2. Dr Andy Wiener Consultant Child and Adolescent Psychiatrist Associate Clinical Director Tavistock and Portman NHS Foundation Trust

3. What we will cover  Structure of CAMHS in Camden  Joint intake and referrals  Our team and treatments offered  CAMHS in primary care  Any clinical scenarios you would like to discuss?

4. Camden CAMHS  North Camden Community CAMHS – “Tier 2/3”  South Camden Community CAMHS – “Tier2/3”  Under 5’s Service  Brandon Centre (Voluntary Sector)  Royal Free Hospital CAMHS (Eating Disorders, ADHD)  MOSAIC CAMHS (Disability)  Camden MALT (Child Protection and Looked After Children)  EIS (1 st Onset Psychosis) C&IFMHT  IEYS (Children’s Centres)  YOS (Offending)  Special Schools and Pupil Referral Units  Refugee Team (Tavi)  Fostering and Adoption and Kinship Care Team (Tavi)  Daytime duty cover at Tavistock  Out of hours 24/7 on call psychiatry rota to A&E  Access to inpatient Adolescent Units – Acute and Medium Stay

5. Joint Intake  Intake Administrator (Jane Laborie) – 020 8938 2241  Cases passed to teams for allocation or consideration  Fortnightly meeting to discuss uncertain cases A year of Joint Intake: Total approx. 1300 referrals PA  Referrals numbers ranked in order (n = 900)  GPs - 254  Other Specialist & Consultant - 229  Self Referrals - 103  Education (SENCOs), - 112  Social Workers, - 125  Voluntary or Private - 13

6. What happens  Choice of initial appt offered to family within 11 weeks max.  75% discharged after less than 10 appts  20% 11 – 30 appts  5% more.  Outreach for cases that need to be seen  Most appointments within 4 weeks, so wait 8 – 10 weeks. Occasional breach of 11 week wait.

7. The Multi Disciplinary Team  Child and Adolescent Psychiatry  Clinical / Educational Psychology  Child and Adolescent Psychotherapy  Family Therapy  Community Mental Health Nursing  Social Work  Occupational Therapy

8. Interventions  “Generic”  Family Therapy (Systems)  Individual Psychodynamic Psychotherapy  CBT  EMDR  Parenting Groups  Psychopharmacology

9. CAMHS in Primary Care  CAMHS clinicians – Consultation Liaison Model:  Training, Consultation, Joint Appointments, Direct work with less complex cases. Referral on of more complex cases.  Pros and Cons of CAMHS in Primary Care:  +ve:  Easy Access  See cases not otherwise seen  Available resource for consultation  -ve:  Cases may not get to see MDT  Lack of Space  Too busy for consultation – you’re the experts

10. Letters to GPs  Letters to GP within 4 weeks of completed assessment and every 4 months at minimum, and within 4 weeks of case closure.  1 st Letter: 1 st appt, how ofter seen, Presenting Problems, Formulation, Treatment Plan, Risks  At F/U the date of the previous letter, regularity with which the patient attended, the progress of the treatment. Any change in the degree of risk the patient poses to themselves or others and any  At Close.

11. Letters to GPs  Letters to GP within 4 weeks of completed assessment and every 4 months at minimum, and within 4 weeks of case closure.  1 st Letter: 1 st appt, how ofter seen, Presenting Problems, Formulation, Treatment Plan, Risks  At F/U the date of the previous letter, regularity with which the patient attended, the progress of the treatment. Any change in the degree of risk the patient poses to themselves or others and any  At Close: Date referred, course and outcome of treatment, continuing areas of difficulty. Re-referral options

12. Who to Contact  Value Continuity  Contact Service Involved  Joint Intake  Director of Associate Director  Commissioner?