A Perfect CAMHS Journey - By Devon Young People


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Every year Devon CAMHS has a cross county conference for all its staff. Each conference is themed and service users are invited to take part.

This year’s theme was ‘The Therapeutic Relationship’. It would have been easy to interpret this as the relationship between worker and client, however four young service users decided to take what was for them a more in-depth and broader view of what this meant. To them the therapeutic relationship meant their relationship with the service as a whole: therapists, managers, receptionists, letters – even CAMHS buildings). To them all these things affect their therapeutic experience of the service.

When we’re using a service it can often be easier, for any of us, to list the things that are ‘wrong’ with it. We’ve had this happen at past CAMHS conferences and that’s fine. However, the group decided to take a more positive position and put together their idea of a perfect journey through CAMHS. Their journey started with seeing their GP, referral into CAMHS, relationships with CAMHS staff and the service as a whole and then through to transition into Adult Services.

They wrote various scripted parts that were distributed around the conference room and then invited CAMHS staff to take these roles at the different times.

They began their presentation with:

‘Welcome to ‘A Perfect CAMHS Journey from a Service User’s Perspective’. The title of our presentation is a bit misleading as we realise we can never have a perfect experience. Also, we know that some of our ideas might be a bit idealistic – but it’s something to aim for…’

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A Perfect CAMHS Journey - By Devon Young People

