This 2005 presentation was for UK social work students studying at Derby and Leicester Universities. The half-day presentation consisted of going through this powerpoint and facilitating numerous activities.

1. WHAT IS MENTAL HEALTH?
 A capacity to enter into and sustain mutually
satisfying personal relationships.
 Continuing progression of psychological
development.
 An ability to play and to learn so that
attainments are appropriate for age and
intellectual levels.
 A developing sense of right and wrong.
 The degree of psychological distress and
maladaptive behaviour being within normal
limits for the child’s age and context.

2. Basics for children’s mental health:
Unconditional love from family
Self-confidence and high self-esteem
The opportunity to play with other children
Caretakers who are supportive and teachers
who are encouraging
Safe and secure surroundings
Appropriate guidance and discipline

3. ADVERSITY FACTORS AFFECTING
THE MENTAL HEALTH OF CHILDREN
 Family disadvantage
 Family discord or separation
 A parent having a mental illness
 Poor parenting skills
 Chronic physical illness in the child
 Chromosomal or other genetic abnormalities in the child
 Brain damage in the child
 Physical, sexual or emotional abuse
 Experiences of sudden and extreme trauma
 Learning difficulties or language or communication
problems
 bereavement

4. Attempted Suicide 2-4% of adolescents
Suicide "7.6 per 1000,000 15-19 year olds"
Major depression 0.5-2.5% among children 2-8% among adolescents
Emotional disorders 4.5-9.9% of 10 year olds
Anorexia nervosa 0.5% of 12-19 year olds 8-11 times more common in girls
Bulimia nervosa 1% of adolescent girls and young women
Obsessive compulsive disorder 1.9% of adolescents
Simple phobias 2.3% - 9.2% of children
Hyperkinetic disorder 1.7% of primary school boys
Tic disorders 1-13% of boys and 1-11% of girls
Substance misuse
Alcohol 29% of of 13 year olds usually drinking once a week
Solvents and illegal drugs 16% of 16 year olds involved in regular use
Minor tranquilisers Very few involved in regular consumption
Cannabis 3-5% of 11 -16 year olds have used it
Severe tantrums 5% of 3 year olds in an urban community
Conduct disorder 6.2-10.8% among 10 year olds
1995 PREVALENCE OF
CHILD AND ADOLESCENT MENTAL HEALTH DISORDERS

5. Who is particularly at risk for
suffering emotional, psychological
and behavioural difficulties?
 Looked after children
 Children with a learning disability
 Children with a parent with a mental health
problem
 Abused children
 Children who have suffered bereavement
 Children who abuse substances
 Children with complex and chronic physical
disabilities
 Children of refugees and asylum seekers.

6. CHILD AND ADOLESCENT
MENTAL HEALTH SERVICES
TIER 1
 A primary level which includes interventions by:
 GP’s
 Health visitors
 School nurses
 Social services
 Juvenile justice workers
 Voluntary agencies
 Teachers
 residential social workers
 CAMHS at this level are provided by non-specialists who are in a
position to :
 Identify mental health problems early in their development
 Offer general advice – and in certain cases treatment for less severe
mental health problems
 Pursue opportunities for promoting mental health and preventing mental
health problems

7. CHILD AND ADOLESCENT
MENTAL HEALTH SERVICES
TIER 2
A level of service provided by uni-
professional groups which relate to
others through a network (rather than
within a team)
Clinical child psychologists
Paediatricians, especially community
Educational psychologists
Child psychiatrists
Community child psychiatric nurses/nurse
specialists

8. CHILD AND ADOLESCENT
MENTAL HEALTH SERVICES
TIER 3
 A specialist service for the more severe,
complex and persistent disorders. This is
usually a multi-disciplinary team or service
working in a community child mental health
clinic or child psychiatry out-patient service,
and including:
 Child and adolescent psychiatrists
 Social workers
 Clinical psychologists
 Community psychiatric nurses
 Child psychotherapists
 Occupational therapists
 Art, music, and drama therapists

9. CHILD AND ADOLESCENT
MENTAL HEALTH SERVICES
TIER 4
 Access to infrequently used but essential tertiary level
services such as day units, highly specialised out-patient
teams, and in-patient units for older children and adolescents
who are severely mentally ill or at suicidal risk. These
services may need to be provided on a supra-district level as
not all districts can expect to offer this level of expertise.
 The most specialist CAMHS may provide for more than one
district or region, and should be able to offer a range of
services which include:
 Adolescent in-patient units
 Secure forensic adolescent units
 Eating disorder units
 Specialist teams for sexual abuse
 Specialist teams for neuro-psychiatric problems

