(CAMHS) and Schools - London Health Programmes

Table 8 Different working cultures between CAMHS and Schools
Issue Schools Ethos CAMHS Ethos Implications Potential solutions
Relationship
with children
Understandin
g of mental
health issues
Attitude
towards
children’s
behaviour
Works with large class
sizes, role is to educate.
Has to balance the needs of
the whole class with those
of individuals.
Teachers are more likely to
identify and respond to
externalising behaviour in
children than internalising,
which may not be picked
up on. Tend to understand
mental health problems in
terms of SEN Code of
Practice.
Discipline is important to
maintain. Disruptive
behaviour presents
enormous problems. Strict
rules and high expectations
of behaviour (no swearing,
dress code, respect).
Work with individuals or small
groups. Role is to address
individual children’s needs within
the context of their family.
Interventions are individually or
family focused and may
emphasise working on internal
and/or external processes.
Intervention focus is on
attempting to understand why
children are challenging rather
than controlling their behaviour.
Rules during intervention may be
different – emphasis on self
expression. For example, children
may be allowed to swear.
Recommendations from health
workers can be unrealistic for
teachers or school.
Teacher’s priority is to find a way
of including the child within the
context of the classroom.
Harder to identify early intervention
and internalised problems.
Conflicting ideas on how to address
children’s behaviour. Health staff
may be seen to be rewarding bad
behaviour which undermines the
teacher’s authority. Health staff
may feel that teachers have too high
expectations of the child in difficult
situations.
Children may be confused by
different rules applied (especially if
both on school grounds)
Health workers in schools can get a better
understanding of the context that the child is
in. Closer links between health services and
LEA / school support services, such as
Educational psychologists help bridge this
gap.
Work together to identify ways of managing
children’s behaviour and identifying structural
problems such as teacher/ pupil interaction
Better collaboration between health services
and teacher support services – better
understanding for teachers. Teachers can
express concerns informally to school based
staff without referring to health services.
Health workers in school can identify and
assess children.
Working together – health staff can explain
childrens’ behaviour to teacher and explain /
consult with the teacher about the strategies
that they are giving the children, so teachers
can use them too.
Teachers can work with health staff to show
implications of their strategies on classroom.
Work together to find ways for teachers to
manage response of rest of the class to special
treatment