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CAMHS
Ricky Emanuel
Clinical Lead CAMHS
Service Development Directorate
Camden PCT
Service Description
Tier 1 - Front line staff
Frontline staff
working with
children in any
setting
TIER 3
Consultation and
Training to Tier 1 staff
must be expanded
(NSF and ECM).
Best achieved working
alongside primary care
TIER 2
and other staff to enable
them to recognise the
TIER 1
contribution they
can
GPs, community paediatricians, HVs,
make. Its their
social workers, teachers, mentors, SENCOs
business too
Voluntary sector community workers
Tier 2 - Multi Agency CAMHS
Assessment, short term
treatment and conduit
for referral to Tier 3 or
other services
TIER 3
TIER 2
Tier 2 workers also in
Tier 3 to facilitate this
and aid recruitment
and retention and
to recognise the
complexity of
cases seen
in Tier 2
Provided in locally
accessible
settings: schools,
primary care, Sure
Start Children’s
Centres
Multidisciplinary,
Multi agency networks,
Team around the child
with tier 1 workers
TIER 1
TIER 3 - Secondary Specialist CAMHS
Specialist Assessments
and Treatments,
sequentially or in parallel
Co-ordinated
interventions of
several CAMHS
professionals
to address
complex
problems
TIER 3
Specialist
CAMHS
professionals
TIER 2
TIER 1
Multi disciplinary
teams of specialist
CAMHS
professionals
working in specialist
CAMHS facilities
How is CAMHS Organised in Camden?
Managed network of multiple providers
Service is currently being
Reconfigured to Integrate
Tier 2 & Tier 3 services
Tavistock and Portman
is the main provider of
Tier 2 services in
Camden
Jointly commissioned by
Camden PCT & Local
Authority with a CAMHS
Commissioner and a
Clinical Lead
Tavistock
& Portman
Royal
Free
UCLH
CAMHS
Brandon
Centre
Anna
Freud
Camden Demographics / Epidemiology
Deprivation index 19/354
Polarised London borough huge gap between rich and poor
Ethnic minorities
45% population 0-19 of 44,100 are not white
Asylum seekers/refugee children
primary schools – 19%
secondary school – 14%
Diagnosable mental health disorder
4000 children (NSF figures)
Using risk factor analysis number more likely to be 8000
High level of unmet need
What Is the Client Group of Our Service?
Age range
- 0-18 yrs
- in some units up to 21 where they have been referred before
18th birthday.
Eligibility
- Any child who lives in Camden or with a Camden GP
- Non Camden children in Camden schools can currently
access CAMHS services in Schools.
How do People Access our Service?
Where do referrals come from?
- Health, education, youth service, self-referrals voluntary agencies
- Hospital CAMHS services accept referrals from anywhere in the
hospital e.g paediatrics, A/E, adult services when children are
involved
What is the process for receiving referrals?
- Different for each setting.
- Tier 2 in primary care and schools direct referral to CAMHS worker.
- CAMHS services in hospitals are liaison services and accept direct
referrals to the service from within the hospital.
- MALT referrals are through Social Services
- All other Tier 3 referrals are thorough Camden CAMHS Joint Intake
Camden CAMHS Joint Intake Service
Single point of entry to CAMHS
ensures equity of access and referral to most appropriate service
Comprises all tier 3 services in Camden
includes Brandon centre and shortly Anna Freud centre
Camden CAMHS joint intake allocate cases to relevant services
along referral pathways
Tier 2 services refer into tier 3 through this mechanism and tier
3 community referrals may be redirected to tier 2 services this
way
Self referrals continue but patients will be informed of joint
intake process
What are the Thresholds for our Service?
688 cases referred to Tier 3 Camden Joint
Intake in 2006/7
CAMHS generally accepts cases with
complex level of mental health needs
Service generally accepts children with some
Level 2 but mostly level 3 level of need
How Does our Service Incorporate
the Tools of Integrated
Working?
Common Assessment Framework (CAF)
Referrals into JI can be made on a CAF, filling out
relevant sections
Practitioners can refer via a CAF to us electronically
–
–
Efficient process (no need to print & post or fax referral)
Information required for the CAF can be obtained from the
initial search of the database and this information will prepopulate the CAF e.g. GP contact details, contact details for the
child, who else is working with the child
ContactPoint
Practitioners can search the database to find out which other
universal services are working with a child or if any specialist services
are involved.
Involvement with mental health, sexual health and substance misuse
services are restricted.
They can find out who their GP, school nurse or health visitor is by
looking up the child’s name.
This will be quicker than having to ring up lots of people to find out
this information
This information can then be used when making an assessment and
referral into our service
Lead Professional
We are a multi-disciplinary service
Our children have complex needs & there will often be joint
working with other agencies
Our practitioners can take up the role of Lead Professional,
when children have complex mental health needs
We will also know when other practitioners are already working
as the lead professional by checking the database. This will
help us to know who to contact quickly if we want to get more
information about a child
Why Do We Need To Work In An
Integrated Way?
Assists Clinicians in Assessments…
Clinicians referring in to, or working in the
service can use information that other
practitioners have already gathered to help them
in completing their assessments and referrals on
the same child
It also reduces the possibility of duplication of
work and the stress on families of repeating the
same information over and over again