Child and adolescent mental health
This week Health Education England have lunched a public health 'Week of Action' celebrating the nursing, midwifery, health visitor and allied health professional contribution to children and young people's health and well-being.
Having worked in the NHS within Child & Adolescent Mental Health Services for over two decades, Sarah Campbell, a Senior Lecturer in the School of Health Sciences at City University London, continues to promote understanding emotional, behavioural and social needs of children, young people and their families/carers at all levels within higher education. This includes her role as Programme Director of the MSc in Advanced Practice in Health and Social Care: Child & Adolescent Mental and also running modules for pre-registered nurses as well as graduates and post-graduates from all professional groups.
Sarah also develops, designs and leads specific training for 'Skills for Child Protection Supervision' which runs within a large local NHS Trust with the aim of enhancing an participant's ability to appraise contain and support the work of their peers and junior colleagues who care for individuals and families where there are significant concerns and vulnerability.
In addition, Sarah maintains clinical contact and works closely with local health Trusts. She was invited to develop and now leads bespoke training focused on child protection supervision for clinical team management. The aim is to enhance participant's ability to appraise, contain and support the work of their peers and junior colleagues who care for individuals and families where there are significant concerns and vulnerability.
As part of the celebrations, Sarah spoke about the course, and some of the key issues in the sector.
What are the key issues currently facing the sector?
Many children services in the UK are experiencing resource restraints and restructuring. They have to provide vital services to specific populations where the definition of 'need' has expanded to include increased poverty, increased substance abuse and increased gang culture alongside conventional mental health and family difficulties. These issues are not exceptional to the UK and resonate internationally.
Gathering good evidence based research of effective approaches is key to finding ways to maintain quality within service provision. We need to constantly evaluate 'what works' and there are excellent areas of good practice. Greater awareness and national policy initiatives over the last decade has brought about wider participation where possible within the health and social care and education workforces. These workforce developments include trends to make services more accessible to children and young people such as working creatively within schools to enhance academic resilience.
However it is important that relevant messages from research involving young people's views on what they feel is helpful are protected and heard. Young people identified that the key aspect of mental health service engagement was through a constant and consistent relationship to help them recognise the disadvantages of old behaviour patterns, to spend time thinking about these and motivating them to change. It is vital that we acknowledge and protect the service user's voice and uphold the skilled professional relationship as central to all key issues.
How does the course enable students to help children and young people have the best start to life?
Children and young people's mental health and emotional wellbeing are fundamental for them to live, learn and relate. It underpins their capacity to access the resources offered by early years services, education and ultimately adult society.
It is imperative to us that students develop their capacity to practice in ways that are collaborative, evidence based and reflective in order to meet these outcomes. Collaborative because services built around children's needs require multi-agency and multi-disciplinary approaches in collaboration with the service user. Evidence based because better outcomes require us to be able to evaluate and to learn from experience. Reflective because this is key to being able to think and act differently.
What's your area of research?
As the Chief Investigator, I recently completed "An enquiry into the provision of mental health services for 16-25 year olds and the relationship to offending behaviour" which was commissioned by the Barrow Cadbury Trust in partnership with YoungMinds. This research formed the basis of a policy document presented in the House of Lords in December 2013. The views of young people who offend as well as views gathered from the health, probation and voluntary services were central to the research design. The findings supported the need to improve mental health services for this vulnerable group to increase better health, prevention and economic outcomes. It became clear that the relationship between serious mental health problems as well as family dysfunction that are often not identified or treated and children who go onto offend is profound. This research led to current journal publications in 2014.
The impact our clinical and practice work has on our ability to think and respond in a clear professional manner is of central importance and led me to lead and develop with valued colleagues the Personal Professional Development Group initiative where all Mental Health Nursing students at City University London attend a weekly closed group with two fixed facilitators for the duration of their training. We are very proud that this activity, now in its third year, has been highly commended by the Nursing and Midwifery Council.
Tell us about the course... is there particular aspect which is unique or special?
The course prepares students to participate in a specialist workforce developing their leadership, research skills and evidence-based practice alongside other students from different professional and academic backgrounds.
The programmes underlying philosophy of relationship centred practicefocuses on two key areas. Firstly the service user and carer are at the centre of decision-making and service re-design. Secondly the development of ethical, culturally sensitive practice is of a primary concern.
This course provides education of key theories and concepts at an advanced level
- that promote understanding child and adolescent psychological development;
- to manage risk and identify resilience;
- of early identification, assessment and formulation of child and adolescent mental health problems;
- evidence-based psychosocial interventions and contemporary issues in child and adolescent mental health.
What kind of students do you normally get on the course?
Our students are curious, enthusiastic and committed to improving outcomes for children, young people and their families and carers. Our students are naturally ambitious and come from all areas of health, education and social care services including youth justice and the voluntary sector. Some students have a professional qualification and come to this programme with experience and will use this Masters degree to widen their knowledge and research capabilities at a Masters level to escalate their careers. Other students are at the beginning of their careers and this programme offers them a sound platform on which to seek career graduate posts in this speciality.
What's next for the sector? What would you like to see changed?
Effective therapeutic engagement and intervention is advanced practice. It defines professionalism and to engage in a competent therapeutic relationship requires solid bedrock of specialised knowledge. This difficult yet rewarding activity can so easily get lost or minimized as not part of a 'trend'. Yet it is the most effective tool any practitioner has and that any good service manager will lead on through investing and promoting its strengths and efficacy amongst all professional groups.