  1. 1. A Perfect CAMHS Journey --From a Service User’s Perspective Presented by Olivia Stanley, Matt Ruane, Rachel Vowden, Jon Davies and with help from Robin Tay.
  2. 2. A Perfect CAMHS Journey
  3. 3. “For many young people, the first step of the CAMHS journey is a trip to their GP…” GP: Hello, I’m your GP. As well as my expertise in physical health, I have an extensive knowledge and understanding of mental and emotional health. When you come to see me I’ll listen carefully to what you say and I’ll focus on the emotional aspects of what you talk about as well as the physical. I’ll tell you about the various services that might be able to support you and I’ll ask for your views on what should happen next. Between us we’ll decide what the next step will be. So let’s say we decided that a referral into CAMHS is the way forward….Someone from CAMHS will contact you in a couple of days, how would you like to be contacted?   Rachel: By phone please   Jon: I’d like CAMHS to write to me please   GP: Okey dokey, no problem
  4. 4. Visit to the GP – Key Points  The GP would consider both our physical and mental health when we go to see them for any emotional or behavioural problems.  They would have an extensive knowledge of the services available for young people to access.  The young person’s individual needs shall be acknowledged and if they are referred to CAMHS they should have a say in how they would like to be contacted.
  5. 5. A Perfect CAMHS Journey
  6. 6. CAMHS Worker no.1: Hi Rachel, I’m a CAMHS Worker and when I give you a call a couple of days after you’ve seen your GP, I’ll chat to you and find out more about what you need and assess whether or not you’re at risk. I’ll tell you about CAMHS and reassure you about the way we work. Also, I’ll let you know roughly how long it will be until your first appointment and I’ll suggest some websites you can look at to get information and support in the meantime.
  7. 7. CAMHS Worker no.2: Hi Jon, I’m also a CAMHS Worker and when I write to you a couple of days after you’ve seen your GP I’ll make sure the letter has a friendly tone and is in plain English – not too formal and complicated. I’ll include information about CAMHS and what we do and I’ll let you know roughly how long it will be until your first appointment. I’ll give you an outline of what being a CAMH Service user means so that you’ve got an idea of what to expect. Also, I’ll include some information about where you can find information and support while you’re waiting for your appointment.
  8. 8. First contact from CAMHS – Key Points  If the young person wishes to receive a phone call, they should be provided with useful information about CAMHS and how they can help.  If the young person decides to receive a letter from CAMHS, it should be easy to read and have a welcoming tone.  In both cases, the young person should receive useful resources which can support them whilst they wait to be seen. A rough estimate of when the young person can expect to have an appointment would also be appreciated.
  9. 9. A Perfect CAMHS Journey
  10. 10. Letter with details of first appointment: I’m the letter confirming the details of your first appointment. I’m reassuring, personal, positive and friendly….I’m definitely not cold and clinical. “First impressions are important. I might be feeling nervous and anxious when I come to CAMHS for the first time. I really want to be made to feel at ease…” CAMHS Receptionist: Hello, I’m the CAMHS Receptionist. Mine will be the first face you see when you come for your appointment and I know how important first impressions are. I realise that you might be a bit on the nervous side so I’ll be attentive, cheerful and welcoming. I’ll find out your name and I’ll always use it when I’m talking to you – I’ll tell you what my name is too. When you come back for more appointments I’ll remember you and I’ll always be pleased to see you.
  11. 11. CAMHS Building: I’m the CAMHS building. When you come here you’ll find all the doors open – no secret codes or magical security key fobs. In the waiting room there are comfy sofas and chairs and there are some children’s toys….but not too many. There’s a variety of reading material including some of the daily papers (but NEVER the Daily Mail). There’s a TV that’s sometimes on in the corner and when it’s on it’s never, ever on the CBEEBIES channel. When the TV is not on, there’s a radio on in the background. There’s a vending machine for hot drinks, a water dispenser and a good supply of cups. Also, there’s some plants – a yucca plant and a bonsai tree. The place doesn’t smell of dodgy air fresheners or anything unpleasant in fact. The walls are neutral colours – not too bright but not too drab either – and there are pieces of art made by children and young people who have used CAMHS on the walls. Some of the floors are wood and some are carpeted – there is absolutely no lino.
  12. 12. CAMHS Worker no.3: I’m the worker that will be with you during your time with CAMHS. When you come for your first appointment I’ll come and meet you in the waiting room. I’ll tell you my name and my job title and I’ll explain my role in a clear way so that you have some understanding of what I do. I’ll be relaxed, confident and friendly. I’ll know your name and I’ll use it. If you’re with someone else, like a parent or carer, I’ll engage with them too and I’ll ask you if you would like them to come with you to your appointment.   When we get to the therapy room you’ll find it cool and airy with some comfy chairs and no desk. I’ll check that it’s cool enough or warm enough for you and I’ll let you choose where you sit. Continued….
  13. 13. CAMHS Worker no.3 (continued)… I’ll break the ice with a few light hearted questions and I’ll tell you a bit about me too. In our first meeting I’ll find out as much as I can about you and your life and I’ll ask some questions about your emotional wellbeing but nothing too pressured and I’ll let you know that you don’t have to answer any questions that you don’t want to. I’ll listen really carefully and I’ll check with you that it’s ok to take notes if I feel I need to. When I’m working with you I’ll think about you in the broadest sense – I’ll consider your family, your friends. School or college, work, pets and anything else that plays a part in your life.   When we get to the end of our first appointment, I‘ll be really clear and honest about what will happen next – for example, how many appointments you’re likely to have and how often.
  14. 14. First visit to CAMHS – Key Points  CAMHS Receptionists play a large role in a young person’s first impression of the service – they’re just as important as therapists and consultants in regards to the CAMHS experience!  Young people would like a waiting area which is contemporary, comfortable and equipped with refreshment facilities.  Positive traits of a CAMHS worker would include – the ability to listen, to be likeable and take an holistic approach when assessing what support the young person needs. This could encompass their family, school, friends, work and even pets!
  15. 15. A Perfect CAMHS Journey
  16. 16. CAMHS Manager no.1: As a CAMHS Manager I’ll make sure that your worker knows to explain the structure of your support and all the details such as where you have to go, how often and how long you’ll get support for. I’ll make sure that your worker uses outcome measures as supporting tool and not as the main factor in hearing what you’ve got to say. As a service, we’ll give you information and resources to help you between sessions. We’ll always listen to what you say, give you advice and guidance when you ask for it and encourage you to contact us between sessions if you need to. We’ll also encourage you to keep a record of how your support is going – maybe a diary – so that you can share these thoughts with your worker. We’ll ask your worker to share with you how they think it’s going too. We hope that this will help the worker to get even better at their job.
  17. 17. CAMHS Manager no.2: Hi, I’m another CAMHS Manager. I’ll make sure you have some choice over the Worker that helps you and I’ll make sure it’s as easy as possible to change your Worker if you need to. As a service, we’ll do everything we can to keep you with the Worker you’re happy with and we’ll be really honest, and give you as much warning as we can, if this has to change for any reason. We’ll make sure you know how to raise a concern about CAMHS in a way that feels safe for you so that you don’t feel uncomfortable or worry that your support might be affected in bad way.
  18. 18. During our time with CAMHS– Key Points  It is important that the young person understands the treatment that they may receive and its structure. In between sessions, the young person can contact their CAMHS worker, if they are in distress or need help outside of appointment time.  We understand the constraints of a health service like CAMHS, but where possible young people would like a choice over the worker they are assigned.  If there are any direct concerns, either by the worker or young person, there should be a dedicated person who can deal with any difficulties or complaints, to ensure that effective treatment is given.
  19. 19. A Perfect CAMHS Journey
  20. 20. “At some point we’ll have to say goodbye to CAMHS and it’s really important to get the ending right…” CAMHS Manager no.3: Hello, I’m CAMHS Manager number 3. When you’re getting towards the end of your time in CAMHS, I’ll make sure your Worker explains how your support will end and what will happen next. You’ll be able to have some follow up sessions to see how you’re doing – these will get less frequent and will end up like occasional check-ups. When your support has come to an end, your Worker will assure you that if you feel you need their help again, you’ll be able to make an appointment with them without having to go through the whole referral process for a second time.
  21. 21. CAMHS Manager no.4: Hi, I’m another CAMHS Manager – I realise we’re starting to look a bit management heavy in this scenario…sorry about that. Anyway, if you’re moving from CAMHS into Adult Services, I’ll make sure that we’re flexible about how this happens – we won’t be too rigid about when this has to happen and we’ll base our decision on your needs as an individual. Before you leave us, we’ll give you lots of information about Adult Services and explain how it’s different from CAMHS so that you know what to expect. Once you’ve moved on, we’ll keep in touch with Adult Services and support their work with you as much as we can. We’ll share any information with them that you want us to in order to help you.
  22. 22. Towards the end of our time at CAMHS– Key Points  The young person should be aware of the support they can receive after they have reached the end of their time at CAMHS. Follow-up appointments should be arranged and would become less frequent, to ensure that the right progress is being made.  Clear information will be given to the young person about adult mental health services, and how it may benefit them.  An agreement between CAMHS and the young person could be reached about the right time for the transition to occur.
  23. 23. CAMHS Worker no.4: And finally…I’m another CAMHS Worker by the way….and if I was your Worker – when we come to the end of our work together I’ll let you know that it’s ok to keep in touch with me and tell me about all of the exciting things you’re doing.
  24. 24. Thank you.