creating a youth mental health service dr jon wilson ...€¢jonathan.wilson@nsft.nhs.uk. title:...

Creating a youth mental health service

Dr Jon Wilson

Consultant psychiatrist

“We can’t solve problems by using the same kind of thinking

we used when we created them…..

Where it all started

Team “C”

Lowers, R et al 2011, unpublished

Range of client needs at 12 months into service, as assessed by the Camberwell Assessment of Need.

Lower, R et al 2011

Outcomes for Team “C”

Development of a youth service

taken from Early Intervention in Psychosis key principles

Key Principles

• Being and to engage this group early

in severe mental illness (allowing staff to develop skills required)

• Being to minimise functional disability and maximisepotential

• Offer with a service user involved approach

• Having an assertive outreach component

• Aiming to / mental health act use

• Working with

• Promoting

with other support agencies

• Using and seeking to where none exists.

Streamed youth-friendly mental health services

• Streamed youth-friendly mental health services are more appropriate

for young people, who are more likely to:

• • be the mental health (or health) system for the

• • have who are being exposed to the mental health system

for the

• • be and to iatrogenic effects (medical or

environmental)

• • experience especially substance use, that require an

integrated model of care

• • be a with varying, and clinically uncertain illness

trajectories

• • be , as they have not had the time to learn about their

illness and how to manage it successfully

• • be prone to exhibit more and deliberate selfharm when

acutely unwell, because they are cognitively and emotionally less mature, are

younger and fitter, and more likely to have comorbid substance use disorders.

Aims of the service

young people at highest risk of developing enduring mental health difficulties

• Provide support

• Get young people well enough to engage with the Norfolk Wellbeing Service or:

• Well enough to engage in treatment

where possible through risk management with the IST / CRHT

• Then ensure that a service user is linked into appropriate (education, youth groups etc)

• Provide support

The problem of transitions…..

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All Referrals - CAMHS and AMHS September 2010 – August 2011

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All Contacts – CAMHS and AMHS September 2010 – August 2011

Ugochukwu O, Maxwell S et al, unpublished, funded by CLAHRC

The youth pilot……

Beck Depression Inventory

Social Interaction Anxiety Scale

Trauma History Questionnaire

Time Use Survey• Mean number of hours per week in structured activity 19.02 (including work,

education, voluntary work, leisure & sports activities, housework, and childcare)

compared to mean of 64.18 hours among a 18-35 year old non-clinical sample.

Current Service Pathway

Triage / Assess for following services:

• Jonathan.wilson@nsft.nhs.uk