developing camhs for children and adolescents with learning disability sarah bernard consultant...
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Developing CAMHS for Children and Adolescents with Learning Disability
Sarah Bernard
Consultant Psychiatrist
The Maudsley Hospital
National Services Framework – Children should be able to access a range of mental health services whether or not they have a developmental disability
Clinical Need/Lack of Services Risk factors
Epidemiological studies confirm increased risk of psychiatric/behavioural disorder
Co morbidity
Diagnostic overshadowing
Fewer protective factors
Long term disorders
Lack of Services
CAMHS mapping (London)
Approx 50% indicated lack of appropriate service provision
Lack of expertise Fragmented services Insufficient resources
THE PLAN
CSIP (DoH) – priority area Mapping exercise Proxy targets “Champions” identified Raise awareness/improve confidence Optimise existing provision
HOW WAS IT DONE?
Aimed at boroughs showing “red” “Champions” to lead (clinicians) Steering group (MDT) Series of conferences Toolkit Clinical skills tutor Master classes Evaluation
The Conferences
Aimed at Commissioners/managers CliniciansContent Theoretical overview Demonstration of need Assessment vs management Models of service
The Toolkit
Multi Author/MDT
Developing Mental Health Services for Children and Adolescents with Mental Health Problems and Learning Disability – A Toolkit for Clinicians
Eds Bernard and Turk RCPsych Publications 2009
FREE DOWNLOAD FROM RCPsych WEBSITE!
The Clinical Skills Tutor
Nursing background Band 8A Secondment 1 year To support service development across
London
FAILED; unable to appoint suitable person
The Master Classes
17 boroughs (of 33)
One day event
am- teaching
pm- consultation
Attended by MDT: 3-10 people
Teaching topics Service development Aetiology and syndromes Mental health assessment Psychopharmacology Legal and ethical issues Parents with LD The high risk patient Multi agency working
Complex cases with diagnostic/management issues Safeguarding Management of risk Family Functioning When to stop Role of IP services
CLEAR
Children with Learning disabilities Evaluation of Accessible Resources
National evaluation Ongoing Identification of appropriate outcomes to be
evaluated pose a challenge
What Next?
Some money still available! “Feel good” factor vs true benefit
More Master Classes? Road shows? “Help line”
Has this been worthwhile? PositivesValued by local servicesMore CAMHS-LD services being developedMore referrals to tier 4Toolkit:+ve reviews NegativesEvaluation not completedTier 3 services want more supportLack of “new” money