Mindsight CAMHS service and a Behaviour Emotional and

Mindsight CAMHS service and a Behaviour, Emotional and Neurodevelopmental Pathway Dr Phil Ferreira-Lay Clinical Director for CYPS Lead Consultant Child Psychiatrist Consultant Psychiatrist in Adult ADHD & ASD Service Phil. Ferreira-Lay@sabp. nhs. uk

What we stand for

Service Model Diagram

One Team

What is Different ' CAMHS One Stop' - Referral & Information Centre for all referrals, which will navigate children and young people to the most appropriate service and through the system , 0300 222 5755, from 1 April A “no wrong door” i. e. all children, young people and families will be supported to find the right help at the right time The threshold criteria for acceptance into CAMHS will be lowered and volumes are expected to increase significantly Expanded operating hours 8 am-8 pm Monday to Friday and 9 -12 on Saturday 0300 222 5755. Services will be made more accessible and user friendly through convenient locations and online services Automated clinical scheduling will ensure capacity, appointments and room availability is transparent and easier to manage A more managed model of care with clear outcome monitoring after every session A fully operationalised range of NICE compliant pathways, including: • • • New behaviour pathway Introduction of CYP IAPT Additional and specific support for adopted children and their families. Many other current CAMHS pathways will be enhanced Reporting requirements from commissioners on activities and outcomes will be more demanding Continued work with CAMHS Youth Advisors and development of an employment pathway for young people.

CAMHS-One Stop (Beacon) Means No Wrong Door

Building Wellbeing and Resilience Guided self help and support materials Primary mental health Kooth. com CYP IAPT TAMHS Youth Support Service Voluntary Sector Counselling Parental Support Programmes

Targeted Services Primary Mental Health 3 Cs Looked After Children* (expanded) Adopted Children* CAMHS Care Leavers (expanded)* HOPE and Extended HOPE STARS (Sexual Trauma and Recovery Support) (expanded)* PIMHS (Parent and Infant MH Service) Behaviour Pathway for children with Neurodevelopmental Disorders*

Specialist Services Community CAMHS CYP Learning Disabilities Service Eating Disorder Service Mindful 16 -25 year olds (Expanded)

Crisis Support Services Extended HOPE Service 365 / 24 / 7 psychiatrist on call Paediatric liaison Home treatment team for 16 - 18 year olds Extending the safe haven model for children and young people Referral through CAMHS One-Stop

Behaviour Pathways- Why are we here? ● In 2013/14, as part of a wider stakeholder engagement to set our 5 year strategic direction, Surrey Commissioners identified the need for improvements to Behavioural services for children and young people. ● With the re-procurement of CAMHS services, an opportunity arose to address these concerns. ● We had the opportunity to specify a much more joined-up model of service provision and address some of the “gaps” in the care and management of children and young people with Behavioural Problems.

Needs assessment - Surrey ● National prevalence: 1 in 10 children between age 5 and 16 years have a mental health problem ● “There is an estimated increase in the number of children with mental health disorders in Surrey from 5, 884 in 2009 to 6, 014 in 2012, based on an increase in the population estimates. ” Surrey Health Needs Assessment, Jan 2014

Needs assessment - Surrey ● The prevalence of ADHD in the UK is estimated at between 2 and 5%. ● In North West Surrey that equates to a population of around 2, 000 - 5, 000 children.

NW Surrey Service Illustration ● Acute Paediatrics Behavioural Services – ASPH seeing about 1, 500 - 2, 000 children per year ● Developmental Paediatrics – VCSL seeing about 250 new patients per year ● Tier 3 Specialised CAMHS services – SABP seeing about 200 patients per year ● Youth Counselling --VCSL ● Education and Schools – PMHW/ School link workers/Educational Psychologist ● Surrey County Council – Tier 2 Targeted CAMHS services -- SABP ● Family Support Service ● Youth support service ● Voluntary/third sector e. g. Carers’ Support, Family Voice, Surrey Youth Action

Young Person’s Journey- Since April 2016 Beacon SPA Screens Referrals will come via the Single Point of Access (SPA) and will include all Children and Young People meeting the criteria with mild to severe difficulties Decision will be made whether the CYP needs to be referred into the BEN pathway. This first stage assessment stage will involve telephone interviews with families, schools and other professionals to gather background information. Also clinical details and completed clinical ASD & ADHD questionnaire. If the young person is not eligible for BEN pathway the young person will be signposted to other areas of the CAMHS service for an initial face-to-face assessment interview.

Hub Received Completed Tool Accepted referrals for the BEN Pathway will either go into the ASD, ADHD pathway or Complex Behaviour Pathway (incl. FASD)

Diagnostic Assessment Diagnostic assessment will differ depending on the complexity and will be done in a variety of locations within Surrey depending of the need of the young person. If the outcome is: Positive they will have a multidisciplinary review, therapeutic interventions plus medication where indicated Negative they would step down and be discharged out of the other service

Step Down & Exit Plans Transition to adult ADHD or ASD service Discharge if moved out area No longer require support Discontinued medication

Pre-Diagnostic & Post-Diagnostic Support Pre-diagnostic support - Will involve individualised and / or group based interventions such us parenting groups, ADHD/ASD support and psychoeducation. For ASD this can involve parenting groups and web based support and psychoeducation Post-diagnostic support – individual and group based interventions will be available.

Get in touch CAMHS One Stop 0300 222 5755 website sabp. nhs. uk/mindsightsurreycamhs email Communications@sabp. nhs. uk https: //twitter. com/sabp. NHS https: //www. facebook. com/sabpnhs

Thank you