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

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Criterion 1.3.2 - The model <strong>of</strong> service provision in community CAMHS is effective <strong>and</strong> coherent, in keeping with the 4 Tier<br />

model, incorporating the original design <strong>and</strong> flexibility within the tiers.<br />

Included in this criterion are two recommendations from Bamford. In addition, the DHSSPS initiative "Card Before You Leave" is<br />

assessed in this criteria.<br />

• The role <strong>and</strong> complement <strong>of</strong> Primary <strong>Mental</strong> <strong>Health</strong> workers should be exp<strong>and</strong>ed in Northern Irel<strong>and</strong>.<br />

• <strong>Mental</strong> health promotion <strong>and</strong> prevention in the school setting should be developed across all schools.<br />

• Introduction <strong>of</strong> "Card Before You Leave" scheme.<br />

Tier 4<br />

Highly specialised services, inpatient, • 4 outreach, day hospital.<br />

Specialist Multi-disciplinary child <strong>and</strong> adolescent teams.<br />

Tier 3<br />

Specialised services for specific severe, • 3 complex or persistent disorders.<br />

Specialist child <strong>and</strong> adolescent teams.<br />

Tier 2<br />

Targeted services, CAMHS specialists • 2 working in a uni-disciplinary way.<br />

Specialist individual pr<strong>of</strong>essionals relating to workers in primary care.<br />

Tier 1<br />

Universal services, non specialist, primary health care.<br />

Primary <strong>Health</strong>care - GP's, <strong>Health</strong> Visitors, Sure Start, School Nurses.<br />

Diagram 3 shows The 4 Tier Model for CAMHS<br />

The review team found that The 4 Tier model was referred to <strong>and</strong> adopted in all trusts. The 4 Tier model was subject to local<br />

interpretation in each trust area, <strong>and</strong> particular differences in the underst<strong>and</strong>ing were identified around Tier 2 <strong>and</strong> Tier 3. Tier 3<br />

75

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