10. WHO IS SPECIALIST CAMHS FOR?
 Children and young people experiencing serious
mental disorders, including depression, anxiety
and related disorders.
 Children and young people with an eating
disorder.
 Children and young people with psychosis.
 Children and young people with severe behaviour
disorders including ADHD and conduct disorder.
 Children and young people who self-harm
or are at risk of suicide.
 Children with autistic spectrum disorders.

11. What does Specialist CAMHS
intend to achieve?
 To develop children’s psychological, emotional, intellectual and
spiritual abilities.
 To enable children and families to initiate, develop and sustain
mutually satisfying personal relationships.
 To assist children and their families’ awareness of others and
to empathise with them.
 To help children and their families to view psychological
distress as a developmental process, so that it does not
hinder or impair further development.
 To encourage children’s ability to play and learn so that
attainments are appropriate for age and intellectual level.
 To facilitate children and their families’ developing ethical
and moral sense of right and wrong.

12. What CAMHS ‘Principles
of Care’ are important?
 Full involvement of children, young people and
their parents / carers in their assessment and
treatment.
 Children are the central focus of the Service.
 Working in partnership with all services.
 Early Intervention.
 Children’s needs should be met by universal
services including schools, plus wherever
possible the support of Specialist CAMHS.

13. What does Specialist CAMHS do
(1) ?
Assessment to the principles of the Assessment Framework
 Family Details
 Family History
 Professional History
 Child/Young Person’s views
 Parent/Carer views
 Professionals views
 Direct Observation
 Mental Health Risk Assessment
 Where appropriate, additional SLT and/or OT
assessment will be requested.

14. What does Specialist CAMHS do
(2) ?
 Formulation
1. Symptoms and problems.
2. Precipitating stressors or events.
3. Predisposing life events or stressors.
4. A mechanism that links the preceding categories together
and offers an explanation of the precipitants and
maintaining influences of the individual’s problems.
 And Planning
 Multi-disciplinary and Multi Agency Working
Specialist CAMHS provides consultation and where appropriate
treatment as part of a multidisciplinary approach to meeting a
child or young person’s needs, sharing information and
providing support where appropriate and agreed.

15. What does Specialist CAMHS do
(3) ?
The following interventions should be available:
 Primary Consultation: Facilitate ongoing work by existing staff
Involves face to face contact with child and family
Actively involves the professionals already involved
Ongoing telephone consultation is made available
 Secondary Consultation: Educate and facilitate ongoing work
Involves regular meetings with professionals
Requires a developing relationship between consultant and
staff
Covers range of clinical problems from multiple cases
 Tertiary Consultation: Focusing on service functioning
Requires active participation of higher levels of management
Can apply developmental, emotional and systemic perspectives
to meeting the needs of clients of the service.
Can bring a systemic perspective to the organisation itself.

16. What does Specialist CAMHS do
(4) ?
All treatments:
 are with children, young people and their families
based on a systemic framework that considers
the child in the context of the family and their
wider social context
 may be provided utilising individual, couple, family
or group approaches
 may utilise a range of therapeutic interventions
including or informed by a range of treatment
models and can be brief, medium or long term.

17. What does Specialist CAMHS do
(5) ?
Clinicians will be specialist trained and may be registered
in the following therapies:
Systemic Practice and Family Therapy
Psychodynamic Psychotherapy
Person-centred Psychotherapy
Creative Arts Therapies
Play Psychotherapy
Psychodrama and Drama Therapy
Group Psychotherapies
Cognitive Behavioural Psychotherapy
Social Learning Theory
Medication
Diet and other physical therapies

18. Some questions to try to
assess mental health
How can I be useful to you today?
What stands in the way of you getting the future you want?
Who wants change the most?
What would the benefits be for everyone concerned?
In what situations is the problem most/least likely to occur?
How much control does the problem have over you,
and how much control do you have over the problem?
When have you solved problems in the past?
So, what strengths, resources and understanding do you
have to deal with those things that support the problem?
How will you / my manager know when things are getting
better / safe enough? What is one small thing you can do
differently to make some progress to achieving this?