The document provides information from Thornby Hall, a residential therapeutic community for adolescents with severe emotional and behavioral issues resulting from early life trauma. It discusses Thornby Hall's experience with adolescents referred from CAMHS (Child and Adolescent Mental Health Services) who were struggling in psychiatric settings. The submission addresses several areas of concern with CAMHS, including large variations in resources/quality between areas, CAMHS sometimes avoiding responsibility by claiming clients do not meet diagnosis criteria, and CAMHS rarely addressing family issues that contribute to a client's presentation. Thornby Hall believes multi-agency collaboration is important for effective interventions but is often difficult to achieve. The adolescents from Thornby Hall prepared their own submission to share their experiences with
A systematic review of prevention interventions to reduce prenatal alcohol ex...BARRY STANLEY 2 fasd
Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol
exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention
interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates
the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work.
Conclusions reached from my involvement with the Canadian criminal justice system. 2011.
amd- 2021
References of papers published by Dr Mansfield Mela, and others regarding FASD, PAE, Mental Health, and the Justice System.
Dr Mela is one of the very few Forensic Psychiatrists who understands and advocates for those with FASD.
Technical brief decision making factors around fp use in luweero, uganda- a r...Jane Alaii
A research brief outlining motivations and tipping points for SBCC to promote the uptake of contraception in a rural community with high TFR in Uganda.
A systematic review of prevention interventions to reduce prenatal alcohol ex...BARRY STANLEY 2 fasd
Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol
exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention
interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates
the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work.
Conclusions reached from my involvement with the Canadian criminal justice system. 2011.
amd- 2021
References of papers published by Dr Mansfield Mela, and others regarding FASD, PAE, Mental Health, and the Justice System.
Dr Mela is one of the very few Forensic Psychiatrists who understands and advocates for those with FASD.
Technical brief decision making factors around fp use in luweero, uganda- a r...Jane Alaii
A research brief outlining motivations and tipping points for SBCC to promote the uptake of contraception in a rural community with high TFR in Uganda.
Challenges in accurately assessing prenatal alcohol exposure inBARRY STANLEY 2 fasd
Comment on the paper - Challenges in accurately assessing prenatal alcohol exposure in a study of Fetal Alcohol Spectrum Disorder in a youth detention center.
APCRSHR10 Virtual abstract presentation of Samreen of Asia Pacific Transgende...CNS www.citizen-news.org
This is the abstract presentation of Samreen, Human Rights and Advocacy Officer of Asia Pacific Transgender Network (APTN), which was made as part of the 12th session of 10th Asia Pacific Conference on Reproductive and Sexual Health and Rights (#APCRSHR10) Virtual. This session was held in lead up to #WorldAIDSDay and #16DaysofActivism against sexual and other forms of gender-based violence, on the theme of "HIV/AIDS and sexual and reproductive health and rights (SRHR) in Asia and the Pacific".
Chair: Jennifer Butler, Director, UNFPA Pacific Sub Regional office based in Fiji
Plenary Speaker: Eamonn Murphy, Regional Director, UNAIDS, Asia and the Pacific | “Solidarity and Accountability: HIV, SRHR and the COVID response”
Abstract Presenters:
-------------------------
* Jude Tayaben | Successes, Pitfalls, and Moving Forward: Adivayan Youth Health Center- A school-based program addressing Adolescent Sexuality, and Reproductive Health Issues in Benguet, Philippines
* Samreen, Manisha Dhakal | Integrating transgender health into HIV and SRHR programming in Indonesia, Nepal, Thailand and Vietnam
* Harjyot Khosa | Stigma, sex work and non-disclosure to health care providers: Exploring dynamics of anal sex through community led monitoring to bridge gaps in HIV care continuum services
* Angela Kelly Hanku, Agnes K. Mek | I can, I want, I will and Young & Positive: Two visual method projects with young women living with HIV in Papua New Guinea
For more information on the session, please visit
www.bit.ly/apcrshr10virtual12
Official conference website: www.apcrshr10cambodia.org
Thanks
Learning from Practitioners: Making adolescent-focused RCTs work (better) in ...StephanieHall57
Helped in developing and presenting a group presentation at the 2017 AEA Conference in Washington D.C. The presentation focused on several adolescent-focused Randomized Controlled Trials that my company was implementing and strategies we found to improve implementation in the various settings. The area that I presented was the Lessons Learned from Implementing an Adolescent-focused RCT in Mental Health Settings.
