The Values-Based Child and Adolescent Mental Health System Commission was set up by the Royal College of Psychiatrists, YoungMinds and the Children & Young People’s Mental Health Coalition to give a fresh perspective on children’s mental health.
The Commission’s report, ‘What really matters in children and young people’s mental health’ puts the role of schools at the heart of improving mental health services for children and young people.
- The lack of a shared language and approach for describing outcomes for children and young people is hampering interagency working.
- Schools and the wider education sector are a key component of the CAMHS system, but they feel disconnected from other parts of the system.
- There were several examples of whole-system transformation, but there were also persistent concerns that these are not adequately funded.
- Whole-system leadership is crucial to delivering system transformation, but is not always encouraged and nurtured.
- The workforce is vital for realising effective service transformation, but often feels excluded and devalued.
- Co-production with children, young people, parents and carers is not only good for services, it is also good for children and young people and helps them to achieve optimal outcomes.
- In-patient services need to be managed and commissioned as part of a whole system, and should include the full range of crisis services and alternatives to in-patient treatment.
- Long-term, sustainable relationships between service providers, commissioners, and children and young people are crucial to delivering effective service transformation.
- Establish a values-based CAMHS system network. The workforce needs opportunities to share and explore its values and their practice implications, and the ability to exchange best practice in a safe space. The network would bring together all parts of the system to achieve this.
- Adopt shared values for the CAMHS system. The departments of state of national administrations and jurisdictions should consider whether they could adopt the Commission’s proposed shared values as the basis of a common set of shared outcomes expressed in a common language to guide their work with children and young people.
- Recognise the role of schools and fund them appropriately. Governments should formally recognise schools as a crucial component of the CAMHS system, in the following ways.
- Undertake mental health impact assessments to ensure that both schools/ education policy and wider government policy and legislation are not detrimental to children and young people’s mental health.
- Help schools to develop a framework for empowering and enabling children and young people to better understand their own mental health and to advocate for themselves. Schools should be able to teach children and young people about mental health in the same way they teach them about literacy or numeracy.
- Ensure that schools are able to identify mental health issues and can easily sign- post pupils to relevant support, either within the school or their local community, and have the accountability to do this.
- Single point of access referral systems should be appropriately resourced to pro- vide access to the full range of services, from support through to diagnosis and specialist intervention.
- Co-production with young people and parents should be at the heart of all recovery, service redesign, commissioning and training.
- 6 Clinical pathways to and from in-patient admission should include access to alternatives to admission, such as crisis intervention teams and home treatment teams. These should be jointly commissioned or managed with in-patient care.
- All training for the children’s workforce – from clinicians to youth workers – should include training in values-based theory and practice, including an exploration of what matters to clinicians and patients, with the aim of developing a community of shared practice.
Commissioning and leadership
- Commissioners of CAMHS should establish sustainable relationships with provider partners and young people.
- Whole-system leadership should be characterised by a collaborative and mutually respectful approach, and include the active participation of clinicians from specialist services.
Research to support development of a values-based CAMHS system
- Further research is needed in the following areas:
- the relationship between co-production, values (what matters) and recovery in children and young people with mental health problems
- staff values (what matters): this is an important and under-researched contribution to understanding why co-production and other aspects of service improvement have proved so difficult to implement in a sustainable way.