scholarly journals Has the COVID-19 pandemic affected out-of-hours presentations in CAMHS?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S321-S321
Author(s):  
Sacha Evans
Keyword(s):  
Mental Health ◽  
Emergency Departments ◽  
Child And Adolescent ◽  
North Central ◽  
Out Of Hours ◽  
Mental Health Act ◽  
The North ◽  
Training Scheme ◽  
Phone Calls ◽  
Mental Health Difficulties

AimsThe aim of this project was to look at whether the COVID-19 pandemic, specifically lockdown, has impacted out-of-hours presentations to Child and Adolescent Mental Health Services (CAMHS) in North Central and East London.MethodSpecialist Registrars (SpRs) on the Royal London/Great Ormond Street CAMHS Higher Training Scheme are contacted for advice regarding all CAMHS presentations in the North Central and East London area. Responsibilities includes provision of advice to 6 hospitals (including 4 emergency departments) and 4 child and adolescent inpatient units. A record of all phone calls and call-outs, including Mental Health Act and Section 136 (S136) assessments are maintained and this study compares pre- and post-COVID-19 data to see if there are any differences in number of presentations, on-site assessments (including Mental Health Act and S136 assessments over 2019 and 2020.ResultNumbers of CAMHS presentations were lower in 2020 (mean 74 patients per month) compared with 2019 (60 patients per month). This was consistent across all months except October and December. The largest difference was seen in March: 109 patients presented in March 2019, compared with 55 in March 2020. This is also reflected in the number of assessments conducted on site. However, there do not appear to be differences in the numbers of Mental Health Act or S136 assessments undertaken over 2020, compared with 2019.ConclusionCAMHS out-of-hours presentations dropped off significantly at the start of the COVID-19 pandemic in the UK, and in particular, with the first lockdown (March to July 2020). Specialist Registrars provided advice via telephone less frequently in 2020 compared with 2019, and were required to do fewer on-site assessments of children and young people presenting with mental health difficulties.There were no significant differences in Mental Health Act or S136 assessments between the two years, however, these numbers are too small to make any meaningful conclusions.It is likely that children and adolescents were less likely to present to emergency departments for assessment of their mental health difficulties during the COVID-19 pandemic, rather than this reflecting a true reduction in mental health difficulties.Recommendations:It is helpful to continue to monitor CAMHS out-of-hour presentations.Trusts may want to consider alternative settings for providing emergency CAMHS assessments, for example, mental health hubs.Limitations:This provision of data is subject to recall bias.

scholarly journals Do we know the legal framework in child and adolescent mental health services? Survey of specialist registrars

2009 ◽  
Vol 33 (10) ◽  
pp. 393-394
Author(s):  
Faeza Khan ◽  
Faria Khan ◽  
Latha Hackett ◽  
Kenneth Ross
Keyword(s):  
Mental Health ◽  
Adolescent Psychiatry ◽  
Expert Witness ◽  
Child And Adolescent ◽  
Legal Framework ◽  
Legal Aspects ◽  
Child And Adolescent Psychiatry ◽  
Mental Health Act ◽  
The North ◽  
Human Rights Act

Aims and MethodThis survey was conducted as part of the baseline assessment of trainees' needs concerning the legal aspects of child care and to evaluate the implications for the regional academic programme. A group of specialist registrars in child and adolescent psychiatry in the North Western Deanery completed a questionnaire-based survey.ResultsNone of the specialist registrars had experience in forensic child and adolescent psychiatry. With regard to the legislation: 13 (100%) mentioned the Mental Health Act 1983; 12 (92.3%) the Children Act 1989; 7 (53.8%) the Human Rights Act 1998. of those surveyed, 13 (100%) were aware of parental responsibility; 10 (76.9%) identified the Children Act as being less stigmatising as compared to the Mental Health Act. Five (38.4%) had written court reports, and eight (61.5%) felt fairly confident after the 1-day training course. Overall interest in becoming an expert witness was 69.2% (n=9).Clinical ImplicationsDeficits in knowledge about the legal framework, limited experience in forensic placements and lack of interest in becoming an expert witness need to be further explored.