A descriptive qualitative study_ exploring factors effecting quality of MH services in primary care level setting in Kabul, Afghanistan. Thesis Defense
Challenges in accurately assessing prenatal alcohol exposure inBARRY STANLEY 2 fasd
Comment on the paper - Challenges in accurately assessing prenatal alcohol exposure in a study of Fetal Alcohol Spectrum Disorder in a youth detention center.
APCRSHR10 Virtual abstract presentation of Samreen of Asia Pacific Transgende...CNS www.citizen-news.org
This is the abstract presentation of Samreen, Human Rights and Advocacy Officer of Asia Pacific Transgender Network (APTN), which was made as part of the 12th session of 10th Asia Pacific Conference on Reproductive and Sexual Health and Rights (#APCRSHR10) Virtual. This session was held in lead up to #WorldAIDSDay and #16DaysofActivism against sexual and other forms of gender-based violence, on the theme of "HIV/AIDS and sexual and reproductive health and rights (SRHR) in Asia and the Pacific".
Chair: Jennifer Butler, Director, UNFPA Pacific Sub Regional office based in Fiji
Plenary Speaker: Eamonn Murphy, Regional Director, UNAIDS, Asia and the Pacific | “Solidarity and Accountability: HIV, SRHR and the COVID response”
Abstract Presenters:
-------------------------
* Jude Tayaben | Successes, Pitfalls, and Moving Forward: Adivayan Youth Health Center- A school-based program addressing Adolescent Sexuality, and Reproductive Health Issues in Benguet, Philippines
* Samreen, Manisha Dhakal | Integrating transgender health into HIV and SRHR programming in Indonesia, Nepal, Thailand and Vietnam
* Harjyot Khosa | Stigma, sex work and non-disclosure to health care providers: Exploring dynamics of anal sex through community led monitoring to bridge gaps in HIV care continuum services
* Angela Kelly Hanku, Agnes K. Mek | I can, I want, I will and Young & Positive: Two visual method projects with young women living with HIV in Papua New Guinea
For more information on the session, please visit
www.bit.ly/apcrshr10virtual12
Official conference website: www.apcrshr10cambodia.org
Thanks
Learning from Practitioners: Making adolescent-focused RCTs work (better) in ...StephanieHall57
Helped in developing and presenting a group presentation at the 2017 AEA Conference in Washington D.C. The presentation focused on several adolescent-focused Randomized Controlled Trials that my company was implementing and strategies we found to improve implementation in the various settings. The area that I presented was the Lessons Learned from Implementing an Adolescent-focused RCT in Mental Health Settings.
A descriptive qualitative study_ exploring factors effecting quality of MH services in primary care level setting in Kabul, Afghanistan. Thesis Defense
Overview of the basic platforms, best practices and an urge to create strategy and measure analytics. This is a slide show from one of our seminars given to people who are beginners in social media. Of course, we present this in person, so you will be missing all of our personal input and notes, as well as the Q&A session we have. To get details, feel free to visit us on our Facebook page and ask questions! http://www.facebook.com/talkingfinger
With our Affordable SEO Services, we custom tailor to your business needs. The goal of our Affordable SEO Company is to help get your website listing seen in organic search results and become successful online. Another SEO Company might charge more for less work when promoting your website listing, contact us today.
58e enquête de conjoncture des PME - 2014Bpifrance
Découvrez les résultats de l'enquête de conjoncture des PME réalisée par Bpifrance. L’étude a été réalisée en novembre 2013 auprès de 28 000 entreprises de 1 à 250 salariés. L’analyse porte sur les 4 571 premières réponses jugées complètes et fiables.
