Professionals

How is CAMHS structured in the Southern Trust?

Welcome to the Southern Trust Child and Adolescent Mental Health Service, commonly known as CAMHS, website. This service is commonly known as CAMHS. CAMHS offers specialist mental health services to children and young people (up to age 18 years) and their families who reside in the Southern Trust area. Presentations of emotional and mental health difficulties vary in severity and complexity. CAMHS is currently organised into four Tiers. The level of intervention will correspond to the severity and complexity of the presenting issue.

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Within Northern Ireland, there will soon be a reorganisation of CAMHS services in Northern Ireland moving towards a 5 Stepped care model of CAMHS.

What services are offered by CAMHS in Southern Trust?

There are a number of different specialist services within CAMHS. 

i-camhs
iCAMHS is our Infant Mental Health Service. This service works with infants below the age of 3 years, where there are difficulties with attachment or bonding issues.  This service strives for the earliest possible intervention. The service provides consultation to other professionals who have identified infants as     being at risk of poor attachment with their care-giver.  In addition, direct clinical work is undertaken with caregivers and their babies.

 

Tier 2 ‘just ask’ 
The Tier 2 Service works with children and young people up to the age of 18 years with mild to moderate emotional or mental health difficulties. The service offers a comprehensive assessment of a young person’s difficulties, followed by clinical intervention, if appropriate, or signposting to more appropriate agencies.  Clinical work undertaken is often 1:1 or family work. Tier 2 also offer group opportunities for young people, such as those creative groups offered by ArtsCare. Consultation and training is also available for other professionals working with children and young people. The Tier 2 service is predominantly staffed by Primary Mental Health Workers from Nursing and Social Work backgrounds, plus input from Clinical Psychology.
As Tier 2 works with an ethos of early intervention and prevention, part of the Tier 2 work is making partnerships with other agencies in the community or voluntary sector.  Within Tier 2, there are specialist outreach posts, working with organisations such as Young Persons Partnership (YPP) and Disabled Children and Young People’s Participation Project (DCYPPP) from Barnardos. The YPP collaboration offers a service to young people aged 12-18 who are experiencing mild-moderate emotional difficulties, associated with hidden harm (parental drug/alcohol/mental health). The collaboration with DCYPPP aimed to develop a better understanding of the emotional and mental health difficulties experienced by children living with disability. Two CAMHS practitioners continue to work with this project, providing input to groups for children and young people living with disability. This is an exciting area of development for CAMHS, and we hope to develop services for children living with disability.

 

Tier 3 CAMHS
The Tier 3 CAMHS team is multidisciplinary, with core team members including representatives from social work, psychiatry, family therapy, clinical psychology, and nursing. The Tier 3 service works with children and young people up to the age of 18, however the multidisciplinary team is concerned with working with moderate to severe presentations. CAMHS is available for consultation to other professionals concerned about emotional wellbeing and mental health issues. In terms of direct clinical work, following a multidisciplinary assessment of the presenting issues, a multidisciplinary team approach will be used to meet the needs identified. Not all young people referred to the service will be known to our Consultant Psychiatrists as CAMHS is not a Consultant-led service. If young people require Psychiatry input, this will be arranged within the multidisciplinary team. Each young person seen will have a lead clinician within CAMHS, who will keep the referrer informed regarding assessment and outcome of interventions offered. In addition, Tier 3 is responsible for specialist assessment of ADHD and ASD in young people over the age of 12 years. Younger children presenting with ADHD and ASD are assessed by Community Paediatrics.

 

Hospital Liaison Service
This service provides a Mental Health Risk Assessment to children and young people who attend the Emergency Department in Daisy Hill Hospital Newry or Craigavon Area hospital. Once the child or young person is deemed medically fit for discharge the Emergency Department or Acute General Ward will make a referral to the CAMHS team and a Mental Health Risk Assessment will be completed. The assessment can take place either in the hospital setting or at a Child and Adolescent Mental Health Service clinic.

 

Community Intensive Intervention Service
The Community Intensive Intervention Service aims to provide a service within a variety of settings i.e. home, clinic, school etc to prevent hospital admission and to facilitate earlier discharge of children and adolescents with mental health difficulties using a recovery model of care. Practitioners provide intensive individual therapy over a short term only.  Support is also given to parents or those with parental responsibility.

