The CAMHS Service in Cornwall and why it must improve
CAMHS or to give its full title, Children and Adolescence Mental Health Service is an extremely valuable service. CAMHS exists to promote the mental health and emotional wellbeing of children and young people and the prevention and early intervention of mental health issues. There are four tiers to CAMHS and they are:
- Tier 1: consists of school nurses, youth workers, teachers, GPs and health visitors
- Tier 2: consists of specialised Primary Mental Health Workers (PMHW’s), educational psychologists, counsellors and social workers
- Tier 3: consist of clinicians, psychiatrists, psychologists, therapists, mental health practitioners
- Tier 4: consists usually of specialised inpatient units
However, since taking on the responsibility as Portfolio Holder for Children and Young People, I have been concerned with the provision of the CAMHS service. From evidence going back to 2008 there has been a lack of demonstrable improvement in the whole service. This has been backed up by inspections and two critical reports. I do acknowledge CAHMS is a complex area, with a greater demand on the service, and nationally there are similar issues like those faced in Cornwall, but for me more has to be done to improve this service. It was not only I who had concerns, as the feedback I was getting from many sources which included schools, young people, practitioners and clinicians raised similar concern too. So when this many people are telling me the service provision is patchy, not delivering and young people not getting assessed quickly, then I have to look into this to see if the concerns are true.
I was also frustrated with the lack of data and more concerning, a clear and up to date strategy to deal with the many issues surrounding CAMHS. You just cannot commission services properly without a clear strategy on how you are going to provide services, and you cannot have a strategy without good data.
So to address the issues I had, I asked the Council’s Health and Social Care Scrutiny Committee – who has statutory functions – to investigate my concerns. One of the powers the committee has is to convene a select committee. This is like those select committees in Parliament like the banking and the Murdoch hearing. This formate would then fully investigate the issues I had raised.
This select committee was established and a two-day hearing was held to gather views and information from service commissioners, schools, users, voluntary sector, officers of the Council and health agencies. The committee asked tough and searching questions to those who gave evidence, and I myself was grilled for over an hour on the provision by the Council.
The Scrutiny then collated all this evidence into a report. The full Scrutiny report can be found HERE.
This is an excellent report which gets to the bottom to the many of the issues in Cornwall’s CAMHS service. In many places of the report it is not an easy read, and many areas is critical. There is no point in asking for something to be investigated if you only want to put a sticky plaster over the cracks. To solve issues you need to fill in those cracks, and the only way to do this is to deliver a hard-hitting report highlighting those cracks.
However, it is easy to point finger of blame, but this solves nothing. And this is certainly what the report is about. This report is about solving these long running issues in the CAMHS service. From this report all agencies and organisations involved in CAMHS must acknowledge the report, but more importantly, start to address those action points contained within the report.
There is no point in looking back; we must look forward if we want to have the best CAHMS service. This looking forward approach has already begun as speaking to our other partners and organisations, there is a will to all work together and address the issue contained in the report. It is not going to be an easy task, but if the will is there, then we will succeed – together. Failure not to address the issues in the report is not an option, as failure will fail our young people who need this service.
I will finish by congratulating the Health and Social Care Committee and those members who formed the select committee. I will also give my thanks to all those who took part in the two-day hearing either in person and/or submitted evidence. I know it was a tough process.
Further information on the CAMHS can be found HERE and Cornwall Council’s Family Information Service HERE. There is also this excellent website from Invictus Trust which offers guidance and advice. This can be found HERE