Les résultats sont très contrastés en fonction de la taille des entreprises et leur secteur d’activité. L’activité est en léger recul sur 2013 ; les entreprises qui exportent et innovent sont les plus optimistes pour 2014
Family life is important for many reasons. Firstly, it provides us with a sense of belonging and identity. Our family members are the people who are closest to us and know us the best. They provide us with emotional support, comfort, and guidance throughout our lives. Secondly, family life helps to shape our values and beliefs. Children learn from their parents and siblings about what is important in life, what is right and wrong, and how to interact with others. Finally, family life can be a source of joy and happiness. Spending time with loved ones and creating memories together can be incredibly fulfilling and rewarding. Family is an integral part of our social and emotional lives. It provides us with a sense of connection and belonging that is hard to find elsewhere. Our family members are the people who know us the best and are always there for us, no matter what. They provide us with emotional support, comfort, and guidance throughout our lives, helping us navigate the ups and downs that come with life.
Moreover, family life plays a crucial role in shaping our values and beliefs. Children learn from their parents and siblings about what is important in life, what is right and wrong, and how to interact with others. They learn about their cultural and religious traditions and the customs that define their family. This early learning forms the foundation of our beliefs and values that can guide us throughout our lives.
Finally, family life can be a source of joy and happiness. Spending time with loved ones and creating memories together can be incredibly fulfilling and rewarding. Whether it's enjoying a family dinner, playing games or taking a vacation together, these shared experiences help us bond and strengthen our relationships. These memories become a source of comfort and joy, especially during difficult times.
Overall, family life is essential to our personal growth, development, and happiness. It provides us with a sense of identity and belonging, shapes our values and beliefs, and creates a source of joy and happiness that is hard to find elsewhere.Overall, family life is essential to our personal growth, development, and happiness. It provides us with a sense of identity and belonging, shapes our values and beliefs, and creates a source of joy and happiness that is hard to find elsewhere. Overall, family life is essential to our personal growth, development, and happiness. It provides us with a sense of identity and belonging, shapes our values and beliefs, and creates a source of joy and happiness that is hard to find elsewhere.Overall, family life is essential to our personal growth, development, and happiness. It provides us with a sense of identity and belonging, shapes our values and beliefs, and creates a source of joy and happiness that is hard to find elsewhere.Overall, family life is essential to our personal growth, development, and happiness. It provides us with a sense of identity and belonging, shapes our values
SROI national specialist family service 2013Minney org Ltd
Phoenix Futures (National Specialist Family Service - substance misuse rehabilitation) Social Return on Investment report. Demonstrates the value for money both in overall terms, and in direct cash flow to local authority social services / NHS / judiciary
Early Intervention: a regional perspectiveYfoundations
(Diversity) This workshop was facilitated by Jessica Toole, Tamworth Youth Care.
With early intervention and prevention being approaches to ending youth homelessness proving the most apt at ensuring young people do not become entrenched in a life of homelessness and marginalisation, Tamworth Youth Care has implemented at Early Intervention and Prevention program which focuses solely on working with young people at risk of or who have recently fallen into homelessness. This presentation covers the aims and design of the program which operates in a regional area of NSW.
Promoting an ethic of engagement in pediatric palliative care research
CAMHS consultation
1. Written Submission from Thornby Hall for Health Select
Committee for Inquiry re Children’s and Adolescent Mental Health
and CAMHS.
The author is clinical lead at Thornby Hall therapeutic community.
Thornby Hall is a part of a charity called Childhood First that offers long
term specialist residential therapeutic care, education, and treatment to
children suffering severe emotional and behavioural disturbance as the
result of early life trauma.
Thornby works with a group of around twenty high acuity adolescents.
Over the last five years more than 60% of admissions have had direct
experience of CAMHS and more than 50% come direct from either NHS or
private tier 4 adolescent psychiatric provision. These are young people
who have become “marooned” in psychiatric settings. This often reflects
complex and intractable circumstances within their families that have
generated the chronic problematic behaviours leading to CAMHS
involvement.
Crucially the setting provides a context in which these young people are
children looked after under the Children Act rather than patients under
the Mental Health Act. This provides the opportunity to receive care and
treatment that creates conditions supporting access to an educational
pathway leading to a position from which they can become net
contributors to society rather than consumers of services. This structure
also enables them to be supported in, and rewarded for, further
educational achievement as independent young adults under the Children
Leaving Care Act. This is in striking contrast to other routes available for
young adults to access support which require them to evidence
vulnerability or an inability to cope, and then to consume services from
health or social care.
