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Child and Adolescent Mental Health Services (CAMHS)

 

There has been wide variation across the UK in the availability and type of mental health services for children and adolescents. Recent initiatives, including substantial increases in government funding specifi cally for CAMHS and the National Service Framework for Children (NSF-Children), should increase the range and uniformity of services. In the future, GPs should expect access to both uniprofessional and multidisciplinary mental health services for children and adolescents.

There is at present no overall consensus about the exact way in which services should be organised locally but there is general agreement that CAMHS should be structured to provide rapid and easy access for all children with signifi cant mental health problems and their families. This framework should ordinarily include generic services for the assessment and treatment of common and relatively uncomplicated problems, possibly delivered by a single professional who may work in a CAMHS setting, a GP service, in school or in social services. In addition, multidisciplinary teams should be available to deal with disorders that are rarer, have greater complexity, or require a highly specialised training for their assessment and treatment. Local services should make their access points clear to GPs and other referrers, including mechanisms for dealing with psychiatric emergencies. An ongoing area of discussion remains the interface between CAMHS, education and social services. Children’s Trusts, arising from the UK government’s ‘Every child matters’ strategy, are aimed in part at reducing the debate between services about where responsibility lies.

In addition, much of the initial new money for CAMHS has been streamed through education and social services, to provide bridges. However, many Children’s Trusts will be virtual rather than real and it is likely that some disagreements will remain. General practitioners have an important role through their Primary Care Trust in directing the development of their local CAMHS in ensuring that the needs of their child patients are met.

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