An Introduction to Specialist CAMHS in Somerset Mark Conway Schools Link Pilot Manager and Specialist CAMHS Clinician

Mental Health of young People 1 in 10 children and young people aged 5-16yrs suffer from a diagnosable mental health disorder. (2004) Between 1 in every 12 and 1 in every 15 children and young people deliberately self harm (2006) More than half of all adults with mental health problems were diagnosed in childhood, less than half were offered appropriate treatments at that time. 80,000 Children suffer with severe depression (2005) 60% of children in Care have behavioural or emotional problems 95% of young offenders have one or more mental health disorder

Suicide “in England one person dies every two hours as a result of suicide”. (DH, 2012) In Somerset the suicide rate is lower than the national average: 8.2 deaths per 100,000, compared with 10.4 deaths per 100,000 However the South West Suicide rate as a whole was 11.9 deaths per 100,000 in 2012 Highest risk groups: Men aged 35-49yrs NHS South Of England’s Zero Suicide Programme: By 10 th October 2018 (World Suicide Day)

Disease Burden Across Age McGorry, 2007

Referrals to Specialist CAMHS 2011 received referrals received referrals 25% Increase in 4 years received referrals received referrals 3401

Mental Health of Young People Self Harm: “A non-fatal act whether physical, drug overdose or poisoning, done in the knowledge that it was potentially harmful and in the case of drug overdose that the amount taken was excessive” (DH 1999) Why do people self harm? To stop or interrupt conscious experiences An appeal for help A way of coping or surviving difficult feelings Does not necessarily have suicidal intent

Admissions to Acute wards following Overdose or self harm – – % Increase in 6 years

Emotional Health and Wellbeing Services in Somerset Tier 1– Universal services Tier 2– Targeted services Tier 3– Specialist Services Tier 4 Universal Targeted Specialist Estimated Annual Need 15% = 16,308 7% = 7, % = 2, % = 87

CAHMS- Child and Adolescent Mental Health Service Community CAMHS teams – 3 main bases (Wells, Yeovil and Taunton) Outreach/Home Treatment Team – intensive support and treatment for children and young people with very complex needs Additional Needs Resource – for children and young people with Learning Disability/Autistic Spectrum Condition as well as mental health needs National Deaf CAMHS (ND CAMHS) – for Deaf children and young people who have mental health needs (based in Taunton, covering South West Region) COMPASS and specialist pediatric psychology service – based in acute hospitals (Taunton and Yeovil) Link to Youth Offending Team (YOT)

Who are we......? Referral and Assessment Practitioners Primary Mental Health Link workers Social worker CPN (Community Psychiatric Nurses) Psychologist/Psychological Therapists Art psychotherapist Family Therapist = 44.6 Clinical staff Psychiatrist For the whole county Mental Health Practitioners Mental Health support workers Carer support worker Service User Participation worker Operational Managers

What do we do? Assessment and diagnosis Care planning, which will include several stages: –agreeing goals –treatment plan and timescales –risk assessment and risk management –relapse/crisis planning and management –regular systematic reviews and –planned discharge from the service Therapeutic treatments and therapies Medication: advice and prescribing

Who Can Refer? GPs Health Visitors Midwives Special Educational Needs Co-ordinators (SENCOs) School pastoral leads/Heads of Year School Nurses Parent and Family Support Advisors (PFSAs) Children’s Centres* Children’s Social Care* Youth Offending Teams and Targeted Youth Support Service* Educational Psychologists Somerset Direct Emergency Duty Team Paediatricians (community and acute) Acute hospitals children’s ward Integrated Therapy Service* NSPCC and other agreed third sector agencies* Somerset Advocacy Service* Children and young people discharged from Specialist CAMHS with an agreed ‘fast track’ route to re-referral as part of an agreed discharge/relapse management plan (“Orange Card”) *NB The referral must be discussed with and agreed by relevant managers within each organisation.

Eligibility Criteria

Training Opportunities Training opportunities: Contact Self Harm Training Mental health Awareness Training Attachment Working with Anxiety Online Training at: MindEd: