(CAMHS) and Schools - London Health Programmes

The issue of whether to actually be based in schools or not is another relevant debate.
To be effective, health workers need to be accepted in the school and yet retain the
support and clinical supervision of the CAMHS team. The importance of being part
of the health team and getting clinical supervision and support, was emphasised very
strongly. It is a difficult balance to maintain, especially when they have different
working cultures. One service had started out with staff individually based in schools,
but found that this was not effective. This was changed to teams of two staff working
together across two schools. This facilitated mutual support and provided more
sustainability in the case of staff turnover or sickness. In another service, one CPN
has started to work based in one school full time. This is at the early stages and she
has worked with this particular school as part of the joint behavioural support system
for three years previously. Although it is at an early stage, she has found that children
are slightly less willing to visit her as she becomes more known in the school and is
identified as a member of staff. There is concern that meeting with her might be come
more stigmatising and children have asked her if she is going to start behaving like a
teacher (e.g. tell them off). To counter this, she is ensuring that she remains casually
dressed, insists on being called by her first name and ensures that she does not instil
discipline.
5.3.6 Working in different contexts
Whilst the majority of the CAMHS who returned the questionnaires were working in
secondary schools, the case study participants felt that working in primary schools
was easier and more accessible. This was attributed to the more nurturing
environment in primary schools with a higher priority given to children’s emotional
well being, the importance of early intervention and the restrictions of the school
curriculum in secondary schools. In addition secondary schools are larger and have a
more complex management system which can make relationships harder to build.
Working with parents was harder in secondary schools where parents seemed
reluctant to attend parents groups. One case study area tried to set up a parents group
and failed. On the other hand, it was pointed out in one case study that in secondary
schools it was important to have a service that young people could access
independently of their parents, and that this was particularly key for rural areas. Many
interviewees stressed the importance of supporting the transition from primary to
secondary schools, and some CAMHs teams ran groups specifically to meet these
needs.
5.3.7 Working with parents
The relationship with parents was a key issue. Schools and education authorities and
the CAMHS tend to have different relationships with parents, and most of the case
study interviewees were sensitive to these differences. School staff emphasised the
importance of the relationship they had with parents, and the delicate balance that this
could represent. They all acknowledged that there was information that parents and
children would want to keep from them and respected this. However, most teachers
also stressed the huge impact that home life had on the mental health of children and
the likely effect they would have on children’s ability to participate fully in school.