Demand for Child and Adolescent Mental Health Services remains high across Western Trust

DEMAND for Child and Adolescent Mental Health Services (CAMHs) in the Western Trust continues to outstrip service capacity - however, help is still at hand and better times are ahead, it is hoped.

Referral rates for mental health services amongst young people fell significantly during the first Covid-19 lockdown, however, rates have continued to rise since restrictions have eased.

Currently, the service has 536 young people on its waiting list.

All referrals are screened and clinically triaged by the CAMHS referral coordinator to ensure the most vulnerable young people at risk receive timely assessment and intervention.

Whilst the service meets regional access targets with respect to emergency (within 24 hours) and urgent referrals (within five days), it has consistently missed regional targets of nine weeks wait for a routine choice appointment.

Waiting times remain under regular robust scrutiny and monitoring by the service senior management team, Trust and HSCB.

Sara McGee, CAMHS head of service at the Western Trust, said: "The service would wish to acknowledge the frustration felt by families in attempting to access the service and targets not met within regional routine access times.

"Unprecedented challenges on the service have been acknowledged by the Trust and HSCB, with additional funding secured to support staffing recruitment and progression of the development of the service over the forthcoming years.

"This has been welcomed by the service, CAMHS management and clinicians whose focus is to deliver a timely compassionate service which endeavours to foster and nurture therapeutic connection with the families and young people in receipt of care and treatment."

A review of mental health services in Northern Ireland has indicated that rates of mental ill-health are approximately 25 per cent higher than in other parts of the UK.

CAMHS has continued to witness a significant rise in referral rates since 2016/17 when accepted referrals to the service reached 1,772.

In 2017/18, accepted referrals figures accounted for 1,975, peaking at a 36 per cent increase in 2018/19 with 2,577 referrals accepted by the service.

The service had a marginal fall in 2019/20 accepting 2,096 referrals.

In keeping with other services, the referral rate fell sharply 2020/21 in the first quarter over lockdown with an annual acceptance rate of 1,192.

During the Covid-19 pandemic, the service remained operational and continued to see young people face to face experiencing a mental health crisis, requiring urgent assessment and all priority groupings.

Sara continued: “The service has endeavoured to mitigate lost capacity (due to ensuring safety with respect to infection control measures through social distancing) by developing virtual clinics and remote working to connect therapeutically with young people and families.

"All young people on the CAMHS waiting list were contacted during the initial lockdown and guidance with respect to useful information given.

“Acknowledging the current waiting times and our determination to support young people, the CAMHs team have progressed a waiting list initiative offering new choice appointments.

"During the rebuilding of HSC Services October 2020 – December 2020 - 385 new young people were seen by the service and 2,330 young people were reviewed."

Prior to the pandemic, research suggested that approximately 35 per cent of those aged 11-16 in Northern Ireland have experienced some concern or worry about their mental health.

Of this cohort, 39 per cent of those sought help, the most common sources of support being family and friends. 24 per cent of those who sought help attended their GP, whilst 13 per cent required support from Child and Adolescent Mental Health Services (CAMHs).

However, enforced removal of contact with the education system and other social supports since Covid-19 has stretched the service.

"This has raised concerns, not only regarding the mental health and wellbeing of children and young people, but also in regards to reduced contact with multi-disciplinary agencies involved in maintaining safeguarding of children and young people," Sara said.

“It is noted that children and adolescents are more likely to suffer the tragic loss of a parent, family member or caregiver during the pandemic.

"The psychological impact of such loss is an important factor in considering the long-term mental health implications on the younger generation."

Evidence would suggest that the pandemic has had a significant impact on young people experiencing an eating disorder.

Suggestions related to this increase report over-reliance on social media, focus on healthy eating and diet, reduction in peer support and restriction to social distraction and compensatory behaviours have compounded young people’s ability to manage negative cognitions.

“CAMHS clinicians deliver assessment and therapeutic work through a variety of mediums, including remotely, face to face, virtual and consultation," continued Sara.

"Home visits can be conducted if clinically indicated. CAMHS is a specialist tier 3 Community Service. Referral may be sought through GP, health visitor, paediatrician, Educational Psychologist, School SENCO or Social Worker."

Child and Adolescent Mental Health Service (CAMHS) and VOYPIC Voice of Young People in Care (VOYPIC) recently launched 'CAMHS Young Minds Matter' an information leaflet and DVD for young people in the Western Trust area who require support to deal with mental health issues.

Sarah continued: "These resources have been developed in conjunction with the young people involved in our service and demonstrate how our staff continue to strive to make improvements to our services by listening to service users on what changes are needed through the eyes and voices of young people who have direct experience of the journey themselves.

“The resource materials have been distributed to schools, colleges, GPs practices, leisure facilities, community and voluntary groups across the Western Trust area and are available on the Western Trust’s website to ensure easy access to all young people and families who have been referred to CAMHS.

"In addition, there are a wide range of apps (the worry box, Booster Buddy, Mindful Gnats, Headspace, Positive Penguins, Chill Panda), and websites include: www.youngminds.org.uk www.mycamhschoices.org www.moodjuice.scot.nhs.uk, www.kidscape.org.uk, www.talktofrank.com, www.beateatingdisorders.org.uk and there are links/resources through PHA that can be utilised."

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