MENTAL HEALTH
Dr McNally said: “It is different; the aim of the project isn’t just to train new thera- pists, like the adult IAPT. It’s setting out to achieve whole-service change within CAMHS. We’re running a short course for supervisors and service managers to help them develop the competencies they need to lead the change and ensure quality de- livery.
“The courses are children and young per- son specific – this training is going to have an enormous impact locally and nationally. The students will receive very high quality training, which is crucial to the success of the whole project.
“Services are going to have to transform to offer more flexibility; they’re going to have to change the model they use for capacity and demand to improve responses to the needs of young people and their families. Whole-service change offers more choice; services working together as partners to develop and deliver.”
Flexibility
Under the new service transformation patients will be afforded greater flexibil- ity over their treatment; and a level of in- formed choice that goes beyond ‘tokenistic’ consultation.
Dr McNally said: “Service user participa- tion is going to be properly embedded into the services at all levels. It’s really easy to ask children, ‘What do you think of this?’, and then services can say they’ve consulted with children and young people, but that’s not proper participation, its tokenism.
“So feedback from service users is going to be key; there are going to be children and young people’s forums set up. They’ve got ‘feedback booths’ in some of the CAMHS services using technology so children can go up and type feedback in themselves.
“Another really important thing is that outcome measures are going to be used on a session to session basis, to inform treat- ment and approaches.”
This approach of constant evaluation could result in more individualisation of treat- ment, as well as helping therapists to mod- ify the service that they deliver.
Dr McNally said: “You can see from week to week if what you’re doing is working, or if you need to change your approach. The whole service will do this; not just the people on the training, but everybody who sees children, young people and parents. It will help inform us about what does work and users will have more choice in terms of their treatment options.”
Promoting engagement
An important aspect of transforming the services is helping users to feel comfortable accessing therapy. Young people rarely choose to talk about their problems of their own accord, and instead are referred or brought in, making engagement essential.
Dr McNally explained: “They’re planning on developing leaflets and DVDs, made by young people who have previously used the service to help reduce the stigma that young people might feel before they come.
“Engaging young people into the services is crucial to help them come back, we want them to have more of a say and feel that they’re part of the process. The data we are collecting is really about guiding patient care.”
Time to talk
Increasing the availability and accessibility of talking therapies is important to provide children and young people with the best mental health care, Dr McNally suggested.
Left: Members of the partnership.
She said: “There’s a sound evidence base for them. They really work, particularly for depression, anxiety, for parenting and for conduct problems. We know about 60% of child mental health problems are emo- tional or conduct disorder based so it’s cru- cial to train the therapists in the evidence- based approach that really works.
“Lots of people prefer talking therapies to medication. That’s not to say that medica- tion isn’t important; it has its place. What I love about talking therapies, particularly CBT and parenting approaches, is that they really help the young person or parents to understand how their problems are being maintained, and they learn through thera- py to change that.
“If the problem returns in the future, they’ve got all the skills help themselves to change again in the future. It gives people a real sense of control when they’ve activated change.”
Collaboration
The process of delivering services in a part- nership can be challenging, yet rewarding. Dr McNally hopes this collaborative aspect of the programme is something that could be repeated and extended in the future.
She described the process as “hard work, but very interesting”.
Dr McNally continued: “It’s very different from the adult model. We have to go out and talk to services and decide which we’re going to form a partnership with. That’s great to gain an understanding of each of the services, and what needs to happen for change to properly occur, what kind of numbers of people they would need to train to really impact on the service.”
The Government’s recent ‘No Health with- out Mental Health’ strategy aims to give mental health more of an equal level of consideration with physical health, some- thing Dr McNally welcomes.
Visit
www.salfordcognitivetherapy.com Dr Deborah McNally
FOR MORE INFORMATION national health executive Nov/Dec 11 | 53
She added: “It’s taken a life course approach to mental health and it’s been developed with young people and children in mind from the outset. I re- ally like the move to place mental health in parity with physical health and the strong focus on early evi- dence-based interven- tion and prevention.”
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