The CAMHS Review

							  The CAMHS Review and beyond
The future of children and young people’s mental
  health and psychological wellbeing services




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What’s it all about?

• Children and young people’s mental health and
  psychological wellbeing (this includes emotional
  health, behavioural, social and cognitive
  aspects)

• Relevant for everyone, but especially anyone
  working with children and young people




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Why is this important?

• Nearly 10% of children aged 5-16 have a recognisable
  mental disorder. A greater number are at risk

• Mental health problems in children are associated with a
  range of social and educational problems

• Unresolved problems in childhood and adolescence may
  also continue in and throughout adult life

• More effective support for children, young people and
  families is needed to reduce the impact of mental health
  problems on them and their communities

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Why a Review?
• Children and Young People’s Mental Health and
  Psychological Wellbeing services have improved in
  recent years

• However the Government is aware that significant gaps
  in the system remain, impacting on children and young
  people’s access to support

• An independent review was commissioned to:
   – consider how the system is working at present
   – identify recent progress and effective practice
   – recommend practical solutions to address current
     challenges and deliver better outcomes for children
     and young people

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What did the Review do?

                   Children, young people,
                  parents and carers from
                Sunderland to the Isle of Wight
 A review                                            Work
of literature                                     on outcome
                                                   measures
                    The Review gathered
                     information from…

  Review of                                   Stakeholder
 practice visits          A call for          workshops
                      evidence (almost
                       400 responses)
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CAMHS Review Findings

Since 2004 significant progress has been made:

• Increases in numbers of multi-agency CAMHS teams

• Increases in numbers of children and young people
  accessing specialist CAMHS

• Increased attention in some areas on meeting needs of
  vulnerable children and young people

• Translated into effective models of good practice across
  universal and specialist services
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CAMHS Review Findings

Further improvements are required because:

• Inequalities in the support for those with similar needs

• Services not sufficiently child and young person focused

• Services not always as well known, accessible or
  responsive as they should be. Insufficient opportunity to
  develop trusting relationships with staff

• Long-standing problems in accessing support persist for
  some particularly vulnerable children


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The Review’s vision for change
• Children’s psychological wellbeing and mental health –
  everybody will play their part so that everybody’s
  business doesn’t become nobody’s business

• Integrated child and family centred services

• Staff across these services will have a clear
  understanding of their roles and responsibilities and an
  appropriate range of skills and competencies

• Children and young people in mind: the final report
  of the National CAMHS Review was published on 18
  November 2008…


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CAMHS Review Recommendations

The Review made 20 key recommendations

The Government’s response:
   • Endorsed the vision set out in the Review
   • Welcomed all of the recommendations
   • Agreed to implement 2 recommendations immediately
   • Accepted another 12 in principle and is currently
     working on plans for implementation
   • Are giving further consideration to 6
     recommendations, taking time to assess the impact of
     different methods of implementation


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To implement immediately…

National Advisory Council
• to act as a champion for children and young people’s
  psychological wellbeing and mental health
• to listen to children, young people, parents, carers and
  professionals so that we can act as a ‘critical friend to
  government
• chaired by Jo Williams, with Lesley Hewson as Vice-
  Chair

National Support Programme
• for people and organisations providing C&YP Mental
  Health and Psychological Wellbeing services
• building on the National CAMHS Support Service

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National Advisory Council

Initial expectations are that the NAC will focus on:

• Supporting improvements in outcomes for children and
  young people through service delivery on the ground
• Building a coalition and momentum for change
• Monitoring the impact on outcomes and hold
  Government to account

• The NAC will produce a ‘one year on’ document looking
  at the measures being taken to achieve the
  recommendations of the CAMHS Review


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Under consideration

Areas where government is still considering the most
effective response:
• Clarification of funding streams in universal services
• Evaluation of assessment frameworks
• Supporting improvements in local transition
   arrangements
• Child development, psychological health and wellbeing
   part of initial training for children’s workforce
• Supporting effective management and supervision
• Assessing the need for additional training in evidence
   based therapies

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Implications of the Review at a Regional Level

• Government Offices and Strategic Health Authorities will
  develop a coherent performance management and
  support/challenge role to drive improvements in
  psychological wellbeing and mental health for children
  and young people

• Regional Boards, or equivalent governance
  arrangements, will be developed. Roles could include:
   – Supporting improvements in service delivery on the
     ground, focusing on key priority areas
   – Building regional coalition and momentum for change
   – Review implementation of priority recommendations –
     ensure a clear feedback loop locally and nationally
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Implications of the Review at a Local Level

• Areas will build on existing structures to improve
  leadership and accountability for children’s psychological
  wellbeing and mental health:
   – Children’s Trusts with a stronger focus on children’s
     psychological wellbeing and mental health
   – Local multi-agency boards to support this

• This will support:
   – A local commissioning framework: a clear agreement
     at a local level on who commissions what
   – A local offer: a clear description of the services
     available for children, young people, parents and
     carers

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Implications of the Review for Local Services

• The CAMHS Review made specific recommendation
  around:
   – Better specialised support (better assessment, clear
     action plans, a lead person as the main point of
     contact and better information)
   – Improved patient experience and reduced waiting
     times
   – Services for vulnerable children (holistic needs
     assessment, individualised package of care delivered
     locally, where possible)
   – Improved transition services
   – Greater use of outcome measures

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Child Health Strategy

The response to the CAMHS Review is supported by the
recent publication of Healthy Lives, brighter futures: The
strategy for children and young people’s health

The strategy cements our standards and ambitions across
children and young people’s health as a whole

The actions, principles and vision set out in the strategy
support those which came out of the CAMHS Review


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Child Health Strategy: Principles for driving
improvement
• Change relies on local authorities and PCTs working in
  partnership in Children’s Trusts to embed joint planning
  and commissioning at the local level and integrated
  working on the frontline
• Power and responsibility resting with families and
  professionals, backed by clear local offers of services
  and inspection/assurance systems informed by children
  and young peoples views
• Implementation will rely on empowered practitioners,
  leading a children’s workforce with the right skills and
  capacity
• All parts of the delivery system must work in the same
  direction – as set out in Local Area Agreements, and the
  Children and Young People’s Plan

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Child Health Strategy: Making it happen

• Effective joint leadership with strengthened local
  accountability arrangements for children’s health

• Stronger joint commissioning for children’s health

• Better use of data, to inform commissioning and delivery

• Strengthen the child health workforce

• Further promote the voice of children and young people

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Our Vision for Local Services

• Local partners working together to commission a
  complete range of services to meet the needs of all
  children and young people in their area

• Personalised services that meet the individual needs of
  each child and young person

• Better outcomes for all children and young people




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Further Information

CAMHS Review final report and Government’s initial
response:
http://www.dcsf.gov.uk/CAMHSreview/

Healthy lives, brighter futures:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publicati
ons/PublicationsPolicyAndGuidance/DH_094400




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Questions for you

• Are you aware of the CAMHS Review?

• Have you discussed it locally?

• What are you doing at a local level?

• How could the government help you achieve this?




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