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


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


• 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


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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