Preliminary reflections of CAMHS in COVID-19 lockdown

Bertz, Sunnhild; Olatoye, Oluwatobi; O'Hanrahan, Susan; Zaidi, Nazuk

doi:10.1017/ipm.2020.33

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…Sensory resources and worksheets should be sent via post so that children and young people can use these resources during virtual sessions. In addition to this, non-verbal cues are instrumental in assessing and engaging people who are experiencing difficulties; thus, the training of mental health professionals should stretch beyond the therapy room itself as training staff to be attentive to non-verbal cues in the online milieu could enhance service provision [17]. Finally, perceived efficacy is context dependent.…”

Section: Discussionmentioning

confidence: 99%

‘Space to hide’: experiences of remote provision across child and adolescent mental health services (CAMHS)

Worsley

Hassan

Nolan

et al. 2022

BMC Health Serv Res

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Background The global COVID-19 pandemic necessitated rapid adoption of remote provision across child and adolescent mental health services (CAMHS). The study aimed to understand young people’s, parents’/carers’, and professionals’ experiences of remote provision across CAMHS in one NHS Trust in the North West of England to inform future recovery practice so that remote sessions can continue where they have been well received but re-thought or replaced where they have not. Methods The study sample comprised three groups: (i) young people, (ii) parents/carers, and (iii) clinical staff. Semi-structured interviews and focus groups were used to collect data. Data were analysed using thematic analysis. Results Three overarching themes were identified: ‘Remote therapeutic experiences’; ‘Spaces and places of therapy’; and ‘Future of CAMHS’. Although remote appointments increased flexibility within the service, the quality of the relational experience was altered, typically for the worse. Clinicians felt less able to examine vital forms of non-verbal communication, which were considered instrumental in assessing and engaging people experiencing difficulties, leaving some questioning their professionalism. Although some young people suggested that remote provision increased comfort levels, others felt their place of comfort and safety was invaded. Conclusions Reduced travel time for both clinicians and families may increase capacity, enabling the service to meet the increased demand if clinical effectiveness can be preserved. In considering future models of provision, assessing clinical need, patient and family preference, and access to space and hardware are all critical when deciding which modality to use for the best outcomes for each individual.

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Section: Discussionmentioning

confidence: 99%

‘Space to hide’: experiences of remote provision across child and adolescent mental health services (CAMHS)

Worsley

Hassan

Nolan

et al. 2022

BMC Health Serv Res

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“…For most (including some with severe/enduring mental illness), the lockdown provided a welcome respite from the stressors of “normal” daily life including school runs, service appointments, extracurricular activities and long commutes to work, all of which led to parents feeling more rested/relaxed, with considerable benefits for the entire family. Likewise, the results of a small study in one CAMHS area in the RoI, indicated that clients reported improved mental health during the first lockdown ( 30 ). Other research has also found that confinement benefitted those with schizophrenia and eating disorders ( 31 – 33 ), although others have reported adverse effects ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Covid-19 and Families With Parental Mental Illness: Crisis and Opportunity

et al. 2021

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The COVID-19 emergency has affected us all, but not equally. Families where parents have mental illness (PMI) are potentially at increased risk, but little is known about how they or their support services managed under lockdown/restrictions. We harnessed our existing partnerships with adult and child mental health services in the Republic of Ireland (RoI) and Northern Ireland (NI) to investigate the qualitative experiences of service users and families in coping during the first COVID-19 lockdown (March–May 2020), and how services were supporting them. Semi-structured phone/online interviews were conducted with 22 clinicians/managers (12 from RoI; 10 from NI) who provided information from their caseloads (~155 families with PMI). Sixteen family members (10 from RoI, 6 from NI) were also interviewed. Data were analysed using standard thematic analysis. Sixty percent of families reported improved mental health, primarily due to respite from daily stresses and the “normalisation” of mental distress in the general population. Approximately 30%, typically with more severe/enduring mental illness, reported additional challenges, and mental distress including: unmanageable child behaviours; fear of relapse/hospitalisation; financial difficulties; absence of child care; and a lack of routines. Service provision varied considerably across regions. The experiences within this case study highlight unique opportunities to address the multiple stresses of pre-emergency daily living. We also highlight how mental health services and governments might become more “pandemic ready” to more effectively support vulnerable families, including addressing service overload issues, optimising the use of digital technologies, and providing in-person contact and social supports where required.

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“…Though emergency departments and hospitals remained open to admissions, some services were reconfigured in anticipation of greater demand for patients with COVID-19, and also working styles were altered to respond to the lockdown and risk of infection spread (eg, use of telemedicine). 20 Bertz et al 21 found that, despite offering face-to-face appointments when necessary in the Child and Adolescent Mental Health Services (CAMHS) community clinics, few CYP attended in person. A significant proportion of young people have also reported disruption to their mental health services.…”

Section: Introductionmentioning

confidence: 99%

Working together better for mental health in children and young people during a pandemic: experiences from North Central London during the first wave of COVID-19

Gorny

Blackstock

Bhaskaran

et al. 2021

bmjpo

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Direct risk from infection from COVID-19 for children and young people (CYP) is low, but impact on services, education and mental health (so-called collateral damage) appears to have been more significant. In North Central London (NCL) during the first wave of the pandemic, in response to the needs and demands for adults with COVID-19, general paediatric wards in acute hospitals and some paediatric emergency departments were closed. Paediatric mental health services in NCL mental health services were reconfigured. Here we describe process and lessons learnt from a collaboration between physical and mental health services to provide care for CYP presenting in mental health crisis. Two new ‘hubs’ were created to coordinate crisis presentations in the region and to link community mental health teams with emergency departments. All CYP requiring a paediatric admission in the first wave were diverted to Great Ormond Street Hospital, a specialist children’s hospital in NCL, and a new ward for CYP mental health crisis admissions was created. This brought together a multidisciplinary team of mental health and physical health professionals. The most common reason for admission to the ward was following a suicide attempt (n=17, 43%). Patients were of higher acute mental health complexity than usually admitted to the hospital, with some CYP needing an extended period of assessment. In this review, we describe the challenges and key lessons learnt for the development of this new ward setting that involved such factors as leadership, training and also new governance processes. We also report some personal perspectives from the professionals involved. Our review provides perspective and experience that can inform how CYP with mental health admissions can be managed in paediatric medical settings.

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Preliminary reflections of CAMHS in COVID-19 lockdown

Cited by 3 publications

References 3 publications

‘Space to hide’: experiences of remote provision across child and adolescent mental health services (CAMHS)

‘Space to hide’: experiences of remote provision across child and adolescent mental health services (CAMHS)

Covid-19 and Families With Parental Mental Illness: Crisis and Opportunity

Working together better for mental health in children and young people during a pandemic: experiences from North Central London during the first wave of COVID-19

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