Developing a Vision for CAMHS
The vision is of child and adolescent mental health services which are effective and efficient and which unite all professions in putting the needs of children and young people at the heart of their approach to services. Mental health problems and disorders in children and adolescents are often linked to issues within the young person’s social context and in society in general. Therefore this approach to child and adolescent mental health must take into account other government initiatives aimed at addressing these possible underlying problems. Any vision for child and adolescent mental health services must be placed firmly in the context of social inclusion. Services for children and young people should be available irrespective of gender, race, religion, ability, culture or sexuality.
The implications for the workforce are that we need to develop diversity within, across and in the staffing of services. This can only occur if CAMHS is strengthened in terms of capacity and skills and through planned commissioning processes which are undertaken in partnership with service providers. The following principles show the kinds of workforce provision that all modern developing services require if they are to be effective. This list is derived from work done by the external working group for the mental health and psychological wellbeing module of the NSF for children in England and a review of key workforce issues facing CAMHS.
The Workforce Vision translates into the following principles:
- Services should be commissioned, provided and evaluated with the key purpose of making a positive difference to children and young people with mental health problems, their family and friends.
- Staff are the means of delivering effective services and need to be valued and supported in doing so.
- Staff within the Mental Health Workforce include professionally qualified and unqualified but trained practitioners.
- Staff may work in statutory services, NHS, Social Services, Education, at all tiers in non-statutory services, voluntary and independent sectors.
- Staff should have the appropriate education, training and supervision to enable them to deliver person centred, socially inclusive services.
- Staff should work collaboratively and flexibly across disciplines and teams, overcoming professional and organisational boundaries, to meet the needs of the people using services.
- CAMH services are child-centred and should seek to know and appropriately take into account the views of children, young people, families and carers and incorporate them into aspects of service delivery including direct work, planning and commissioning of services. Service users’ and carers’ contributions are crucial to delivering effective services and need to be valued and supported
- All frontline staff working with children, young people and their families have sufficient knowledge, confidence and training to promote the emotional well-being of children and their families. Have the ability to recognize or suspect when a child’s emotional well-being is at risk and take appropriate action to prevent or treat mental health problems, or refer on to specialist child and adolescent mental health services when appropriate.
- All children, young people and their families have access to high quality, timely, multidisciplinary, specialist child and adolescent mental health services that are inclusive of difference and diversity, delivered by skilled and supported staff, working in appropriate and safe settings
- All CAMH services are commissioned on a multi-agency basis, informed by the assessment of local need and the best available evidence to ensure that services deliver effective outcomes and best value for money.
- Investment in workforce development, both the enlargement and appropriate training of the existing workforce and the development of new workforce, recognising that the traditional professions cannot between them train enough people quickly enough to meet demand
- Core specialist child and adolescent mental health services (CAMHS) are strengthened
- The workforce is of adequate size and skill mix reflecting the needs of service users and their families, not isolated but an acknowledged part of a network
- Services are well led and well managed
- The design of services is based on evidence and value-based approaches and espouse a similar ethic in practice
Understanding Workforce Issues in CAMHS (Nixon 2005) a review of workforce issues facing CAMHS identified 6 key themes to be addressed including :-
to improve workforce design and planning so as to root it in local service planning and delivery;
- to identify and use creative means to recruit and retain people in the workforce;
- to facilitate new ways of working across professional boundaries;
- to create new roles to tap into a new recruitment pool and so complement existing staff types;
- to develop the workforce through revised education and training at both pre- and post-qualification levels;
- to develop leadership and change management skills