 

Eating Disorders Team
This team is made up of nurses, dietician, family therapy, with input from Psychiatry and Community Intensive Intervention. The team specialises in the assessment and treatment of young people who are referred presenting with Anorexia Nervosa, Bulimia Nervosa and Eating Disorders Not Otherwise Specified (EDNOS).
When a young person is referred, the team provides a family and individual assessment. If the eating disorder service is appropriate to meet their needs, a range of interventions are available, such as Motivational Work, Individual Therapy, Family Therapy, Individual Nutritional assessment, education and reviews, Nutritional education groups (6 weeks) and Carers support education group (8 weeks).

 

Substance Misuse Practitioner 
The Substance Misuse Practitioner delivers clinical interventions for the management and treatment of children and young people with co morbid mental health and substance misuse problems.  This work may be undertaken in conjunction with other mental health practitioners in CAMHS. The post is also involved in building links with other agencies and substance misuse services such as adult addiction services and community based substance misuse agencies. Therapeutic intervention will be aimed at discussing the young person’s use of both legal and illegal substances, reflecting on the physical, psychological, social, educational, systemic and legal issues related to their substance misuse. The interventions are implemented in order to empower children and young people in the hope that they set goals to reduce or stop misusing substances. The Substance Misuse Practitioner offers opportunities for consultation and educational group sessions to professionals, children and young people their families and carers.

 

Supporting Carers 
This project supports long term foster carers to help them to better understand and manage the difficulties experienced by young people in their care. The goal of this project is to use an attachment perspective to ‘learn the child’, that is, to understand the young person’s difficulties differently. The project seeks to identify specific ideas and strategies that are useful to the carers, and to provide a supportive, cohesive process for the carers. The Supporting Carers Practitioner works predominantly with carers of young people, using a consultation model.

 

Family Therapy

 

Following an assessment in Tier 3 CAMHS, a family may be referred for family therapy. Family therapists are systemic psychotherapists who are trained to work with children, young people and their families, as well as working with other professionals. They try to find ways of talking together with families about positive changes and to find ways that work best for them. Sometimes family therapists work as part of a team with other colleagues and at other times work uni-disciplinary. Family Therapy is useful for children, young people and adults experiencing a wide range of difficulties and cir­cumstances as well as relationship problems, including:

  • Family communication problems
  • Child/adolescent behavioural difficulties
  • Self-harm, school refusal, conduct disorder
  • Eating disorder
  • Bereavement/loss/separation
  • Trauma
  • Fostering/adoption, kinship care or looked after children.

 

Family Therapy can be challenging but, in their feedback, families tell us that it is very useful. Click here to see comments made by previous families referred for this approach.

What presenting problems are seen at Tier 2 and Tier 3?

Tier 2 CAMHS works with mild-moderate emotional or mental health presentations. Tier 3 CAMHS works with moderate-severe mental health presentations. Generally, more severe or complex presentations are seen by multidisciplinary team in Tier 3. The CAMHS referral coordinator will be able to triage each referral to the appropriate team within CAMHS. However, in the interests of clarity, please see below for examples of presentations seen by each Tier.

 

Tier 2 presentations

 

  • Mild mood disorders
  • Mild anxiety
  • Mild phobias of significance
  • Mild OCD
  • Anger management
  • Self-esteem difficulties
  • Transition or adjustments issues
  • Mild to moderate emotional & mental ill health presentations
  • Complex Bereavement & Loss

Tier 3 presentations

 

  • Moderate to Severe Mood & depressive disorders
  • Self-harming behaviours
  • Suicidal Ideation
  • Tics / Tourette’s
  • OCD
  • Eating Disorders
  • Selective Mutism
  • Psychosis
  • Attachment Disorders
  • Complex Family dynamics
  • ADHD diagnosis post primary & medication management
  • ASD diagnosis post primary & management
  • Severe alcohol/drug abuse
  • Comorbid Disorders

How do I make a referral to CAMHS?

All CAMHS referrals are initially received and triaged by our Clinical Referral Coordinators. Their role is to ensure that each young person is seen by the correct service based on the description of their needs provided in the referral letter/form. The referral coordinators may contact you to discuss a case. They will direct your referral to the right team within CAMHS eg Tier 2, Tier 3, Eating Disorders. They will also advise if an alternative agency would be more appropriate for the young person being referred.

