1. Overview of the Forensic Child and Adolescent Mental Health Service for Northern Ireland Dr Kelly Andrews, Specialist Clinical Psychologist

2. FCAMHS FCAMHS became operational in January 2015. Joint venture by HSCB, YJA and SET.  Service delivered by South Eastern Trust but is a regional service. Base at Woodland’s JJC. Two branches to the service.  CAMHS In Reach – Step 2/3 (same as generic CAHMS in the community).  CFCAMHS – Step 5 of the step care model.

3. TEAM COMPOSITION Vacant Post Fiona Orr – Secretary (1 FTE across Community and In Reach Services ). Pauline McGovern – Operational Nurse Manager (1 FTE across Community and In Reach Services ). Dr Kelly Andrews – Specialist Clinical Psychologist (0.85 FTE Community and 0.15 In Reach). Sarah Ruston – Forensic Psychologist (0.85 FTE Community and 0.15 In Reach). Aveen Boyle – Clinical Nurse Specialist (1 FTE Community). Dr Peter Gallagher – Locum Consultant Psychiatrist (0.2 FTE In Reach). Michael Vernon – Specialist Nurse Practitioner (0.8 FTE In Reach). Vacant full-time Forensic Psychiatrist across both services.

4. IN REACH CAMHS Assessment and Treatment Service Multiple Disciplinary Team Health Care Standards for Children and Young People in Secure Settings CHAT - Comprehensive Health Assessment Tool Referral Pathway Interfaces Training

5. COMMUNITY SERVICE Advice, consultation, assistance with risk management and recommendations. Interface with CAMHS, DAMHS, YJA, PSNI, Social Services, LAC therapeutic services, Education, Regional Services. Specialist risk assessment, formulation and recommendations for interventions. Look for protective factors and windows of opportunity. Clinical responsibility remains with referrer. Accessibility to telephone enquiries. Future training and interventions.

6. COMMUNITY FORENSIC CAMHS Referral Criteria Up to 18 years old at the time of referral. Living in Northern Ireland. Severe disorders of conduct and emotion, neuropsychological deficits or serious mental health problems or legitimate concerns about the existence of such disorders. Involved in dangerous, high risk behaviours whether they are in contact with the youth justice system or not. Includes behaviours that present a high risk to others such as fire setting, sexual offending, use of weapons, physical assaults.

7. REFERRERS The team will be accessible to a range of agencies including :- CAMHS Youth Justice Agency Social Services Welcome enquiries from anyone who has concerns about a young person.

8. CASELOAD STATISTICS Community Referrals Jan 2015 – Dec 2015

11. PRIMARY CONCERN IN ADDITION TO HSB

12. PRIMARY FORENSIC CONCERN IN ADDITION TO HSB

13. CASE EXAMPLE Example of good practice. Young person with complex cognitive, developmental, attachment and childhood trauma (Neglect, potential physical, emotional and sexual abuse). Presenting with HSB, violence and theft. Multiagency case consultation (Residential carers, Social Services, NSPCC, CAMHS (ASD), LAC Therapeutic Services). Support, advice, guidance, collaborative thinking. Joint assessment, formulation and recommendations. Feedback. Discharge.