Child and Adolescent Mental Health Services

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WRITTEN QUESTION TO THE MINISTER HEALTH AND SOCIAL SERVICES BY DEPUTY M.R. HIGGINS OF ST. HELIER

ANSWER TO BE TABLED ON TUESDAY 24th MARCH 2015

Question

Will the Minister update members on the current situation in the Child and Adolescent Mental Health Services (CAMHS) using the key findings and recommendations of the Health and Social Security Scrutiny Panel Report of 16th June 2014 as his guide, illustrating what has and not changed in the service?

Answer

The action plan developed from the Scrutiny recommendations has been a priority for CAMHS and the wider organisation. The former Health and Social Services Minister in her response to the review indicated that there were two significant planned processes that would underpin the development of children and young people's mental health services and the implementation of the recommendations of Scrutiny. These were:

• The CAMHS Rapid Process Improvement Week (RPIW) which enabled the CAMHS staff to review their service with key partners across States departments and the voluntary sector in response to the Scrutiny recommendations and to develop a challenging action plan for Service reform using Lean principles. This plan has been implemented and monitored continuously over the last 6 months.
• The Mental Health Service Review which is nearing the end of the development process. Determining the main themes has involved Jersey residents, service users, States Members, professionals across States departments, business and the charity and voluntary sector. This is due to go to consultation in June 2015 and will provide the strategic direction for Comprehensive

CAMHS.

There has been significant progress which has only been possible due to the commitment and effort of the CAMHS team and Children's Services, while still maintaining a service to the community. Health and Social Services will be providing a detailed update to the Scrutiny Panel in April 2015. However, I am able to outline some of the areas that still require addressing, while stressing the major improvements that have been implemented to date.

• Areas currently being addressed :
  • Finding appropriately skilled and dedicated management expertise for the Service (we are competing with other jurisdictions also seeking individuals with these particular skills and expertise)
  • Developing appropriate, robust and efficient data collections systems
  • Finalising a quality framework for the Service
  • Finalising policies and pathways with partner agencies
  • Managing the demand for therapeutic interventions to reduce the waiting time for therapy
  • Developing a designated place of safety for young people
• Improvements

• Interim specialist appointments at senior leadership level

• Reducing the waiting time to first appointment, which has dropped from 14 weeks to under 3 weeks
• More efficient processing of referrals. The referral process has been redesigned including new eligibility criteria, referral form and daily decision making. This ensures referrers are aware of the remit and threshold of specialist CAMHS and are able to provide relevant information. Decisions can then be based on this information and are made on a daily basis. This reduces the number of inappropriate referrals and facilitates a more rapid response so that once the referral has been received a family will be sent an appointment date for first appointment within 24 to 48 hours.
• A range of clinical pathways to ensure that evidence-based care is delivered and provides a standard to monitor the effectiveness and efficiency of the provision.
• A system to ensure that the staff member with the most appropriate skill set is allocated to work with each individual client and their family so that with the changes outlined above young people and their families will be offered effective evidence-based interventions in a timely fashion.
• The standardisation of questionnaires to monitor outcomes and satisfaction with the service to ensure that treatment is leading to positive change and that the young people and their carers are satisfied with the service offered. This will be benchmarked against national outcome data through the CAMHS Outcomes Research Consortium (CORC).
• A targeted Systemic Family Therapy Service for children and young people with significant mental problems and their families so that therapeutic intervention can include all family members when required.
• Some of the key themes that are emerging have highlighted the importance of prevention and early intervention both in the life of a child and of a condition and the need to ensure a coordinated response across all providers of service. The strategy will therefore provide direction for all those working with children.

Next Steps

• Full completion of action plan prepared in response to Scrutiny including Rapid Improvement Plans
• Implementation of any changes needed in line with the new Mental Health Strategy later this year
• Increased engagement with partners and users of the service
• Move service to an appropriate user-friendly environment
• Develop link with Jersey Talking Therapies
• Provision of talking therapies for children and young people planned for 2016 as part of P82; however, this is dependent on the MTFP for funding.