“The idea of inpatient care requires a huge leap of faith for the child, family and referring professional alike. We do not underestimate this process but truly believe that, for the small number of deeply troubled children and families whose lives have become strained beyond endurance, an inpatient admission may offer a real hope of respite, understanding and the possibility of change.”
Central and North West London NHS Foundation Trust
Setting the Scene
Good mental health is central to the development of children and young people. In the United Kingdom, around 1 in 10 children and young people have problems with their mental health at some time in their lives. One of the reasons why it’s so dreadful is that it affects the whole of a young person’s life; their development, self-esteem and confidence, educational pursuits, employment, relationships, and so on. Mental health problems are associated with early death, while those with an emotional disorder are more likely to smoke, drink and use drugs than their peers.
According to The Good Childhood Report 2016, 14% of girls and 11% of boys between the ages of 10 to 15 are unhappy with their lives leading to emotional problems such as anxiety and depression. These problems are associated with happiness with appearance and life as a whole. This research was carried out by Children’s Society who along with the findings have provided recommendations for change including: making sure there’s access to support in educational settings, a firm commitment from the Government to understanding and acting on children’s well-being, and making sure that they have a voice in decision-making.
On average, the peak age of onset for mental health problems occurs in late childhood / early adulthood, and it’s at this time when getting the right help is most crucial. Early intervention and prevention are the main ways that lasting change can be achieved. An increasing number of young people are seeking help for devastating mental health problems leading to huge challenges for already stretched services. Those who get the help they need and deserve, often eventually experience greater wellbeing, and as a result, they learn better and are more likely to fulfil their potential. Thankfully, there are dedicated and specialised child and adolescent mental health services (CAMHS), and the heroic staff that work in them. As with other staff groups, most CAMHS wards’ staff are impressively creative and compassionate.
According to The Good Childhood Report 2016, 14% of girls and 11% of boys between the ages of 10 to 15 are unhappy with their lives leading to emotional problems such as anxiety and depression. These problems are associated with happiness with appearance and life as a whole. This research was carried out by Children’s Society who along with the findings have provided recommendations for change including: making sure there’s access to support in educational settings, a firm commitment from the Government to understanding and acting on children’s well-being, and making sure that they have a voice in decision-making.
On average, the peak age of onset for mental health problems occurs in late childhood / early adulthood, and it’s at this time when getting the right help is most crucial. Early intervention and prevention are the main ways that lasting change can be achieved. An increasing number of young people are seeking help for devastating mental health problems leading to huge challenges for already stretched services. Those who get the help they need and deserve, often eventually experience greater wellbeing, and as a result, they learn better and are more likely to fulfil their potential. Thankfully, there are dedicated and specialised child and adolescent mental health services (CAMHS), and the heroic staff that work in them. As with other staff groups, most CAMHS wards’ staff are impressively creative and compassionate.
However, the prospect of being admitted into inpatient care takes a great deal of trust and courage for everyone involved, especially the young person themselves and their family or carers. Having to stay in any kind of hospital is tough. Being away from home, friends and things young people enjoy can be really hard, especially when they’re already feeling exceptionally confused, upset, stressed or down. Young people are a group of particularly vulnerable inpatients for whom a hospital admission can potentially be very traumatic – but also potentially very healing and resilience-building.
The impact of being in hospital on teenagers and their needs throughout a period of ill mental health are unique to this age group. Previously it was thought that adolescents were just as adept at coping with challenging or unsettling situations as adults. Now it’s recognised that teenagers are distinct from adults because they’re still maturing and developing. Similarly, adolescents are different to children because they’re undergoing a distinct developmental phase to their former selves and their younger peers. These differences really need to form the foundation of any package of care they’re offered within health services.
The impact of being in hospital on teenagers and their needs throughout a period of ill mental health are unique to this age group. Previously it was thought that adolescents were just as adept at coping with challenging or unsettling situations as adults. Now it’s recognised that teenagers are distinct from adults because they’re still maturing and developing. Similarly, adolescents are different to children because they’re undergoing a distinct developmental phase to their former selves and their younger peers. These differences really need to form the foundation of any package of care they’re offered within health services.
However totally rubbish having to go into hospital may be, there are lots of good things that can come from this extreme experience. CAMHS wards throughout the country provide a rich assortment of therapeutic, educational, social and clinical interventions. Being an inpatient offers an opportunity for young people to attain new skills and achievements, to build up their muscles of resilience, to discover hope, to feel validated and safe, to be heard and involved, to do something fun, enjoyable and constructive, to express themselves, to make new friends, and to grow and move forward in their own developmental and recovery journey.
Working on a CAMHS ward is one of the most challenging and rewarding jobs in healthcare. It’s also one of the most important, for how this work is put into action shapes in part the unique recovery journeys of the next generation, their breadth of life skills, and their perceptions about themselves and their place in our ever-shifting world.
There are imaginative efforts by wards throughout the country that are expertly putting the CAMHeleon approach into practice - this site is both an inspiring "gallery" and a colourful celebration of this work.
There are imaginative efforts by wards throughout the country that are expertly putting the CAMHeleon approach into practice - this site is both an inspiring "gallery" and a colourful celebration of this work.
Foreword by Dr Miranda Wolpert and Professor Peter Fonagy
"For those who are part of the country’s ten percent of young people experiencing a diagnosable mental health problem, life can feel lonely, desperate, and burdened. Those who are particularly vulnerable and who face the most serious problems may be admitted into a specialist Child and Adolescent Mental Health (CAMHS) hospital. This can feel like an enormous step of trust and hope amidst a crisis point where the structure of everyday life is deteriorating.
Those who provide care and support in this context can find this one of the most rewarding environments in mental health care, despite many challenges, as they can play a key part in supporting recovery of young people and helping support families also. What is needed is that young patients, their families and ward staff alike are equipped and supported - emotionally and practically.
CAMHeleon offers an accessible body of understanding and the potential tools and practice ideas garnered from experienced staff and existing material. CAMHeleon suggests, through a wealth of useful examples, that when young people’s emotional worlds are met and validated with sincerity, attention and containment, they are much more able to be mindful of triggers, find sanctuary, develop their resources, and explore new possibilities.
Ward staff and those who are involved in training and managing them will no doubt discover various ways to translate and implement this inspiring content that CAMHeleon brings together.
CAMHeleon doesn’t promise to have all the answers, nor does it claim to be the finished article (it invites users to help its evolution through the submission of new practice examples). It does, however, provide the inspiring and encouraging raw material which may benefit the work done with some of the country’s most vulnerable people and their families, and therefore enhance the inpatient experience."
Dr Miranda Wolpert (Director Service Improvement and Evaluation Anna Freud Centre) and Professor Peter Fonagy (Chief Executive of the Anna Freud Centre)
Anna Freud Centre work to improve the lives of thousands of children and young people with mental health problems. They provide specialist help, train others, and carry out innovative research.
www.annafreud.org
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Treat young people’s minds and bodies equally.
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