scholarly journals The psychiatry virtual-on-call experience: Can it improve confidence of foundation and GP trainees with out-of-hours work in psychiatry?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S28-S29
Author(s):  
Charlotte Harrison ◽  
Helen Blamey ◽  
Alistair Roddick ◽  
Kate Saunders ◽  
Tina Malhotra
Keyword(s):  
Mental Health ◽  
Interpersonal Communication ◽  
Multiple Testing ◽  
Learning Experience ◽  
Junior Doctors ◽  
Out Of Hours ◽  
Mental Health Act ◽  
Telephone Advice ◽  
Introductory Lecture ◽  
Perceived Preparedness

AimsOut-of-hours (‘on-call’) work can be perceived by junior doctors to be a daunting experience, associated with feeling unprepared and less supported. Simulated on-call programmes have been used to great effect in medicine and surgery to improve junior doctors’ skills in task prioritisation, interpersonal communication and confidence on-call. However, few psychiatry-specific programmes exist.We aimed to: i) Develop a psychiatry specific virtual-on-call programme, ii) Investigate if the virtual-on-call programme improved confidence amongst junior trainees in key areas of psychiatry practice.MethodThe Psychiatry Virtual-On-Call programme commenced in December 2020. It involves attending an introductory on-call lecture, followed later in the rotation by a 2-hour simulated on-call shift. All trainees are expected to attend during their attachment and the simulated shifts are ongoing. During the shift, trainees are ‘bleeped’ with different psychiatry specific tasks. They work through the tasks, using local intranet policies and telephone advice from the on-call psychiatry registrar. Due to COVID-19 the sessions were delivered virtually. Participants completed a questionnaire evaluating confidence in ten domains, rated on a Likert scale from 0–10. Questionnaires were completed at four time-points during the programme; pre- and post-introductory lecture and pre- and post-simulated shift. Scores were compared using Mann-Whitney U tests. Significance was defined as P < 0.05 with Bonferroni correction applied for multiple testing.ResultTwenty-nine trainees attended the introductory lecture, 25 and 21 trainees completed the pre- and post-lecture questionnaire respectively. A non-significant improvement in confidence was reported in three domains: seclusions reviews, prescribing, detention under the mental health act.At the time of writing, ten trainees had attended the on-call shift. All participants completed a pre- and post-session questionnaire. The on-call shift was a useful learning experience (median score 9), and significantly increased perceived preparedness for on-call work from 3/10 to 7/10 (p < 0.001). Confidence was significantly improved in seven domains, most markedly in seclusion reviews, prescribing and mental health act tasks.ConclusionThe psychiatry virtual-on-call programme fills a niche in the training curriculum and is perceived by trainees to be a useful learning experience. The introductory lecture improved confidence in several domains, but not as effectively as the on-call shift. The on-call shift was well received by participants and significantly improved confidence in 7/10 domains. In summary, the virtual-on-call experience improves preparedness for out-of-hours psychiatry work. Follow-up of participants at the end of their psychiatry rotation will ascertain if they felt the programme to be useful during out-of-hours work.

Developing a Vision for Therapists Working within Child and Adolescent Mental Health Services: Poised or Paused for Action?

2005 ◽  
Vol 68 (4) ◽  
pp. 181-185 ◽  
Author(s):  
Melanie Harrison ◽  
Kirsty Forsyth
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Occupational Therapy ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
The Face ◽  
Therapy Services ◽  
Mental Health Difficulties ◽  
Practice Development

This opinion piece invites a professional debate on the organisation of Child and Adolescent Mental Health Services (CAMHS) occupational therapy in order to deliver the modernisation agenda while sustaining its excellent record for practice development and innovation. In the face of such challenges, there needs to be reflection on whether CAMHS occupational therapy is ‘poised’ or ‘paused’ for action and what strategies would tackle existing challenges and support its growth. The piece puts forward a potential vision involving occupation-focused theory and developing academic and practice partnerships in order to ensure that children with mental health difficulties access occupation-focused, theory-driven and evidence-based occupational therapy services.

