ADOLESCENT MENTAL HEALTH

1 CHILD AND ADOLESCENT MENTAL HEALTH SERVICES (CAMHS)Information for ProfessionalsInformation for ProfessionalsChild and ADOLESCENT MENTAL HEALTH Services NHS Lincolnshire Partnership32 All children and young people up to their 18th birthday who are resident and/or registered with a GP within Lincolnshire can be referred to the Lincolnshire CAMHS provided:These MENTAL HEALTH needs include mild to moderate emotional wellbeing and MENTAL HEALTH problems, as well as moderate, acute and severe, complex and/or enduring MENTAL HEALTH problems or disorders that are causing significant impairments in their lives. INTRODUCTIONThe service provides a range of comprehensive, multi-disciplinary, community MENTAL HEALTH services for children and young people with MENTAL HEALTH needs, and their parents/carers, through integrated, targeted and specialist teams.

2 REFERRALS THE SERVICE INCLUDES: A Single Point of Access (SPA). Support to universal services. An integrated CAMHS provision delivering evidenced based pathways and focused on outcomes known as Core CAMHS. Access to Crisis Intervention and Home Treatment 24 hours a day, seven days a week. A community based eating Disorder Service. Support to vulnerable groups including young people with a learning disability. Care and support through transition to adult services where targeted and specialist children and ADOLESCENT MENTAL HEALTH service (CAMHS) is part of a multi-agency pathway that begins in universal services and provides a route through to very specialised CAMHS provision, including in-patient services where to CAMHS Crisis & Home Treatment Service are for young people actively displaying suicidal ideation or following suicide attempts, severe symptoms of depression with suicidal ideation, life threatening harm to self, harm to others as a result of a MENTAL HEALTH concern, acute psychotic symptoms or presentation of anorexia with severe physical are concerns about their MENTAL HEALTH and/or psychological wellbeing.

3 ANDThey have received support from professionals in universal services that has not helped to make sufficient improvement to their problems are at a significant level that means the referrer feels they need immediate access to assessment and treatment from MENTAL HEALTH a young person has moderate to severe learning disabilities along with MENTAL HEALTH , emotional and behavioural problems. FURTHER TO THIS WE CANNOT ACCEPT REFERRALS:When an emergency response for an immediate physical or medical HEALTH emergency is required (contact emergency services or take to an Accident and Emergency Department).A young person is displaying behavioural problems but no other interventions have been tried with parents/carers and school in accordance with the Collaborative Lincolnshire Behaviour Pathway .For the assessment, diagnosis of, or review of medication for ADHD or for the diagnosis/treatment of Autism Spectrum Disorder (ASD), Tourette s Syndrome, Dyslexia, Dyspraxia and other neurodevelopmental disorders of childhood.

4 (These are not diagnosis of exclusion and a young person with a diagnosis of ADHD, ASD and other neurodevelopmental disorders of childhood who is referred to CAMHS with a clear secondary MENTAL HEALTH need will be able to access a service for the period of treatment for the MENTAL HEALTH problem).For the provision of purely physical HEALTH and/or sexual HEALTH in isolation of a MENTAL HEALTH treatment of a substance misuse problem, however if there are coexisting MENTAL HEALTH problems, these should be discussed with CAMHS through the Professional Advice Line. Child and ADOLESCENT MENTAL HEALTH Services NHS Lincolnshire Partnership54 RESPONSE TIMESSUPPORT TO UNIVERSAL SERVICESPROFESSIONAL ADVICE LINE (PAL)The service is committed to achieve the following response times:The service works closely with, and provides support to, universal services.

5 The main service features include:This is delivered by experienced and qualified CAMHS staff and provides:A 9am-5pm professional advice line (PAL), for professionals to obtain general MENTAL HEALTH advice, support and and training to partnership range of self-help psychosocial education materials for use with young people. A directory of the local child and ADOLESCENT MENTAL HEALTH services and other potential services for signposting that may be beneficial to young and advice to universal services. Criteria for referral to Core CAMHS and advice on whether a referral should be gateway to CAMHS for all professionals other than GPs, paediatricians and social to appropriate alternative services. Psycho-education. Anonymised advice about young people. Early prevention strategies. The Professional Advice Line is available on 01522 309120, , Monday to Friday.

