Mental health problems which begin in childhood and adolescence are not only common but can have wide-ranging and long-lasting effects. These can lead to significant distress, poorer educational attainment and employment prospects, social relationships, and longer-term physical and mental health problems.
Accessing services quickly and easily is of central importance to children, young people and families. It is important everyone involved understands the process and feels supported, the scrutiny panel carried out an in depth and valuable review of services provided for children, young people and their families.
The Ad-Hoc Scrutiny Panel which Cllr Cahal Burke Chaired was established to undertake a review into the provision of CAHMS in the Kirklees area in response to growing concerns regarding the operation of the organisation and its efficiency in providing a satisfactory level of service provision. The service had been subject to negative publicity in the press, and it had been acknowledged by South West Yorkshire Foundation Trust, who were commissioned by Greater Huddersfield, Calderdale and North Kirklees Clinical Commissioning Group to run the service, that they did not have adequate resources to cope with the level of demand.
The Terms of Reference of the Ad-Hoc Panel were;
– To scrutinise the performance of the Child and Adolescent mental Health Services in Kirklees, with a particular focus upon;
(i) Developing an understanding of the services provided by CAMHS and its current performance in line with national requirements
(ii) Scrutinising the CAMHS transformation plan and the supporting action plan
(iii) Seeking the views of service users and considering benchmarking information nationally on the provision of CAMHS services.
Recommendation (1) – That the process for referrals into the system should become more accessible and transparent, and that the processes should be widely publicised, particularly amongst key stakeholders.
Rationale – The Panel felt that too many key stakeholders lacked a feeling of inclusion in the process of referrals, which prevented a holistic approach towards supporting a child/young persons who may have additional needs. The Panel considered that the involvement of partners (eg, GPs, schools) was essential to ensure high quality service provision and that the delivery of training courses on the function and operation of CAMHS, including how to make a referral, may be an effective way of embedding engagement of partners. The Panel felt that clarity of working relationships was fundamental to the provision of sound advice and support.
The Panel also considered that communication methods between CAMHS and the service users needed to be strengthened to enable a two way communication process from the point of initial referral, and then throughout the waiting time and the provision of treatment. Service users would benefit from having clear access points into the service at different stages, eg, to seek clarification on waiting times, links to support staff etc. At all stages of the process there should be ongoing communication with the referee/parent/carer/school/service user regarding the next steps and expected timeframes, which would assist in ensuring that the information held by CAMHS was relevant and up to date. The circulation of a regular generic email to those on the waiting list, providing relevant information, may also be useful in acknowledging ongoing engagement with the process.
Recommendation (2) – That improved clarification be provided on the pathways both into and within the CAMHS system in order to provide transparency, access and understanding of the operation of service provision.
Rationale – The Panel considered that the mechanisms for referrals into CAMHS needed to be more clearly defined as there continued to be confusion and misunderstanding amongst service users and potential service users.
The Panel considered that a visual diagram should be published and readily available which set out potential links into the service, and approximations of waiting times at each stage. This should be distributed to schools, GPs and other key stakeholders, and also be available and easily accessible online.