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


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

Executive Summary


The review of Child and Mental Health Services (CAMHS) in Northern Ireland

was conducted by RQIA in July 2010. The review examined the quality and

availability of a range of services and professional groups involved in the

delivery of specialist mental health care for children and young people in

hospital and community settings.

Over 25 per cent of the population in Northern Ireland are children and young

people. Epidemiological evidence would suggest that 20 per cent of children

will develop a significant mental health problem. Child and adolescent mental

health services in Northern Ireland are provided through a four tiered system

which includes a network of all children's services.

Due to the complexity of CAMHS, a wide range of systems, reports, services

and professional groups were assessed in the review. Services at Tier 1

(primary healthcare - universal services) are acknowledged for their

importance in early identification and intervention in mental health problems.

Tier 1 services are excluded in this review as they are outside the

management and scope of mental health services within HSC Trusts.

The first review of CAMHS in Northern Ireland by Professor Bamford (see

section 1.4 page 10) in 2006, reported that CAMHS in Northern Ireland was

consistently viewed as under resourced, fragmented and lacking in a strategic


Bamford's view was partly due to the variability and availability of specialist

services and timely access to inpatient CAMHS. This has resulted in a

number of children going for treatment outside of Northern Ireland and to

young people being admitted to adult psychiatric wards. The impact of the

underdevelopment of community CAMHS, was described at that time by

Bamford, as resulting in long waiting times, delayed discharge from inpatient

facilities and a recognition that support is provided too late in the development

of a mental disorder.

Progress has been made since the Bamford review in 2006. The

development of a purpose-built inpatient service has increased capacity for

young people requiring admission to hospital. Services have been developed

in areas such as eating disorders and crisis intervention and this has

contributed to improvements in the range and availability of CAMHS.

Despite this, young people continue to be admitted to adult mental health

wards. The review team considered that admission of young people to an

adult ward is an admission to an inappropriate environment. However it was

noted throughout the review that significant safeguards have been developed

and implemented in the way young people are managed and accommodated

in this adult wards.


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