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he future seems bright for mental when staff shortages were pushing up waiting times again, health services for children and young people. The made further adaptations to provide a quality service government has endorsed a strategic model for the within existing limited resources. In the second example development of CAMHS to form the basis of a Tony Gillam describes the award wining Goldenhill comprehensive service, including mental health project to support the parenting needs of mental health promotion and early intervention, to be in place by 2006. service users who have children. Both these initiatives To help bring all this about a national CAMHS support show the importance of a ‘can do’ attitude: when clients service has been created and an additional £250 million are listened to and there is a willingness to frame allocated. acceptable services to meet their needs much can be And yet, the future for CAMHS has been bright for at achieved at a grassroots level which, after all, is where least the last decade; it is the present that causes concerns. effective intervention takes place. During the nineties, following various authoritative But mental health services do not seem to reach some reports, attempts were made to bring the isolated and vulnerable young people. Juliet Lyon presents a shocking somewhat introverted CAMHS into closer partnership account of young people in prison, 90 per cent of whom with mainstream mental health services and with other have a diagnosable mental disorder and 10 per cent a services for children. There was a raft of government severe psychotic disorder. A small but growing number guidance setting out the strategic direction, new funding kill themselves in custody each year. She sets out a plan was allocated and progress, albeit slow, began to develop. for action, much of it in the public health sector and in But in 2001, as Stella Charman shows in the Framework accordance with the government’s view of CAMHS being Feature, the establishment of primary care trusts led to an element of a wider children’s service. But why are the jettisoning of health authorities and, disastrously for there psychotic children in prison when there is provision CAMHS, the loss of their specialist commissioning and for them to be transferred to hospital under the Mental public health skills that had begun to steer development. Health Act 1983? More recently there has been the Children’s mental health services currently lack a landmark judgement that the Children Act 1989 applies congruous provider structure and are awaiting the to children held in prison. Under this Act local authorities outcome of pilot studies to demonstrate whether the have a duty to protect the welfare of children which is proposed children’s trusts (of which CAMHS would be a held to be paramount. key component) are viable. Other problems are the It is disgraceful that a country that has ratified the chronic shortage of suitably qualified staff, inadequate United Nations Convention on the Rights of the Child administrative backup, and that priority tends to be given and has appropriate domestic legislation in place should to adult mental health services at the expense of detain psychotic young people in prison. Children are our CAMHS. Despite all this, the government’s explicit legacy for the future. Effectively meeting their mental commitment to CAMHS, the increased investment and health needs helps to ensure that the next generation is the requirement for annual improvements does seem to better equipped to minister to the needs, both physical be having results and services are changing so as to better and mental, of children for whom they themselves meet the needs of their users. become responsible. By meeting our responsibilities we This issue of the Mental Health Review features two set up a benign, humane and progressive cycle and help such examples. The Case Study contains a report on a to bring a bright future into the present. CAMH service that effectively reorganised itself twice. Elizabeth Parker Initially to significantly reduce waiting times and then, 2 The Mental Health Review Volume 9 Issue 2 June 2004 © Pavilion Publishing (Brighton) 2004
Mental Health Review Journal – Emerald Publishing
Published: Jun 1, 2004
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