Transcript The Strength of Tier 2 approaches to Mental Health

National Conference
Devon County Hall, Exeter
13th November 2012
Andrew Starr
Primary Mental Health Worker, Leicester CAMHS
The main differences between Tier 2
and Tier 3 in CAMHS
Tier 2
10 times as many children
affected
Larger range of professionals
with relevant experience
Initial, or lower level mental
health problems (low risk)
‘Public Health’ issue that
intervening early is cheaper,
and causes less distress
Short waiting times
Tier 3
‘Statutory’ right to a service
Probably the own available
service
Higher levels of mental health
‘risk’
Largely a ‘reactive’ service
approach
Prioritised waiting
‘Active’- not Reactive
Tier 1
Tier 2
84%
15%
Tier 3 &4
1%
‘Library’, not ‘Filing Cabinet’
Tier 2 Model
Tier 3 Model
Network Model
“Who is helping this child now?”
“Who else might be able to help?”
“How can I help these people?”
PMHW
CAMHS Priorities
At Tier 3
At Tier 2
Assess Serious Mental
Ill-Health in children and
Young People
Support other
Professionals and
Services in their role
Offer Treatments to
Children and Young
People
Assess Serious Mental
Ill-Health in children and
Young People
Support other
Professionals and
Services in their role
Offer Treatments to
Children and Young
People
Research and
Development
Research and
Development
‘Access’ and Health Inequalities
• What are the barrier?
Within Sociality
• Gender, Race, Religion, Age, Culture, Class,
Ethnicity, Sexuality, Spirituality
Within Services
• The same?
Lessons from Adult I.A.P.T. ?
• Rationing resources
– Shorter, focused appointments
– Use of one main therapy
– Uniform (evidence based) approaches
– Using Health Centres
But- for CAMHS
•
•
•
•
•
Often more than one Patient
Different Ethical framework for children
Many professionals already involved
Too many children to see them all
Mental Health is Everyone's Business
Accessibility
• Examples of how Tier 2 CAMHS has brought
mental health services into communities.
– MAP in Tower Hamlets
– Traveller Projects
“Hello, Mum....the Doc wants to know if I have difficulty
making decisions. What do you think?”