 

In addition to arranging for a young person to be seen for assessment in CAMHS, the Referral Coordinators can also arrange for a professional Consultation with CAMHS staff. Our referral coordinators are based at Bocombra Lodge in Portadown but deal with all referrals into CAMHS across the Southern Trust area.

 

To discuss a potential referral, please contact the Referral Coordinators on 028 383 92112 (09:00-13:00 & 13:45-17:00).
Email:  CAMHS.Teams@southerntrust.hscni.net
Contact address: Clinical Referral Coordinators, CAMHS, Bocombra Lodge, 2 Old Lurgan Road, Portadown, BT63 5SG.

Who can make a referral to CAMHS?

i-CAMHS – accept referrals from any professionals involved in the care of children under 3. Referrals must be made in hard copy using the iCAMHS referral form.

 

Tier 2 – any health, social or education professional who is concerned about mild-moderate difficulties.

 

Tier 3 – including specialist services such as Eating Disorder, Substance Misuse etc. More complex mental health presentations should be seen by their GP, who can ascertain if a referral to CAMHS is required. A generic Tier 3 assessment will be made in the first instance, followed by direction to the appropriate team within CAMHS.

 

Hospital Liaison – referrals from Emergency Departments or Hospital Wards in Daisy Hill Hospital and Craigavon Area Hospital. Please use the CAMHS Emergency Liaison Request form to make a referral

 

Supporting Carers – referrals can be made from within CAMHS, or from Social Workers working with children in the Looked After System. Please use the supporting carers referral form.
All CAMHS referrals must be made to the Clinical Referral Coordinators.
Telephone: 028 383 92112 (09:00-13:00 & 13:45-17:00)
Email:  CAMHS.Teams@southerntrust.hscni.net
Contact address: Clinical Referral Coordinators, CAMHS, Bocombra Lodge, 2 Old Lurgan Road, Portadown, BT63 5SG.

Do I need to use a referral form?

Eating Disorder Service, i-CAMHS, Supporting Carers and Hospital Liaison have special referral forms – see links below:

EDS Referral Proforma
i-CAMHS – Referral Form
Supporting Carers Referral Form
Hospital Liaison Referral Form
For other services, it is possible to refer by letter.

It is helpful to our referral coordinators if the referral information is comprehensive. Please include details of presenting issues, family structure, and significant stressors or precipitants to the young person’s difficulties. It is also helpful to know about involvement from other agencies and outcome of this. It is important that each family consents to the referral being made to CAMHS prior to referral paperwork being submitted. If in doubt regarding a referral, please contact the CAMHS Referral Coordinators for advice.

Telephone: 028 383 92112 (09:00-13:00 & 13:45-17:00)

How quickly will my referral be seen?

Once the referral is received by CAMHS it will be coded as Urgent or Routine. Within Tier 3 CAMHS, Urgent appointments are seen within two weeks. Routine referrals will not wait for more than 9 weeks for a first appointment, often less. If you are worried about how long your referral is waiting for an appointment, you have the option of contacting one of our referral coordinators to discuss your concerns on  028 383 92112.
After initial assessment, you will receive a clinical letter to update you regarding the outcome of assessment. This letter may be accompanied by a FACE risk profile.

How do I contact the CAMHS teams?

Please see below for address and telephone/email contact details for all three CAMHS clinics in the Southern Trust area.

Armagh & Dungannon Newry & Mourne Craigavon & Banbridge  Eating Disorder Service and i-CAMHS (Infant Mental Health)
CAMHS
D Floor
South Tyrone Hospital
Dungannon BT71 4UA
CAMHS
Needham House
Kiln Street
Newry BT35 8EQ
CAMHS
Bocombra Lodge
2 Old Lurgan Road
Portadown BT63 5SG
The Sperrins
Cedarwood Building
Longstone Hospital Site, Loughgall Road
Armagh BT61 7NG
Tel: 028 8771 3494 Tel 028 3083 5400 Tel: 028 3839 2112  Tel: 028 3836 0680

Trust-wide Email:  CAMHS.Teams@southerntrust.hscni.net
NB:  All referrals should be directed to the Clinical Referral Coordinators, based at Bocombra Lodge.