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‘Accessibility’ The Strength of Tier 2 approaches to Mental Health

National Conference Devon County Hall, Exeter 13 th November 2012. ‘Accessibility’ The Strength of Tier 2 approaches to Mental Health. Andrew Starr Primary Mental Health Worker, Leicester CAMHS. The main differences between Tier 2 and Tier 3 in CAMHS. Tier 2

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‘Accessibility’ The Strength of Tier 2 approaches to Mental Health

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  1. National Conference Devon County Hall, Exeter 13th November 2012 ‘Accessibility’The Strength of Tier 2 approaches to Mental Health Andrew Starr Primary Mental Health Worker, Leicester CAMHS

  2. The main differences between Tier 2 and Tier 3 in CAMHS Tier 2 10 times as many children affected Larger range of professionals with relevant experience Initial, or lower level mental health problems (low risk) ‘Public Health’ issue that intervening early is cheaper, and causes less distress Short waiting times Tier 3 ‘Statutory’ right to a service Probably the own available service Higher levels of mental health ‘risk’ Largely a ‘reactive’ service approach Prioritised waiting

  3. ‘Active’- not Reactive Tier 1 84% Tier 2 15% Tier 3 &4 1%

  4. ‘Library’, not ‘Filing Cabinet’ Tier 2 Model Tier 3 Model

  5. Network Model “Who is helping this child now?” “Who else might be able to help?” “How can I help these people?” PMHW

  6. CAMHS Priorities At Tier 3 At Tier 2 Assess Serious Mental Ill-Health in children and Young People Offer Treatments to Children and Young People Support other Professionals and Services in their role Research and Development Support other Professionals and Services in their role Assess Serious Mental Ill-Health in children and Young People Offer Treatments to Children and Young People Research and Development

  7. ‘Access’ and Health Inequalities • What are the barrier? Within Sociality • Gender, Race, Religion, Age, Culture, Class, Ethnicity, Sexuality, Spirituality Within Services • The same?

  8. Lessons from Adult I.A.P.T. ? • Rationing resources • Shorter, focused appointments • Use of one main therapy • Uniform (evidence based) approaches • Using Health Centres

  9. But- for CAMHS • Often more than one Patient • Different Ethical framework for children • Many professionals already involved • Too many children to see them all • Mental Health is Everyone's Business

  10. Accessibility • Examples of how Tier 2 CAMHS has brought mental health services into communities. • MAP in Tower Hamlets • Traveller Projects

  11. “Hello, Mum....the Doc wants to know if I have difficulty making decisions. What do you think?”

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