local commissioners may be well-placed to develop a view about the overall shape of the specialist CAMHS needed. However, there is a risk that in the absence of indicative figures, NHS Boards and their partners will not be well-placed to make reasoned judgements about the scale of service.

CAMHS are able to offer a range of therapeutic interventions and staff are able to offer training and supervision to others developing therapeutic skills via:

  • Generic teams of mental health practitioners specialising in work with children and young people across the care pathway.
  • Liaison with services for looked after and accommodated children and young people.
  • Substance misuse services.
  • Forensic services.
  • Children and young people with learning disability and mental health problems services.
  • Children and young people with complex physical disorders services.
  • Liaison with secondary health care.
  • Early intervention services.
  • Primary mental health work.
  • Inpatient psychiatric services.
  • Intensive outreach services.
  • Emergency and out-of-hours mental health arrangements .
  • Planning and commissioning.  

     www.youngminds.org.uk/camhs/

Further information