This annual report - Taranaki District Health Board

child and adolescent mental health inpatient services some DHBs have child andadolescent beds allocated in adult units. Some DHBs have separate services for youngerchildren and youth while others have services which cover the whole 0–19 year age range.Services are staffed by a range of professionals including mental health nurses,psychologists, social workers, psychiatrists, occupational therapists and alcohol and drugworkers [357]. Not all staff who work in CAMHS are members of health or social serviceprofessional bodies.In addition to DHB-provided services, there are over 80 NGOs providing DHB-fundedCAMHS and AoD services. Many of these NGOs also receive funding from a range ofother sources including the Ministry of Social Development, the Accident CompensationCorporation and Youth Justice [357].In recent years funding for CAMHS and AoD services has increased (up 16% from 2007 to2010) and there has been development of new services, in line with the Government’spriorities set out in Te Raukura [354], Te Tāhuhu [353] and Te Kōkiri [357]. Auckland andCounties Manukau DHBs now have dedicated maternal and infant mental health servicesand MidCentral DHB CAMHS has collaborated with Group Special Education in theprovision of a Conduct Disorder Service. There have been increases in services forchildren of parents with a mental illness, youth forensic services, eating disorder services,and services for Māori and Pacific peoples and migrants and refugees [357].Ministry of Health service specifications state that Community CAMHS services include,but are not limited to:Specialist assessment and diagnosisProvision of medication and psychotherapiesOn-going monitoring of symptoms and periodic reviews of progress and treatmentsAttention to mental health prevention and promotion matters including earlyintervention, health maintenance and relapse preventionProvision of consultation and liaison services to primary care providers and otherrelevant agencies (including health, education and welfare agencies)They are required to make provision for specialist mental health assessments for particularsub-groups including those with attention deficit hyperactivity disorders, eating disorders,autism, those with mental illness in association with drug and alcohol use, intellectualdisability or brain injury, and refugees. CAMHS for these groups are required to providespecialist advice and information to primary care providers, to respond to acute mentalhealth problems and to collaborate with other health, education and welfare agencies thathave responsibilities for providing services to children and adolescents. In the provision ofservices to these groups it is expected that CAMHS will focus on addressing specificmental health problems that require specialist intervention [358].The Ministry of Health expects that, where funding for specialist mental health andaddiction services does not support coverage for all target populations, DHBs will prioritisethe provision of services to people with the greatest level of need [359]. The Mental HealthCommission has stated that: “An unfortunate effect of this policy is that mental healthservice providers have tended to practice diagnostic rationing and prioritise acute andemergency services over early intervention services which could potentially prevent theneed for crisis intervention” [360].Access criteria for specialist Child and Adolescent Mental Health ServicesThe moderate to severe mental health issues that CAMHS clients may have include [361]:behavioural and developmental disorders including attention deficit hyperactivitydisorder and autism spectrum disordersanxiety, depression and post-traumatic stress disorderseating disordersIn-Depth Topic: Mental Health Issues in Children - 371