(CAMHS) and Schools - London Health Programmes

‘Working in multi-agencies you have a better understanding of the challenges the
others are faced with. Health workers have definitely enhanced the provision and
broadened the experience within context of education.’ (LEA senior manager)
In North Shields, there had been staff exchanged across the sectors – the previous
head of pupil support in the LEA had moved on to be Head of Children’s Services
(SSD), and the current head of pupil support had worked for the health service. Staff
in three areas also identified that being quite a small service helped staff to get to
know each other.
Workers also stressed the importance of the values and ethos of the service. This
mostly revolved around commitment to helping children, and putting the child at the
centre rather than the needs of the service.
5.1.2 Management arrangements
Management arrangements were highlighted as key problems, especially in the three
areas where there was management across the different organisations (Cornwall,
North Shields and Portsmouth). The two different agencies, health and education,
have different traditions of management style, salaries and terms and conditions. In
North Shields and Portsmouth health staff were seconded to education departments ,
and in Cornwall, health and education staff were in locality teams jointly managed by
health and education. In Southwark, mental health staff were a specific schools team
within the Tier 2 CAMHS, and were linked into the EAZ. These structures are
complex to manage, and several managers identified this as a problem. In the first
three situations workers had two managers – day to day line management in their
locality teams, often from the other service, and professional (clinical) supervision
from their own organisation. Where services have been brought together, there was
some controversy about different salary scales, and terms and conditions between two
organisations. Having joint working as part of people’s job description and
assessment process is also important if it is to be a respected part of their job.
5.1.3 Different expectations of the service and appropriate referrals
Different expectations and understanding of the services provided seemed to be an
issue on various levels in each case study area. Almost all interviewees discussed the
issue of expectations of the service and inappropriate referrals. Two of the services in
the case study areas (Cornwall and North Shields) had the experience of launching
themselves as a new service, when in fact they were simply re-organising the existing
provision, and adding one or two members of staff. This had raised huge expectations
amongst schools and clients.
Health workers became inundated with referrals, many of whom were referred for
being disruptive in a classroom, but were not necessarily in need of therapy. Some
workers who regularly went into schools felt that they were prone to be used as a ‘sin
bin’ where naughty children were sent. Mental health workers also described being
asked to talk to children who seemed upset, but without the worker having a proper
referral or a chance to contact the parents or work with the family.