Forensic Child & Adolescent Mental Health Service Dr Aileen Blower Consultant Child & Adolescent Psychiatrist Grampian & Forensic Network, Aberdeen Oct 12

Recommended NHS provision for Mentally Disordered YO’s Regional medium & low secure inpatient units Community Forensic CAMHS In-reach into YOI’s & secure schools Youth Offending Teams & clinician Grampian & Forensic Network, Aberdeen Oct 12

Provision for young offenders HM YOI Polmont Secure schools Youth Justice Grampian & Forensic Network, Aberdeen Oct 12

Provision for Mentally Disordered Young Offenders Regional YPU’s x3 Generic CAMHS (Forensic CAMHS – GG&C) Grampian & Forensic Network, Aberdeen Oct 12

NHS GG&C service redesign for MDYO’s Regional (open generic) & English (secure) Inpatient services Forensic CAMHS “Hub” (psychologist & psychiatrist) 8 x Locality CAMHS + 2 Forensic practitioners Youth Justice & secure schools + 1 Forensic practitioner Therapeutic Foster Care Multi-systemic Therapy Parenting Interventions Grampian & Forensic Network, Aberdeen Oct 12

FCAMHS Referral criteria age 8 – 18y (mean 15y, boys > girls) Resident within Greater Glasgow & Clyde Inpatient within national child or regional adolescent unit serious mental disorder significant risk of serious harm Grampian & Forensic Network, Aberdeen Oct 12

Hospital admissions 2011-12 9 boys; 4 girls Mean age of admission 15y (13 – 17y) > 80% secure school or prison 70% from Glasgow City All detained in adult locked wards 30% admitted to secure adolescent unit Grampian & Forensic Network, Aberdeen Oct 12

Primary Diagnosis Grampian & Forensic Network, Aberdeen Oct 12

Forensic risk Grampian & Forensic Network, Aberdeen Oct 12

Risks to self Grampian & Forensic Network, Aberdeen Oct 12

Mental health strategy 2012-15: key commitments Faster access to CAMHS Faster access to psychological therapies Improved access to Intensive Home Treatment & 1st episode psychosis services Prevention agenda – focus on early years Reduced admissions to adult wards Policy: connect with justice & children’s services Grampian & Forensic Network, Aberdeen Oct 12

Early detection & intervention Preschool Infant mental health Victims of abuse & neglect Childhood Conduct Disorder Neuro-developmental Disorders Adolescence Psychosis Depression Substance misuse Suicide Grampian & Forensic Network, Aberdeen Oct 12

Workforce Increased CAMHS staffing since 2008 Increased training in: - child psychotherapy - infant mental health awareness - evidence-based parenting programmes - suicide prevention Grampian & Forensic Network, Aberdeen Oct 12

Issues Increased age range for CAMHS (0 – 18y) Increased minimum age for prosecution Diversion from prosecution Alternatives to remand / secure care Access to safe inpatient care in Scotland Grampian & Forensic Network, Aberdeen Oct 12