Trialling the Choice & Partnership Approach Right time, Right intervention with the Right people Mental Health Division of Canterbury District Health Board

Our Team

“7 helpful habits of a successful Child and Adolescent Mental Health Service” Handle demand, Extend capacity, Let go of families, Process map and Design, Flow management, Use care bundles and Look after staff

Difficulties for children that we work with Mood disorders Anxiety disorders Attention Deficit Hyperactivity Disorder Autistic Spectrum disorders (ASD) Eating disorders. Specific Learning Disabilities Disruptive Behaviour disorders Developmental problems Sensory/perceptual problems. Health problems (epilepsy, diabetes, acquired brain injury) Significant parent-child relationship problems

Traditional process through CFSS: Waiting Time: 6-9mths Caseloads: 35 -45, cases open for years, aimless ‘follow-up’ sessions Internal referral wait: norm of 8 months Initial appointment: 2hr+ session, prescribed format, pathology focused, no mention of strengths in dialogue or paperwork. Case management: -by CM not with family. Depended on CM’s skill base. Closed to involvement by other clinicians, less communication Goal focused? No goals set with family, no tasks for family Morale: Feeling burdened and cynical. Unfocused involvement. Community involvement: minimal Paperwork: Formal psychiatric reports to the GP/ referrer. Families cc’d brief copy –lack of explanation about the troubles and what they could do about it. Service focus: procedure done to suit service rather than families Recovery: No expectation that families can be independent and help themselves Arya talk to

CAPA process Green team gets every 3rd referral that comes in Families and referrers sent identical letter re trial and to phone us Referred families matched to our availability slots, paperwork posted. First appointment emphasis getting to know you rather than full assessment. Agreement on description of issues and what we, the family and the community can do about it. Goals set and family given info & tasks. Families invited to book for further assessment and/or treatment. We must have clear guidelines re referral criteria and to check with provider Choice Appointment Summary written to the family in plain language and cc’d to GP. A move towards being “contact”/liaison person Interventions taken up as family feels motivated to do so. Brief summary is forwarded to the referrer. When work is seen as being completed for now, which does not mean that all of the problems have been solved, a brief discharge summary is written and is sent to the family and referrer.

Evaluation results People seen and discharged sooner Positive feedback Choice appointment Positive Feedback after discharge Positive feedback from GP Staff enjoying process Changes in desired direction on the pre & post questionnaires