Consultant responsibilities in child and adolescent mental health services teams: a systems dilemma

2003 ◽  
Vol 27 (2) ◽  
pp. 68-70 ◽  
Author(s):  
Peter Reder
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Clinical Implications ◽  
Ultimate Responsibility ◽  
Legal Responsibilities ◽  
Definition Of ◽  
Child Psychiatrists

Aims and MethodsA number of relevant professional bodies were invited to state their views on the responsibilities of consultant child psychiatrists within multi-disciplinary teams in order to ascertain whether there was any consensus on the issue.ResultsLittle consensus or clarity emerged, save for agreement on child psychiatrists' expertise with medical matters. Only medical organisations believed in a notion of the consultant holding ultimate responsibility, although definition of this remained elusive.Clinical ImplicationsConsultants may need to seek clarity about their clinical and legal responsibilities from their employing Trust. However, there are many other dimensions to responsibility which have relevance for the training of child psychiatrists.

scholarly journals Consultant responsibilities in child and adolescent mental health services teams: a systems dilemma

2003 ◽  
Vol 27 (02) ◽  
pp. 68-70
Author(s):  
Peter Reder
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Clinical Implications ◽  
Ultimate Responsibility ◽  
Legal Responsibilities ◽  
Definition Of ◽  
Child Psychiatrists

Aims and Methods A number of relevant professional bodies were invited to state their views on the responsibilities of consultant child psychiatrists within multi-disciplinary teams in order to ascertain whether there was any consensus on the issue. Results Little consensus or clarity emerged, save for agreement on child psychiatrists' expertise with medical matters. Only medical organisations believed in a notion of the consultant holding ultimate responsibility, although definition of this remained elusive. Clinical Implications Consultants may need to seek clarity about their clinical and legal responsibilities from their employing Trust. However, there are many other dimensions to responsibility which have relevance for the training of child psychiatrists.

scholarly journals Burnout in consultants in child and adolescent mental health services (CAMHS) in Ireland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e030354 ◽  
Author(s):  
Fiona McNicholas ◽  
Sonita Sharma ◽  
Cliodhna Oconnor ◽  
Elizabeth Barrett
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Child Psychiatry ◽  
Well Being ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Medical Council ◽  
Cross Sectional ◽  
Child Psychiatrists

Physician burnout has reached epidemic levels in many countries, contributing to adverse personal, patient and service outcomes. Adverse socioeconomic conditions, such as the economic downturn in the Ireland post 2008, contribute to a situation of increased demand but inadequate resources. Given a recent unprecedented increase in referrals to Irish child and adolescent mental health services (CAMHS), coupled with a fragmented and poorly resourced service, it is important to reflect on consultant child psychiatrists’ well-being.ObjectivesTo report on the level of burnout among consultants working in CAMHS in Ireland using a cross-sectional design.SettingCommunity CAMHS in Ireland.ParticipantsAn online questionnaire was sent to all consultant child psychiatrists registered with the Irish Medical Council (n=112). Fifty-two consultants replied (46% response rate).Primary outcome measuresQuestions assessed demographic and occupational details, career satisfaction and perceived management, government and public support. The Copenhagen Burnout Inventory measured personal, work and patient-related burnout.ResultsThe prevalence of moderate or higher levels of work-related and personal burnout was 75% and 72.3%, respectively. Fewer (n=14, 26.9%) experienced patient-related burnout. There was a strong correlation between work burnout and personal (r=0.851, n=52, p<0.001) and patient-related burnout (r=0.476, n=52, p<0.001). Lack of confidence in government commitment to investment in CAMHS (p<0.001) and perceived ineffective management by health authorities (p=0.002) were associated with higher burnout scores. Few consultants (n=11, 21%) felt valued in their job. The majority (n=36, 69%) had seriously considered changing jobs, and this was positively associated with higher burnout (p<0.001). Higher burnout scores were present in those (n=15, 28.8%) who would not retrain in child psychiatry (p=0.002).ConclusionThe high level of burnout reported by respondents in this study, and ambivalence about child psychiatry as a career choice has huge professional and service implications. Urgent organisational intervention to support consultant psychiatrists’ well-being is required.

scholarly journals Professional life in child and adolescent mental health services may be getting more complicated, but cases are not

