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

Term of Reference 1 Theme 3. Access & availability to CAMH services
Criterion: BHSCT & SEHSCT NHSCT SHSCT WHSCT
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
Tiers.
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
capacity.
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
Trust.
The Western Trust has a
PMHW providing an
educative, consultative and
therapeutic role, providing
8-10 sessions of short-term
interventions.
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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