RQIA Independent Review of Child and Adolescent Mental Health ...

Key areas for improvement identified in the McCartan Report include:
• unavailability of regional inpatient beds in emergency situation for
children and adolescents
• management of self-harm and children and adolescents at risk of
suicide
• transitional/interface arrangements between CAMHS and adult mental
health services
• governance arrangements
• lack of user and carer involvement
Key recommendations of the report highlight that all practicable steps should
be taken to avoid admission to adult wards and that policies and protocols for
this occurrence should be developed.
This review gave consideration to the recommendations and lessons learned
from the McCartan report, as they relate to CAMHS and the interface with
adult mental health services.
Circulars from DHSSPS
The DHSSPS Deputy Secretary's (Primary, Secondary and Community Care
Group) Circular (13 March 2006) set down six specific directives for the four
health and social service boards and trusts to implement when children and
adolescents are admitted to adult wards. These directives were developed
to ensure safe and needs-led care of children and adolescents admitted to
adult wards.
In a circular dated 28 April 2006, DHSSPS Director of Mental Health and
Disability Services sought further assurances from trusts and HSC Board that
protocols had been developed to deliver on all the directives issued by the
circular of 13 March 2006.
Further considerations were identified in respect of medical, educational,
social and leisure needs of young patients, alongside the identification of
risks and how they are managed.
An assessment of progress made by trusts and the HSC Board in regard to
the implementation of the above directives was central in examining the
quality and safety of services provided to children and young people in adult
wards.
Promoting Quality Care Report
The significance to CAMHS of this guidance report, published in 2009, is
twofold. Firstly it provides the fundamental principles of risk assessment of a
child who is at risk to him/herself or others and, secondly it highlights
additional responsibilities and obligations for all staff in responding effectively
to suspected child abuse.
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