1. CAMHS Introduction to MALT CAMHS Services In Nottingham Sally Falkner & Rebecca Tivey September 2011

2. Introduction to MALT CAMHS Services Welcome Introductions Facilitators: Rebecca Tivey – MALT CAMHS North LD Practitioner & Sally Falkner – MALT CAMHS North Team Manager

3. TIER 4 inpatient Camhs services- Adolescent Unit, C TIER 3- Specialist Camhs services (Thorneywood) Acute or enduring complex mental health problems. Head 2 Head, Drug and alcohol, Self harm, Psychiatry, Psychotherapy. WOTCH. Child Protection. CLA team TIER 2- The MALTS- Targeted CAMHS Community based services for children, young people and their families with social, emotional and behavioural difficulties. Camhs, ceps, Family support, Community Paeds, school nurse, sexual health. Voluntary Sector TIER 1 – Universal services- school nurses, Gps, SENCOS, health visitors, teachers, Youth service, Connexions,Midwifes, Learning mentors, Sure Start, Voluntary Sector, Meeting Children and Young peoples social, emotional, behaviour and mental health needs.

4. Referral Pathways Direct referrals from young people and families. School Multi Agency Panels. Referrals from Universal/ Targeted Services using the CAF Health referrals – Single Point of Access

5. The MALT Service

6. Recent Changes to MALT Over the last few months the MALT’s have been integrated into the Family Community Teams as part of the Nottingham Children’s Partnership Family Support Strategy. These teams incorporate a range of family support services including Play, Youth, CAMHS, Educational Psychology, Disabled Children’s Team Youth Offending Team and Educational Welfare Offers

7. MALT CAMHS The team works with children aged 0-18 years, their parents and the professionals in contact with them. Community CAMHS should be the first point of access for children & young people in the locality identified as potentially in need of Child and Adolescent Mental Health Services (CAMHS)

8. Who is in a MALT CAMHS team? Team Manager Practitioners Family Support Workers Learning Disability (LD) Practitioner Sexual Health worker

9. What do MALT CAMHS do? The team offers a range of services including: Mental health assessments Direct work with individual children & their families Work with parents & families includes parenting advice / support & groups Signposting to other agencies and services Group work with CYP Training & consultations to help professionals working with CYP, develop their skills, knowledge & confidence in promoting CYP’s emotional & social competence Transition of cases between MALT CAMHS & Thorneywood CAMHS

10. Referrals Parents and carers can make a ‘self referral’ by directly calling the MALT CAMHS team in their locality Professionals can refer a CYP (with parental consent) using a completed CAF form and Request for Targeted service Form Young people (13 yrs+) can refer themselves SPA (Single Point of Access) – all referrals from health professionals are received via the SPA

11. Everybody’s Business ‘Anyone in contact with a child has an impact on that child’s mental health and psychological wellbeing. The challenge for all of us is to remember that and to be able to respond if things start to go wrong’ (CAMHS Review 2008)

12. Case study The link between Adult and Child’s Mental Health

13. Genogram 8 Mum Dad ? Accessing AMHS – diagnosed ED (NOS), Anxiety, Depression. Post-natal depression. Difficult relationship with mum. Doesn’t believe in Mental Health. Lilly Historical contact with AMHS. Accessing AMHS ? ?

14. Mental Health Issues Attention seeking behaviour Aggressive behaviour Withdrawn behaviour Tearfulness Soiling & bedwetting Low mood & Poor concentration Problems making /sustaining friendships Problems sleeping High levels of irritability High levels of worry /anxiety Describing a child as potentially having emotional and mental health difficulties means they are exhibiting some or all of the following: Low confidence and self esteem Separation anxiety Self Harming & suicidal ideation Lack of interest in activities Frequent lying or stealing Loss of appetite / overeating

15. Prevalence of mental health problems in children & young people Distinction needs to be made between mental health problems and disorders The former (problems) are seen to encompass a very broad range of emotional and behavioural difficulties which may cause concern or distress. They are relatively common and encompass mental disorders. The latter (disorders) however are more severe and persistent and usually defined using fairly clear diagnostic criteria.

16. Statistics about children & young people These statistics refer to mental disorders and young people According to the 2001 Census there are about 8,823,293 five – sixteen year olds in Great Britain. Of these 4,381,047 are aged between 5-10 years old and 4,442,246 are aged between 11-16 years old. Mental Disorders – these figures are based on findings of the Child and Adolescent Mental Health Survey, 2004.3 9.6% or nearly 850,000 CYP aged between 5-16 years have a mental disorder 7.7% or nearly 340,000 children aged 5-10 years have a mental disorder 11.5% or about 510,000 young people aged between 11-16 years have a mental disorder

17. So what Theories, Approaches and Interventions do we use? Attachment theory (Themes of grief, separation and loss) Genograms Systems theory Child developmental theories Solihull Approach Solution Focused Brief Therapy Resilience Theory CBT & Mindfulness Approaches Narrative & Family Scripts Psycho-education Creative/Expressive approaches Strength Based Approaches

18. Any questions? And how to contact us… MALT CAMHS Central – 01159158902 MALT CAMHS South – 01159152991 MALT CAMHS North - 01158762160

19. Useful Websites www.rcpsych.ac.uk www.everychildmatters.gov.uk www.youngminds.org.uk www.nottinghamcity.org.uk www.winstonswish.org www.circleofsecurity.org www.childbereavementtrust.org.uk www.relate-nottingham.org.uk www.itsnotyourfault.org