11.1 Providing high quality CAMHS is dependent on having sufficient numbers of appropriately trained staff to deliver high quality services in all four tiers, with a balanced skill mix to ensure the necessary range of skills. This will require a significant increase in the workforce in line with the guidance set out in section 9.
11.2 As part of the development of the workforce, it is important to identify any new or extended roles that might be appropriate to help deliver the expanded services, for example:
- CAMHS Workers in Primary Care to act as a key link between primary care and specialist CAMHS services;
- New types of child and adolescent mental health workers;
- Extended roles for professionals acting as first on call in emergency and out-of-hours services;
- New support roles, and
- Paediatricians and general practitioners with a special interest in child mental health.
11.3 Services also need adequate management expertise to deliver multi-agency services and to have adequate access to support staff (for example, the administrative workforce should be sufficient to ensure that all necessary administrative functions, including data collection, can be fulfilled).
Primary Care Trusts, Local Authorities and services ensure that: All staff working in universal services with children and young people have the Common Core skills, knowledge and competencies outlined in Standard 3. Multiagency training is provided across schools, primary care, social care and youth justice. Staff working in child and adolescent mental health services have the core competencies set out under Standard 3. In addition, joint training, continuing professional development and mentoring is needed to ensure that staff have the necessary skills and competencies to: - Work across agency boundaries and within a variety of settings;
- Engage children, young people and their families who have difficulty accessing services, including those from black and minority ethnic groups;
- Offer a range of modalities of treatment, including interpersonal, psychodynamic, systemic, cognitive behavioural therapies and psychiatric intervention, including the use of psychoactive medication, and
- Deliver interventions based on the best available evidence. Where the evidence is limited, creative and innovative practice should also be encouraged, taking into account the views and wishes of the users of the service and subject to the process of audit and evaluation.
Specific training is also needed in the following areas: - Training for CAMHS professionals in developing areas such as learning disability, drug and alcohol misuse and use of psychoactive medication, cognitive behavioural therapy and other specific treatments;
- Multi-agency and multi-disciplinary training for joint service provision across health, education and social care;
- Shared training for professionals in the competencies required for 'residential' care and for specialist treatments;
- Training for those providing first on-call to children presenting with acute psychiatric illness in emergency and out-of-hours services;
- Training for all staff working in accident and emergency departments who may carry out initial social and medical assessment of children with mental health problems;
- Training for adult mental health professionals to enable them to be aware of the development needs of young adults making the transition across services;
- Training for managers in providing multi-agency CAMHS services;
- Training for commissioners in understanding CAMHS services (initially delivered by service providers), with the development of networks of CAMHS commissioners to help spread knowledge and best practice, and
- Training in mental health legislation.
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