6 CAMHS telephone response within 4 hours. Face-to-face emergency response within 13 hours (24/7). Face-to-face within 72 hours. Face-to-face within 6 TO THIS Vulnerable groups are supported by the following access times:24 hours for Self-Harm Assessment and Intervention Service. 4 weeks for support to Looked After Children (LAC). 3 weeks for young people in contact with the Youth Justice System (YJS). IN ADDITION Young people requiring a Community eating Disorder service are subject to:13 hours for face-to-face emergency response. 72 hours for face-to face urgent response. Treatment start: within one week for urgent cases and four weeks for :URGENT:ROUTINE: Child and ADOLESCENT MENTAL HEALTH Services NHS Lincolnshire Partnership76 CORE CAMHSCRISIS AND HOME TREATMENT TEAMCore CAMHS is a multi-disciplinary community MENTAL HEALTH service for children and young people with MENTAL HEALTH difficulties, including those in vulnerable service is available seven days a week, between , 365 days per year, with a range of multi-disciplinary practitioners being accessible within these hours.

7 Outside of these hours, cover is provided for emergency advice and crises via an on-call is delivered via EVIDENCE BASED PATHWAYS for:Depression General anxiety Anxiety - specific OCD Social anxiety PTSD Self-harm Attachment Disorder (primarily for Looked After Children, post-adopted children or for young people at risk of becoming looked after)Harmful sexualised behaviour Forensic Psychology Assessments Psychosis Behaviour (as part of Lincolnshire County Council s Collaborative Behaviour Pathway).THE SERVICE IS AVAILABLE FOR:Children and young people meeting the criteria for moderate to severe MENTAL HEALTH problems as a minimum requirement. Where MENTAL HEALTH needs and emotional disturbance is to a degree that the level of risk the young person poses cannot be contained by Core CAMHS alone, but support by a specialist community service could provide an alternative to admission to inpatient whose deterioration in MENTAL state and functioning renders them liable for admission to an inpatient requiring discharge from an acute inpatient service following an episode of children and young people requiring an intensive acute care service is not a stand-alone service but an extension of Core CAMHS and the eating Disorder Service, thereby supporting continuity of care where possible for the child, young person and family, and enabling an effective step-up, step-down service works to maintain the child or young person in their home setting.

8 And works closely with local Accident and Emergency services, adult Crisis Intervention Services and the Duty Team within Children s , the children and young people requiring this element of the service will have one or more of the following: Severe depression/emotional disorders. Newly presenting or acute untreated psychosis. Obsessive Compulsive Disorder. Imminent risk of suicide or history of serious self-harm. Imminent risk of harm to others. A primary diagnosis of eating disorder where the young person needs an acute intervention in relation to complexity of risk, MENTAL illness ( depression) and/or low BMI requiring emergency service operates core hours of , Monday to Friday, with hubs open between and late opening until 8pm in one hub, Monday to Thursday, to provide improved access and choice.

9 The service is provided in FOUR HUBS ACROSS LINCOLNSHIRE:The Galaxy Suite, BostonSycamore Centre, GranthamThe Horizon Centre, LincolnWindsor House, Louth Satellite clinics are used to enable choice and care close to home, when required. Child and ADOLESCENT MENTAL HEALTH Services NHS Lincolnshire Partnership98 COMMUNITY eating DISORDER SERVICES FOR CHILDREN & YOUNG PEOPLE (CEDS-CYP)VULNERABLE GROUPSThe eating Disorder service implements a NICE Guidance eating disorder pathway which includes:CAMHS ensures that children and young people in vulnerable groups are able to access the most relevant pathway to match their presenting need and this is supplemented by the required level of additional support and shorter waiting times to access with an evidence based pathway, the team uses a clear stepped care approach which includes escalation to inpatient facilities if required.

10 Young people with an eating disorder are also able to access the full range of supportive interventions available in the Core team. The team operates out of the local hubs and also offers a home treatment and family TEAM PROVIDES: Psychiatric assessment. Medical assessment (in partnership with GP/paediatrician). Rapid response. Staff trained in evidence based psychological interventions for eating disorders. Home treatment and family NERVOSA When a person tries to keep their weight as low as possible; for example, by starving themselves and/or exercising When a person goes through periods of binge eating and is then deliberately sick or uses laxatives to try to control their eating (BED) When a person feels compelled to overeat large amounts of food in a short space of eating DISORDER Some people, particularly those who are young, may have some but not all of the typical signs of an eating disorder and this is known as an eating disorder not otherwise specified (EDNOS).