Families' struggle to get mental health care for their children highlighted in report
A Family Voice Surrey report highlights the struggle many Surrey families experience trying to get treatment for their children’s mental health conditions by CAMHS (Child and Adolescent Mental Health Service). The research, carried out between June and October, included 96 responses to a detailed survey and in-depth interviews with parent carers. Recommendations have been accepted by Surrey County Council's Children & Health Select Committee and raised with Surrey's cabinet.
Two thirds said the referral process was ok/good, but this concealed a more complex picture with parent carers needing to find supportive professionals and often having to escalate referrals as their child’s condition worsened
Only 14% of respondents were aware that the Single Point of Access (One Stop) offered support for parents and carers while waiting for a CAMHS appointment
52% said they had to wait 3 months or longer for assessment, with 23% waiting longer than 6 months
64% were offered treatment after assessment
Only 7% said treatment outcomes were mostly achieved. 58% said treatment outcomes were not achieved at all
More than 1 in 5 (22%) of respondents’ children had at least one mental health crisis event in the last year. Different routes – including A&E admissions – were used, with help from GPs being the commonest support sought
88% reported their child’s discharge from CAMHS was not well managed, with 97% not aware of a Health and Wellbeing Plan in place
After discharge, 33% were re-referred, with 80% referred back into the same service
80% said staff were sympathetic, 60% helpful, 50% knowledgeable and 38% informative
The research uncovered some positive progress. 89% of respondents said the location, time and facilities for appointments were convenient or suitable. 85% of those offered treatment were seen within 3 months and 46% within 1 month; these were shorter waiting times than for assessment.
A full copy of the report can be downloaded here. Family Voice Surrey has presented the research to health and social care commissioners, CAMHS providers and Surrey County Council cabinet members, making the following recommendations:
1. Improve information, communication and customer-focus – CAMHS staff need to better inform young people and their families of where they are in the service at each point of contact. Care plans and processes need to be communicated clearly, without using acronyms that won’t be understood. Young people and families want friendly and helpful staff on reception, and their calls returned
2. Work with young people and their families –use feedback from young people and families to guide changes. Involve young people and their families, keeping them fully-informed so that so that they can fully participate in decision-making.
Processes – from referral to discharge:
3. Referral – improve the referral process by clarifying and training those staff able to refer.
4. Improve support and advice for parents - Make sure the single point of access can effectively support families whilst they wait for assessment.
5. Reduce waiting times – for both assessment and treatment.
6. Ensure care plan in place (and health & wellbeing plan after discharge) – One form and one plan! Have a seamless system of planning which ensures continuity and clarity about processes and plan for all parties, right through to discharge. This needs to include a crisis plan if necessary. Plans must be owned by young people and their families.
7. Improve crisis care – raise child and family awareness of what to do in a crisis. Ensure the required services are prepared. Use cases to identify how crises can be reduced, especially admissions to hospital.
8. Improve discharge process – Include the discharge process within the individual’s plan, ensuring all parties have been involved and agreed the process. Young people and their families cannot be left in crisis. Ensure that transfers to partner agencies are effective and that user experience of this is measured.
Overall service improvement:
9. Bring schools on board – increase the understanding of the referral process and of what CAMHS offers. Work towards increasing referral numbers from schools, which will likely improve early intervention.
10. Measure effectiveness/outcomes – the CAMHS service should know where every young person is within its service, requiring the systematic collection of user experience.
11. Consider parent and self-referrals by young people – this could avoid the issue of low numbers of school referrals, support working together with families and may support early intervention.
Family Voice Surrey thanks all the people who completed this survey. We know how difficult it is to complete a survey on such an emotional subject – especially if your family is in crisis. We want parent carers to know that their answers and words have made a difference, providing strong evidence to support the anecdotal feedback already available. This will, we hope, help to drive the changes that are so badly needed in CAMHS.