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  • Print publication year: 2008
  • Online publication date: August 2009

17 - The interface with the Child and Adolescent Mental Health Services (CAMHS)

from Part II - Interface issues



There are many similarities between the psychiatric intensive care of adults and the management of children and young people who present with serious mental health problems. However, there are equally a number of differences stemming from the biological, developmental and social aspects pertinent to childhood and adolescence.

In everyday clinical practice young people presenting with severe and complex psychiatric disorders requiring inpatient treatment receive that treatment in a variety of settings. At best they are treated in adolescent inpatient units or the few adolescent intensive care or forensic units, but an increasing number of young people go on to receive treatment in adult mental health units including Psychiatric Intensive Care Units (PICUs). This happens mainly because of a lack of specialist inpatient resources in the Child and Adolescent Mental Health Service (CAMHS) sector.

This chapter will focus on the key components and functions of CAMHS with particular reference to the group of young people with serious psychiatric and/or behavioural disorders who pose a high risk to themselves or others and are likely to require admission to adult PICUs.

CAMHS service structure

Child and Adolescent Mental Health Services can be managed by Primary Care Trusts, Mental Health Trusts or in some cases acute hospital services as part of paediatric services. Children's Trusts are a more recent development in which social services, education and health come together jointly to commission and to provide comprehensive children's services including CAMHS.