scholarly journals Mental health in hospital emergency departments: cross-sectional analysis of attendances in England 2013/2014

2020 ◽  
pp. emermed-2019-209105
Author(s):  
Simona Baracaia ◽  
David McNulty ◽  
Simon Baldwin ◽  
Jemma Mytton ◽  
Felicity Evison ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Departments ◽  
National Study ◽  
Hospital Emergency ◽  
Cross Sectional ◽  
Out Of Hours ◽  
Psychiatric Conditions ◽  
Sectional Analysis ◽  
Hospital Emergency Departments ◽  
Index Of Multiple Deprivation

ObjectiveTo describe the population of patients who attend emergency departments (ED) in England for mental health reasons.MethodsCross-sectional observational study of 6 262 602 ED attendances at NHS (National Health Service) hospitals in England between 1 April 2013 and 31 March 2014. We assessed the proportion of attendances due to psychiatric conditions. We compared patient sociodemographic and attendance characteristics for mental health and non-mental health attendances using logistic regression.Results4.2% of ED attendances were attributable to mental health conditions (median 3.2%, IQR 2.6% to 4.1%). Those attending for mental health reasons were typically younger (76.3% were aged less than 50 years), of White British ethnicity (73.2% White British), and resident in more deprived areas (59.9% from the two most deprived Index of Multiple Deprivation quintiles (4 and 5)). Mental health attendances were more likely to occur ‘out of hours’ (68.0%) and at the weekend (31.3%). Almost two-thirds were brought in by ambulance. A third required admission, but around a half were discharged home.ConclusionsThis is the first national study of mental health attendances at EDs in England. We provide information for those planning and providing care, to ensure that clinical resources meet the needs of this patient group, who comprise 4.2% of attendances. In particular, we highlight the need to strengthen the availability of hospital and community care ‘out of hours.’

scholarly journals Barriers to sharing information with schools

2018 ◽  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Educational Needs ◽  
Exchange Of Information ◽  
Mental Health Difficulties

A recent study by Tania Hart and Michelle O’Reilly has found that the exchange of information between Child and Adolescent Mental Health Services (CAMHS) and schools needs improving to sufficiently support the educational needs of young people with emotional mental health difficulties.

Detaining patients in the general hospital – current practice and pitfalls

2019 ◽  
Vol 64 (3) ◽  
pp. 91-96
Author(s):  
Murray Smith ◽  
Rian O’Regan ◽  
Rainer Goldbeck
Keyword(s):  
Mental Health ◽  
General Hospital ◽  
Current Practice ◽  
Electronic System ◽  
Royal Infirmary ◽  
General Hospitals ◽  
Out Of Hours ◽  
Mental Health Act ◽  
Written Information ◽  
Psychiatric Staff

Aims Much has been written about the use of the Mental Health Act in psychiatric settings. There is, however, little written on its use to detain patients with mental disorder in general hospitals. Method and results We therefore carried out a survey of the use of the Mental Health Act in general hospital settings in Aberdeen, and also posted a questionnaire to Scottish Liaison Psychiatrists, asking about their experience of the use of the Mental Health Act in general hospitals. Over a six-month period in Aberdeen Royal Infirmary, we identified 39 detentions. Out of hours, the use of Emergency Detention Certificates was more common than use of Short Term Detention Certificates – the latter is recommended by the Mental Welfare Commission, as patients are afforded more rights. When psychiatric staff were not directly involved, procedural and administrative errors were more likely to occur. Liaison psychiatrists elsewhere in Scotland reported similar observations. Conclusion General hospital clinicians are unfamiliar with the Mental Health Act and its use. Errors in its application therefore arise, and are more common when psychiatric staff is not involved. Better education, including the provision of written information and consideration of an electronic system, may improve current practice.

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