CAMH SNAP Report

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Only Connect
Perspectives from the frontline
12th December 2006 Phil Wilson General Practice
and Primary Care University of Glasgow
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Acknowledgements

• Graham Bryce - psychiatry
• Louise Phin - psychology
• Judy Furnivall social work
• Rose Barbour sociology/nursing
• Graham Connelly - education
• Elaine Lockhart - psychiatry
• Mike van Beinum psychiatry
• Anna Stallard psychology
• Anne Lewins sociology/IT
• The SNAP core group
• HeadsUpScotland
• NHS Health Scotland

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SNAP reports

• Needs assessment programme
• Commissioned by Scottish Executive Health
  Department

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CAMH SNAP process
Phase 1 survey
National seminar
Phase 2 survey
Regional seminars
Final report
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SNAP survey phase 2 (2002/3)
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(No Transcript)
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Responses
Response Rates Teachers 366/603 61 General
Practitioners 137/280 48 Field Social
Workers 105/234 45 School Nurses 100/230 45 Resid
ential Workers 104/289 35 Health
Visitors 71/142 50 Paediatricians
54/70 50 Authority Reporters 24/32 75 Panel
Chairs 19/32 59 Police 5/?? Foster
carers 38/?? Voluntary Workers 56/?? Total 1
049 responses
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Questionnaire A -1

• Whats your job?
• Whats your caseload?
• Whats your training?
• How do you get help with CAMH issues?
• What sort of new service would you like?
• Would you like more training?
• Would you like to be involved in planning?

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Questionnaire A-2

• Tell us about
• your most recent case
• Your most worrying case in the past 3 years
• your most satisfactory case in the past 3 years
• What was the problem and what did you do?
• What would you like to have done?
• What were the barriers to achieving desired
  outcomes?
• What gave you satisfaction?

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The qualitative data

• Content analysis of free-text responses
• Huge dataset - need for multi-professional
  teamwork and innovative uses of IT

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Comments 1

• Too many obstacles for children, parents and
  primary care professionals to negotiate before
  getting first assessment by a child mental health
  profession (GP) 

A register of what is available. We feel this is
an area of need with little resources that we are
aware of (HV)
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Comments 2
Feel inadequate as not trained in mental health
(School nurse)
I feel this is an area which is sadly lacking
within health services. Education services do not
"like" health involvement instead of working
jointly we end up working alongside each other so
the pupil receives no benefit or help from either
(School nurse)
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Comments 3
our views in school based on many hours
contact are usually disregarded. (Secondary
school head teacher)
Other professionals don't have the
time/resources to bring to child, time passes,
little done, and other professionals don't want
'amateurs' to deal with case. (Primary school
class teacher)
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Comments 4
We have no direct access to child family
psychiatry. The amount of time and effort we
spend trying to get children seen is
disproportionate to the value of the service
received. The psychiatrists are not approachable
and do not view social workers as equal
partners. (Social worker)
A barrier is Issues of patient
confidentiality, even though it is explicit in
guidance that child protection matters override
this, there's a lack of information/
understanding of the role of police/ social work
in child protection enquiries by health care
professionals. (Social worker)
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Comments 5
The problem remains. We cannot walk away the
way that medical personnel can. (Residential
worker)
No two people agreed on anything, or could give
an explanation. (Foster carer)
The twins have no awareness of danger and do not
understand 'no'. One of the twins climbs on
everything and could climb out of his cot over 30
times until I stayed with him. I asked for help
in January from OT who came in April. Sent a
joiner to review in June. I tied one fireguard on
top of the other and did various other temporary
measures to keep them safe. (Foster carer)
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Working with other professionals- Key issues

• Referrals between services
• Communication and liaison
• Understanding and respecting each others roles
  different mindsets and languages
• Inter-agency work or working as part of a team?
• Co-ordination and joint planning
• Training and consultancy

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How do we make it work?