Reframing CAMHS

Poor mental health is closely related to many other complex and interdependent health and social concerns for young people, including educational achievements, employment, family, relationships and substance use¹.  If we accept that young people aged 16–25 have their own distinct mental health needs, then the question which arises is how such needs are best addressed within the mental health service system.

One argument which has been made is that CAMHS support could be extended to the age of 25, with a specific component within it focusing on the 16–25 age range.

Young people involved in Right Here have indicated, quite clearly, that they do not want their mental health to be  seen in isolation from other aspects of  their life and would prefer a ‘one stop’ approach to addressing their needs.

Therefore, an extended CAMHS would  need to consider how it could provide mental health support alongside help for other social or physical health issues young people may be facing.

Such changes in emphasis need to be lobbied for with commissioners, and we have produced a specific guide about how to commission better services for young people[11. See ‘How to… commission better mental health and wellbeing services for
young people’, available at http://www. mentalhealth.org.uk/publications/].

In the meantime, there is also much to be gained from ensuring that existing CAMHS services are doing their best for those in the upper age range of their client group.

“We need common sense and the human touch, not a person being clinical”

– Young person, Right Here Brighton and Hove

The following suggestions from Right Here’s experience may help those involved in CAMHS to consider how to tailor their service for older young people:

Consult with young people about what they want from the service and develop links with youth agencies that have experience in participation methods to support this work. Using the skills of an experienced participation worker can add great value to the process.

Demonstrate that your services are youth-friendly by working towards ‘You’re Welcome’ standards or equivalent.

Work with local voluntary sector providers and youth counselling services to examine what can be done to support early intervention to address needs before they get to the level where support is needed from CAMHS. Create clear referral routes and are pathways that bring CAMHS and young counselling services together. Voluntary sector services can often be less stigmatising and more engaging than traditional mainstream services and therefore need to be seen as a part of the whole support system.

Recognise that involving young people in service design and delivery takes time. It cannot be rushed and short deadlines will constrict the process and inhibit proper dialogue.

Don’t discharge young people until you are sure that safe and appropriate services have been set up for them to move on to.

Consider developing a multi-skilled, multi-agency adolescent health team/hub that includes Tier 2 CAMHS professionals, substance misuse workers and sexual health workers.