2013 ◽  
Vol 37 (10) ◽  
pp. 326-330 ◽  
Author(s):  
Anne E. Thompson ◽  
Amulya Nadkarni ◽  
Saeed A. Nazir ◽  
Walid Sorour ◽  
Victoria Owen ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Professional Life ◽  
Clinical Implications ◽  
Case Complexity ◽  
Significant Change ◽  
Over Time

Aims and methodIn 2006, staff in child and adolescent mental health services (CAMHS) in Lincolnshire, UK, felt that cases were becoming increasingly complex. The Pearce Case Complexity Scale (PCCS) and a staff opinions questionnaire were used to measure subjective and objective changes in case complexity in a relatively stable CAMHS service over a 10-year period from 1996 to 2006, with data examined between 2008 and 2010.ResultsClinicians reported an increase in case complexity over time. However, the PCCS did not show a significant change in the decade studied.Clinical implicationsStaff anxiety could be a determinant of judgements they make about case complexity in CAMHS.

scholarly journals Psychiatrists' views of in-patient child and adolescent mental health services: a survey of members of the child and adolescent faculty of the College

2001 ◽  
Vol 25 (6) ◽  
pp. 219-222 ◽  
Author(s):  
Adrian Worrall ◽  
Anne O'Herlihy
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Clinical Implications ◽  
Design Changes ◽  
Specialist Services

Aims and MethodTo obtain a prioritised list of psychiatrists' concerns relating to in-patient child and adolescent mental health services. Four-hundred and fifty-four members of the child and adolescent faculty of the Royal College of Psychiatrists were asked to list their main concerns.ResultsTwo-hundred and seventy-four members responded. The most reported themes included lack of emergency beds; lack of services for severe or high-risk cases; lack of beds in general; poor liaison with patients' local services; lack of specialist services; and poor geographic distribution of services.Clinical ImplicationsThe range of themes identified from this survey have served to focus the National In-patient Child and Adolescent Psychiatry Study (NICAPS) and several design changes have been made to NICAPS as a result.

scholarly journals Primary consultation clinics in child psychiatry: an evaluation of referrers' views of the service

2008 ◽  
Vol 32 (3) ◽  
pp. 90-92
Author(s):  
Puru Pathy ◽  
Neleema Yanamani ◽  
Aristos Markantonakis ◽  
Paul Wilson ◽  
Russell Mason
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Child Psychiatry ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Clinical Implications ◽  
Direct Involvement ◽  
Feedback Data

Aims and MethodTo collate referrers' views on primary consultations in child psychiatry, feedback data were collected by questionnaires over a 12-month period.ResultsReferrers found reports clearly written, informative and helpful, but wished for further, more direct involvement, support and follow up, and also for a clear plan of action for the children referred.Clinical ImplicationsPrimary consultation clinics should be further developed and audited in the future, in view of the recent changes in child and adolescent mental health services.

Making sense of child and adolescent mental health services (CAMHS): An audit of the referral journey and the use of routine outcome measures (ROMS)

2021 ◽  
pp. 135910452199970
Author(s):  
Naomi Gibbons ◽  
Emma Harrison ◽  
Paul Stallard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measures ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Completion Rates ◽  
Making Sense ◽  
North East ◽  
Over Time

Background: There is increased emphasis on the national reporting of Routine Outcome Measures (ROMS) as a way of improving Child and Adolescent Mental Health Services (CAMHS). This data needs to be viewed in context so that reasons for outcome completion rates are understood and monitored over time. Method: We undertook an in-depth prospective audit of consecutive referrals accepted into the Bath and North East Somerset, Swindon and Wiltshire (BSW) CAMHS service from November 2017 to January 2018 ( n = 1074) and April to September 2019 ( n = 1172). Results: Across both audits 90% of those offered an appointment were seen with three quarters completing baseline ROMS. One in three were not seen again with around 30% still being open to the service at the end of each audit. Of those closed to the service, paired ROMS were obtained for 46% to 60% of cases. There were few changes in referral problems or complexity factors over time. Conclusion: Understanding the referral journey and the reasons for attrition will help to put nationally collected data in context and can inform and monitor service transformation over time.

scholarly journals Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024230 ◽  
Author(s):  
Stephen Rocks ◽  
Melissa Stepney ◽  
Margaret Glogowska ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Resource Utilisation ◽  
South East England ◽  
The Impact

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

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