This submission is based on engagement with twenty five different
authorities over the last five years to provide individual placements for
highly complex young people. Circumstances have also evolved in which
young people with equivalent complex presentation referred by other
authorities have not been placed because their CAMHS services have
judged they do not have mental health needs.
The young people from Thornby Hall are aware of this inquiry. We have
discussed it in our community meeting. A group of residents have
prepared their own submission which they have sent alongside this one.
What has impressed me through this process is their preparedness to
reflect on their own experience with CAMHS and their wish to represent it
2. in a way that might mean other young people could benefit from their
experience in the future. I am aware that they have asked for the chance
to talk directly with you about these things. They are articulate and would
be able to take the opportunity to describe their experiences and views in
greater detail if that would help the progress of the inquiry.
I have laid out my own responses to the terms of reference below:
The current state of CAMHS, including service provision across all
four tiers; access and availability; funding and commissioning;
and quality
1. There is enormous variation of resource and skill between
authorities.
2. There seem to be clear occasions when CAMHS agencies describe
young people as not meeting criteria for diagnosis either to avoid
responsibility for risk management or through limited resource. –
This observation is based in anecdotal experience in which young
people with equivalent difficulties have access to widely varying
services depending on the area in which they live.
3. Our predominant experience is of tier 4 provision and based in the
records provided and the accounts professionals and young people
give us of their experience as service users. This suggests a huge
variation in quality based in part on available skills and resources,
but also on the constitution of the group of young people being
treated at any moment.
4. It is extremely rare for tier 4 provision to provide a coherent well
prepared analysis of the composition and function of a young
person’s family. In our view this often means key elements in the
aetiology of their presentation are not addressed. It would also be
important to notice that this often reflects enduring and intractable
complexities in family function that would be best addressed
through effective inter-agency working.
5. There are some authorities in which there appears to be a growing
gulf between psychiatrists and commissioners which can impede
decision-making and action.
Trends in children’s and adolescent mental health, including the
impact of bullying and of digital culture
1. A proportion of young people who, in our judgement, would
previously have presented as complex cases within the social care
sector are now presenting through tier 4 psychiatric services. This
3. reflects a reduction in the availability and coherence of social care in
some authorities.
2. 100% of the young people we have admitted over the last five
years are reported to have had difficulties in the area of bullying
predominantly as victim but also as perpetrator
3. 66% of the young people we have admitted over the last five years
are reported to have had difficulties that have arisen through the
internet and mobile phones.
Data and information on children’s and adolescent mental health
and CAMHS
1. Childhood First are participant members of the Camhs Outcomes
Research Consortium. The data gathering and processing this
facilitates is helpful both in the assessment of individual progress
and to benchmark quality across the sector.
2. It would be helpful to find a way in which young people’s histories
and family function could be recorded in greater detail to support
targeted clinical work.
Preventative action and public mental health, including multi-
agency working
1. Our consistent experience is that a pathway plan leading from
“patient” to “student” makes sense to young people, professionals,
and families and motivates progress.
2. Multiagency working is pivotal in constructing a robust framework
that enables admission, treatment, and discharge processes that
can properly assess, intervene, consolidate, and sustain
improvement for young people.
3. The best conditions for an effective intervention are achieved when
it proves possible to attain a united view between health, care, and
education professionals, and their respective commissioners. This is
a complex task that requires expertise, focus, and energy. Often
this seems only achievable when the young person has generated a
crisis that “concentrates the mind” of the network. The first task in
a referral and admission process is to proactively engage with the
professional network to achieve these conditions.
4. The promotion and maintenance of an effective multiagency
network to support placement requires regular network meetings,
for the most part we achieve this by synchronising education and
health review processes to run in parallel with the LAC review
framework.
5. Education Health and Care plans as proposed in the Children and
Families Bill (2013) could potentially provide a structure to further
4. develop these processes. Thus far only one referring authority has
referenced their implementation.
Concerns relating to specific areas of CAMHS provision, including
perinatal and infant mental health; urgent and out-of-hours care;
the use of S136 detention for under 18s; suicide prevention
strategies; and the transition to adult mental health services
1. We regularly look after young people past their eighteenth birthday.
We have been impressed with the number of CAMHS services who
have found creative ways to ensure that psychiatrists who have had
consistent relationships with clients over years can continue to
maintain these into early adulthood.
Mark Waddington
Deputy Director