a Pilot Project

Report
Improving the Transition for Young People
from CAMHS to CMHT: a Pilot Project
Dr Joanne Cocksey & Dr Lisa Da Silva
Clinical Psychologist
Counselling Psychologist
Background
NATIONAL
• Identified need for an improvement to the process of transition for young people from
CAMHS to CMHT (Children and Young People in Mind: National CAMHS Review,
2008; No Health without Mental Health, 2011).
• In London only 4% of young people reported a good experience of transition, with
many disengaging from services (Singh et al., 2008).
LOCAL
• In Berkshire, the Windsor, Ascot & Maidenhead (WAM) locality, service user feedback
indicated that young people and their parents experienced the transition from child to
adult services as challenging.
• Differences in ways of working and expectations between children and adult services
led to service user distress/confusion, complaints, and negative inter-service
communication.
• A lack of liaison and care planning between CAMHS and CMHT resulted in disjointed
and late transitions and extended out of area placements.
Objectives and opportunities
•
Improve the quality of care for young people and their families plan
transitions around individual client needs.
•
Ensure a more seamless client experience.
•
Improve the engagement of young people with complex mental health
problems in transition.
•
Provide peer support and focused learning opportunities for parents/carers .
•
Bringing together existing resources in CAMHS and CMHT to more
effectively manage transitions:
– Enhancing collaboration and sharing knowledge between professionals/teams
– Decreasing costs (reduce replication of input and time in out of area placements)
The pilot
• CAMHS – CMHT joint meetings
• Transitions Group
• Parents’ Group
CAMHS-CMHT meeting
• Monthly meeting between CAMHS and CMHT Team Managers,
Leads and Senior Clinicians. Young people are discussed in the
meeting from when they turn 17, leading to improved transition
planning and early joint care co-ordination.
• Since the start of the project approximately 52 young people have
been reviewed in the meeting. Of these, 14 have been/are being
transitioned to CMHT. Of these 2 disengaged once transitioned to
the CMHT.
• In the year prior to the start of the project there were 3 complaints
regarding the transition from CAMHS to CMHT. Since the project, no
complaints have been received from this cohort.
Parents’ Group
• All parents, relatives and carers of the above cohort, focussing on
peer support and skills review/learning.
Transitions Group
• Clients aged 17 and 18 years of age who meet criteria for CMHT or
just below.
• Focuses on the development of skills to manage emotional and
psychological difficulties, and provides peer support.
• Modular with a range of topics: Self-care; Anxiety; Low mood;
Identity; Self-esteem; and Relationships.
• Weekly for 1½ hours away at non-mental health premises.
• Facilitated by a CAMHS and a CMHT psychologist .
• Individual reviews at the end of each module.
Transitions Group
4 to be
reassessed
post crisis
37
young people
considered
6 accepted
17 offered
10 discharged
6 to specialist
services
11 declined
Outcomes of Transitions Group
Measures
• Revised Child Anxiety and Depression Scale (RCADS)
75
74.5
74
73.5
73
72.5
72
71.5
Time 1
Time 2
Outcomes of Transitions Group
Measures
• CORE
2.1
2.05
2
1.95
1.9
1.85
Time 1
Time 2
Outcomes of Transitions Group
Measures
• Education and Employment
6
5
4
3
2
1
0
Time 1
Time 2
Outcomes of Transitions Group
Measures
• Feedback
9
8
7
6
5
4
3
2
1
0
Enjoyed the
group
Group
helpful
Learnt
something
new about
myself
Material
relevant
Confident to # sessions Liked venue
make
right
and
changes &
facilities
manage
difficulties
Likert scale: 1 Completely disagree; 10 Completely agree
Challenges
• Majority of those offered the group declined it (11 of 17) = low
numbers
o Timetable issues
o Anxiety about groups
• Heterogeneous group
• Repetition of previous input
• Engaging parents
Conclusions
• Addressing an identified need for this age group.
• Enhanced joint working and better communication between CAMHS
and CMHT.
• Improved care planning and joined up preparation for transition.
• Reduced likelihood of disengagement.
• Enhanced service user experience.
Thank you for listening!

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