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Aitchison, JK, Meehan, K, Murray, RM. 1999 First Episode Psychosis.London: Martin Dunitz, pp. 16–27
American Academy of Child and Adolescent Psychiatry. 1998 Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J Am Aca Child Adolesc Psychiatry 37 [Suppl. 10]: 63S–83S
American Psychiatric Association. 1994 Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association
Audit Commission. 1999 National Report (1999). Children in Mind: Child and Adolescent Mental Health Services. London: Audit Commission
Balding, JW. 1999 Young People in 1998. With a Look Back as Far as 1983. Exeterw: Schools Health Education
Biederman J, Wilens T, Mick E et al. 1999 Pharmacotherapy of attention deficit/hyperactivity disorders reduces risk of substance use disorder. Paediatrics 104: e20
British Psychological Society and the Royal College of Psychiatrists. 2006 The Management of Bipolar Disorder in Adults, Children and Adolescents in Primary and Secondary Care. National Clinical Practice Guideline Number 38. London: British Psychological Society and Royal College of Psychiatrist
Crome BI, McArdle P, Gilvarry E, Bailey S. 2004 Treatment. In: Crome I, Ghodse H, Gilvarry E, McArdle P (eds) Young People and Substance Misuse. London: The Royal College of Psychiatrists
Department of Health. 1999a NHS National Service Framework for Mental Health. London: HMSO
Department of Health. 1999b Code of Practice to the Mental Health Act 1983 (revised 1999). London: The Stationery Office
Department of Health. 2003 NHS Confidentiality Code of Practice. London: Department of Health
Department of Health. 2004 Standard 9. The Mental Health and Psychological Wellbeing of Children and Young People. London: Department of Health
Department of Health. 2004 National Service Framework for Children, Young People and Maternity Services: Executive Summary. London: The Stationary Office
Department of Health. 2006 Report on the Implementation of Standard 9 of the National Service Framework for Children, Young People and Maternity Services. London: Department of Health
dosReis, S, Barnett, S, Love, RC, Riddle, MA, Maryland Youth Practice Committee. 2003 A guide for managing acute aggressive behavior of youths in residential and inpatient treatment facilities. Psychiatric Serv 54(10): 1357–1363
Dunn, V, Goodyer, IM. 2006 Longitudinal investigation into childhood and adolescence-onset depression: psychiatric outcome in early adulthood. Br J Psychiatry 188: 216–222
Fonagy, P, Target, M, Cottrell, D, Phillips, J, Kurtz, Z. 2002 What Works for Whom? A Critical Review of Treatments for Children and Adolescents. New York: Guilford Press
Gillick v West Norfolk and Wisbech Area Health Authority. 1986 AC 112
Goodman, R, Scott, S. 1997 Child Psychiatry. Oxford: Blackwell Science
Goodyer IM, Cooper PJ. 1993 A community study of depression in adolescent girls. II: the clinical features of identified disorder. Br J Psychiatry 163: 374–380
, Goodyer IM, , Herbert J, , Tamplin A. 2003 Psychoendocrine antecedents of persistent first-episode major depression in adolescents: a community-based longitudinal enquiry. Psychol Med 33: 601–610
Harrington R. 1994 Affective disorders. In: , Rutter M, , Taylor E, , Hersov L (eds) Child and Adolescent Psychiatry: Modern Approaches, 3rd edn. Oxford: Blackwell Science, p. 330–350
, Harrington R. 2001 Depression, suicide and deliberate self harm in adolescence. Br Med Bull 57: 47–60
Harrington R, Dubicka B. 2001 Natural history of mood disorders in children and adolescents. In: Goodyer IM (ed) The Depressed Child and Adolescent. Cambridge Child and Adolescent Psychiatry Series. Cambridge: Cambridge University Press, pp. 311–343
Hawton K, Rodham K. 2006 By their Own Young Hand, Deliberate Self Harm and Suicidal Ideas in Adolescents. London: Jessica Kinglsey
Health Advisory Service. 1986 Bridge over Troubled Waters: A Report on Services for Adolescents. London: HMSO
Health Advisory Service. 1995 A Handbook on Children and Adolescent Mental Health. London: HMSO
Health Advisory Service. 1996 Children and Young people: Substance Misuse Services: The Substance of Young Needs. London: HMSO
Hollis C. 2000 Adolescent Schizophrenia: Advances in Psychiatric Treatment. London: Royal College of Psychiatrists
Institute for the Study of Drug Dependence. 1993 National Audit of Drug Misuse in Britain. London: Institute for the Study of Drug Dependence
Kaplan, Tet al. 2002. From a short life project to a mainstream service: convincing commissioners to fund a community adolescent mental health team. Child Adolesc Mental Health 7 (3): 114–120
Linszen, Det al. 1994 Cannabis abuse and the course of schizophrenic disorder. Arc Gen Psychiatry 51: 273–279
, March J, , Silva Set al. 2006 The Treatment for Adolescents with Depression Study (TADS): methods and message at 12 weeks. J Am Acad Child Adolesc Psychiatry 45(12): 1393–1403
Martinez-Arevalo, MJ, Calcedo-Ordonez, , Varo, Prieto JR. 1994 Cannabis consumption as a prognostic factor in schizophrenia. Br J Psychiatry 164(50): 679–681
McClure, W, Schaffer, Det al. 1966 Psychiatric diagnosis in child and adolescent suicide. Arch Gen Psychiatry 53: 339–348
Mears A, White R, Banerjee S et al. 2001 An Evaluation of the Use of the Children Act 1989 and the Mental Health Act 1983 in Children and Adolescents in Psychiatric Settings (CAMHA –CAPS). College Research Unit Report. London: Royal College of Psychiatrists
Miller, P, Plant, M. 1966 Drinking, smoking and illicit drug use among 15 and 16 year olds in the United Kingdom. Br Med J 313: 394–397
NHS Health Advisory Service. 1995 Together We Stand: Thematic review of the Commissioning, Role and Management of Child and Adolescent Mental Health Services. London: The Stationery Office
NICE 2002 Schizophrenia: Core Interventions in the Treatment and Management of Schizophrenia in Primary and Secondary Care. Clinical Guideline 1. London: NICE
NICE 2004 Self Harm Clinical Guideline 16. The Short Term Physical and Psychological Management and Secondary Prevention of Self Harm in Primary and Secondary Care. London: NICE
NICE 2005 Depression in Children and Young People. Identification and Management in Primary, Community and Secondary Care. Clinical Guideline 28. London: NICE
NICE 2007 Community Based Interventions to Reduce Substance Misuse Among Vulnerable and Disadvantaged Children and Young People. NICE public Health Intervention Guidance 4. London: NICE
O'Herlihy, A, Worrall, A, Banerjee, S, Jaffa, Aet al. 2001 National In-patient Child and Adolescent Psychiatry Study. College Research Unit Report submitted to Department of Health, May 2001
Ramsey, M, Baker, P, Goulden, Get al. 2001 Drug Misuse Declared in 2000: Results from the British Crime Survey. Home Office Research Study 224. London: Home Office
Royal College of Nursing. 2003 Restraining, Holding Still and Containing Children and Young People. Guidance for Nursing Staff (1999 updated 2003). London: Royal College of Nursing
Secretary of State for Health. 1999 Saving Lives: Our Healthies Nation. London: The Stationery Office
Shiers, D, Lester, H. 2004 Early intervention for first episode psychosis: needs greater involvement of primary care professionals for its success. Br Med J 328: 1451–1452
Street C. 2000 Whose Crisis? Meeting the Needs of Children and Young People with Serious Mental Health Problems. A Young Minds Study. Ward Guidelines. Guy's Hospital, South London and Maudsley Trust: Snowsfields Adolescent Unit
Treatment for Adolescents With Depression Study (TADS) Team. 2004 Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. J Am Med Assoc 292: 807–820
UK Government. 2000 The Mental Health of Children and Adolescents in Great Britain. London: Office of National Statistis
White R, Harbour A, Williams R. 2004 London: The Royal College of Psychiatrists
Wolpert L. et al. 2006 Drawing on Evidence. Advice for Mental Health Professionals Working with Children and Adolescents, 2nd edn. London: CAMHS Publications
World Health Organization. 1992 The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization
World Health Organization. 1996 Multiaxial Classification of Child and Adolescent Psychiatric Disorders. Cambridge: Cambridge University Press
Zeitlin, H. 1999 Psychiatric comorbidity with substance misuse in children and teenagers. Drug Alcohol Depend 55: 225–234