- 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.
 
THRIVE workshop feedback
- 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
 
- 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?
 
- 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
 
- 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
 
- 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