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THRIVE workshop feedback

Stigma

  • Some young people may have an issue including school and not open 52 weeks of the year.
  • Want to access services on their services and in their time. – kooth.com 50% will use this service. Power remains with the young person. Once engaged more inclined to then engage with services if further help is needed.
  • Families may worry about a label and their child entering services.
  • Behavioural schools – stigmatizing and increase anxiety for those children who have behavioural problems.
  • Education is getting better but still stigma in schools and with health professionals
  • Want help early without issue.
  • Need = continuality between physical and mental health. Mental health not given same priority.
  • Any point in rebranding? Unless the stigma is addressed, anything it’s called will eventually become negative.

Crisis

  • Get the care in hospital but when you get home there’s no support
  • Information given out on discharge needs to be geared to young people
  • Appropriate numbers eg. Childline
  • And appropriately designed for young people, eg. specialist foster carers
  • Increase provision of facilities like Sedbergh Drive and develop a crisis bed (like Arnwood House in Carlisle)
  • Needs to be a multi agency solution
  • Need to be able to move people on eg only stay 3 days,
  • If seen by CAMHs crisis service you are seen every day for a weeks then go back onto core CAMHs waiting list
  • The adults crisis service has open access
  • Very hard to get staff from agencies at short notice
  • Need our own bank of trained people
  • Need somewhere to care for young people who are in crisis needing assessment or short term place:
  • Often families have other children at home to look after
  • The adult model is better
  • Crisis café idea – but how could it work in dispersed geographical area – virtual solution? – use another existing centre?
  • 24/7 service possibly via 111? Possibly by Skype
  • Could be something that exists nationally already but ideally access to records and knowledge of local service & parents, child & YP and professionals.
  • Telephone line for people in emotional distress as well as MH problem – the YP feels like they’re in crisis
  • My time waiting list too long
  • 16 – 18 year old missing out
  • No crisis support
  • How many hospital admissions before you receive help
  • No 24/7 crisis for CAMHs
  • Contact number is not friendly for youngpeople in crisis
  • CAHMs risk assessment area not detailed – they are rushed
  • When crisis happens at night time or weekend children have to wait on childless wards
  • What support for families / carers?
  • No help in crisis for FASD
  • Listen to your people before it’s too late
  • What is a crisis? Lack of clarity and criteria about who can access CAIS

Transition

  • In children’s OT we liaised with Adult Social Care OT’s simple pathway of how to handover children with equipment.Shared / joint visit 6 months prior to transitioning (have it electronically v basic)
  • Adult services don’t take CYP mental health issues seriously enough – we need to work more closely
  • Child & adult services need to work together to create family approach to support – not enough emphasis on earlier intervention in adult services.
  • CAMHS should NOT discharge until young person is “ready”
  • Need YP services to think out of the box in terms of committing i.e. services for 14 – 24 yrs
  • Preparation for change in legal services for young person – need to manage parents expectations and work with YP to understand their rights and responsibilities as an adult – especially important for children with co-morbidity.
  • Depends on age at entry to CAMHS
  • 6 months prior to 18th birthday CAMHS contact adult services – or appropriate age depending on maturity / needs
  • Adult service will have a “line worker” – joint visits with CAMHS worker / adult service worker
  • Need to be discussing transition way before 17 and a half, needs more preparation with young person and family
  • Family need enough information about difference in adult and children approach to manage expectation
  • Joint working identified transitions meetings once a month between child and adult services to promote discussions around potential need
  • Clarity around what may be available in next services
  • Get the transition right not working at the moment.
  • How can early intervention happen without trained professionals.
  • No policy or seamless approach.
  • Adult digital provision supports transition.
  • Not enough joined up approach between child and adult mental health services
  • First step – not considered until post 18. How can ‘transition’ happen?
  • First steps – define what you do?

Access

  • Postcode lottery – access to wider psychological therapies eg attachment + trauma focused expertise and therapy= less ie referrals as helping to identify and ‘treat’ underlying cause.
  • Mental Health F.A volunteers next steps?
  • Cumbria is split – How can Cumbria offer an equitable service across the county?
  • Waiting list is unacceptable
  • Buildings inaccessible to wheelchair users
  • Lack of other options
  • People are unaware how to access services
  • No out of hours support
  • Information about services is poor
  • Initial access is timely but access to actual treatment is too long
  • No self referral in Cumbria
  • Difficult getting access to psychiatry
  • Was there not meant to be a Cumbria hub?
  • North/South split of CAMHS
  • Difficulty with high number of referrals being rejected
  • Young people don’t feel professionals take them seriously
  • The service is not accessible or friendly for young people
  • Can’t get help early enough
  • Triage is done in North Cumbria. How is that accessible from South Cumbria?
  • Not enough consideration of family/school views
  • Too long to access support

Care of the most vulnerable

  • We’re working with same group of kids
  • How do we support YP/families who are “Non-engaging”
  • Who decides?
  • No service for young people with eating disorders. “postcode lottery” for very vulnerable (physical risk).
  • Getting support shouldn’t depending on having a specific condition
  • Working well – interface with children’s centre support – my time including early help
  • Gaps age 11 in ASD/LD Morecambe.
  • No dedicated LD/ASD Staff in CAMHS Cumbria
  • Charity referrals are never taken seriously when we deal with the most vulnerable.
  • Lack of services that meet the needs of children with/or going through ASC assessment/diagnoses.
  • YP whos families/carers have own MH issues ‘normalise’ their behaviours as don’t know any different or are scared to ‘show up’ what goes on at home. Also parent/carers cant always support due to their own MH needs.
  • Who supports children with complex physical needs +/or with no voice.
  • No easy access to clinical psychology for C&YP with LD, ASC and their families.
  • Children/YP in need of tier 4 services but to access this means to separate from family and access via residential care – too far and exasperates issues. Also egs of children discharged without plan in place to support in return home
  • YP who have learnt to cope with their issues (we see drink, drugs, cse risk, abusive behaviour to siblings/self/family, self harm etc) sometimes are so entrenched in dealing with things their way are past it when CAMHS support becomes available and will not access the service
  • Significant % if students medically unfit for school are signed by CAMHS and then become isolated outside mainstream school and remain at HNTS for 1-3 years and struggle further post 16 transition to move on as so out of the ‘normal’ system.
  • Pupils in PRU/HNTS where need is clear have never been referred or have but won’t attend have huge needs that go unsupported
  • Need to support young people where parents themselves have MH issues

Digital

  • Evaluate what activity is currently going on
  • Family response to crisis – what can parents tap into?
  • Parents comments and forum to professionals
  • System – to bring her down, family/parents educational drop ins.
  • No dedicated working GRP for digital services in Cumbria CAMHS
  • Have People Forgotten how to Communicate?
  • Digital – noYP presence – made by adults / IT not friendly / helpful