Helping children with mental illness

MENTAL health chiefs are putting forward plans that would end current practices which often result in children and young people with mental health problems in Warrington being placed in adult accommodation or children’s wards in general hospitals.
The Five Boroughs Partnership NHS Trust is to carry out a consultation on the development of a comprehensive child and adolescent mental health service at Warrington.
The Trust – which provides mental health services for Warrington, Halton, St Helens, Wigan and Knowsley – proposes to establish the services at Fairhaven, Winwick, Warrington.
Consultation is to start on September 2 and continue until November 25.
Initially, bodies being consulted include borough councils, NHS Trusts, Social Services, libraries, parish councils, Investing in Children Project Groups, GP practices and other health professional groups, MPs and Trade Unions.
But Trust staff, service users, their families and carers will also be consulted.
The aim is to develop an extended range of specialist mental health services for children and young people up to the age of 18 in the five boroughs in response to concerns about “significant gaps” in current services.
Currently there is a recognised shortfall in child and adolescent mental heath services (CAMHS) beds in the North West.
It is planned to operate the service from a former learning disability facility at Fairhaven, in Birch Avenue, Winwick
Health chiefs have been concerned for some time about increasing numbers of children and young people being admitted to paediatric wards while awaiting assessment or admission to secure accommodation.
Admissions of young people to adult mental health wards have also continued at a high level, contrary to good practice guidance
There is a significant shortball in CAMHS beds in the North West – 1.2 beds per 100,000 population compared with the Royal College of Psychiatrists recommended level of 2-4 beds per 100,000.
Over the last two years, 75 under-18s have been admitted to adult acute mental health beds across the five boroughs, amounting to a total of 1,669 bed days.
The preferred option for under 16s has been local paediatric wards in hospitals and a recent survey identified 50 in-patient admissions for 14-18 year-olds with mental health problems to Warrington Hospital paediatric ward.
All were admitted because of the risk of self-harm.
In addition, 189 emergency CAMHS assessments were undertaken on children at accident and emergency departments.
Current CAMHS provision is carried out on an outpatient basis at clinics in all five boroughs. But there are no emergency out-of-hours arrangements.
Because of the regional shortage of beds, many young people are admitted to adult mental health departments were staff do not have the relevant skills and there are no age appropriate facilities, or to paediatric wards in acute hospitals.
Three options are being considered. The preferred one involves a inreach-outreach service, intensive day therapy unit and in-patient faciltity
This would provide a comprehensive and fully integrated CAMHS service, with the resources to maintain young people safely in the community and provide them and their carers with intensive assessment and therapeutic interventions in times of crisis.
The service would have access to local specialist CAMHS in-patients beds leading to a significant reduction in the use of inappropriate adult mental health and paediatric beds and out of area placements. More children and young people would also be supported home while the small number needing in-patient care would get locally in age appropriate, specialist facilities.
A second optios would provide inreach-outreach services and intensive day therapy unit, but current arrangements for in-patient care would continue.
The third option would, essentially, mean “no change”.
The Five Boroughs Partnership Trust expect to make it decision on November 27.
The full consultation document is available at www.5boroughspartnership.nhs.uk or from the communications team, 5 Boroughs Partnership NHS Trust, Hollins Park House, Hollins Lane, Winwick, Warrington, WA2 8WA.