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


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

Term of Reference 1 Theme 3. Access & availability to CAMH services


The review team found that The design of services The design of the service

the design of service indicated there was some indicated that there is good

delivery in the Belfast Trust recognition of the Tiered understanding of the tiered

indicated a good

model; however it was under model and some

understanding of the tiered developed and only partially compliance with the

model. However, the implemented. It was evident system. This design will

current design will not that the present design does partially facilitate each of all

facilitate all the functions of not facilitate all the functions the functions of the tiered

the tiered model. The of the tiered model, as it was model as was originally

review team found that the originally intended, and will intended.

current operation of the not facilitate reducing the

tiers will not reduce the need for referrals into

need for referrals into CAMHS at Tiers 3 or 4.

CAMHS at Tier 3 or Tier 4.

1.3.2 The model of

service provision in

CAMHS is effective

and coherent, in

keeping with the

four Tiered Model

incorporating the

original design and

flexibility within the


At present the model is

partially implemented and

developed, as there is no

PMHT worker at Tier 2, to

facilitate early intervention

and signposting and Tier 3

is under developed. The

trust reported that they

have no Tier 2 but maintain

links with a range of

voluntary and community

At present there is no

PMHW, the trust reported

they have provided Tier 2

via family centres and that

they have a referral

coordinator who provides

advice and support for

referring agents.

The Northern Trust reported

having three, Tier 3 generic

mental health teams. The

At present the Southern

Trust has a Referrals Coordinator

in each of the Tier

3 clinics. These

practitioners co-ordinate

referrals but also have

some clinical

responsibilities and

undertake casework,

depending on their


Tier 3 services in the

Southern Trust consists of

the Eating Disorder service,

The design of the service

indicated that there is a

good understanding of the

tiered model and attempts

to ensure compliance. This

design will facilitate the

tiered model as was

originally intended in some

of the areas in the Western


The Western Trust has a

PMHW providing an

educative, consultative and

therapeutic role, providing

8-10 sessions of short-term


The initial Primary Mental

Health pilot proved effective

in gate keeping GP

referrals from specialist

CAMHS. The Western

Trust reported that the

Primary Mental Health

worker service has been


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