Five new CAMHS hubs offering intensive supports to children and young people aged up to 18 years, were launched in September, as part of a Model of Care to support CAMHS Teams in delivering enhanced responses to children, young people and their families/carers in times of acute mental health crisis.
The New CAMHS Pilot Hubs aim to deliver intensive multidisciplinary mental health interventions and support in the home and community. Teams consisting of professionals from various disciplines will assess the individual’s needs and develop an individual care plan tailored to support their recovery journey. The HSE said this multidisciplinary approach would ensure that individuals received comprehensive and holistic care. . By offering support in the home or community, the model aims to respond quickly to individuals’ needs and empower them on their recovery journey.
The CAMHS Hub Teams would complement and support the work of CAMHS Community Teams, at times where the CAMHS Community Mental Health Team required an additional intensive brief intervention service to manage and de-escalate the acute mental health crisis. They would provide services for people up to the age of 18 experiencing an acute mental health crisis, where it was determined the needs of the child or young person required a rapid response, time-bound intensive brief intervention.
“The CAMHS Hub Team will use the skills of the multidisciplinary Team to assess the child or young person’s needs and to develop an individual care plan that supports them on their recovery journey.”
The HSE said support from these hubs was time-limited, providing intensive intervention and support with sufficient flexibility to respond to different young people’s or parent/carer needs. Typically, this entails a range of evidenced informed therapeutic approaches, including medication management, psychotherapeutic based individual, group and family interventions. The service would be child and young person centred, recovery focused and trauma informed.
The pilot implementation of the CAMHS Hub will be independently evaluated over the testing phase of 18-24 months. The HSE said this evaluation would help assess whether the desired outcomes were being met and inform future development of the service. “By continuously learning and adapting based on the evaluation results, the HSE can improve the model and ensure it meets the needs of individuals with mental difficulties.”
By providing intensive supports during times of acute mental health crisis, the model seeks to offer an alternative response and reduce the need for inpatient admissions when appropriate.
Minister for Mental Health and Older People, Mary Butler, said, “The development of this new multi-disciplinary Model of Care and the expansion of CAMHS Hubs nationally has been a priority for me and for the HSE. Support from these Hubs is designed to be over a short period of time, as they provide targeted and intensive intervention and support with flexibility to respond to different young people’s or parent/carer needs. We have worked hard to make sure this service will be child and young person centred, recovery focused and trauma informed.
“This is a welcome and significant new service development to advance in particular Recommendation 35 of our Sharing the Vision policy to develop a comprehensive specialist mental health out-of-hours response for children and adolescents in all geographical areas.”
The HSE said the needs for CAMHS service development was increasing significantly. Between 2020 and 2021, referral rates into CAMHS increased by 33%, while the number of new cases seen increased by 21% in that same period. The organisation and delivery of Mental Health Services and supports into the future, required the development of stepped care approaches, to ensure each person could access a range of options matched to their needs.
This Model of Care will be piloted across pilot learning sites. There will be an independent evaluation undertaken of the pilot implementation of CAMHS Hubs over the pilot testing phase 18 – 24 months in line with the Standard Operating Procedure and the Model of Care.
On completion of the mixed methods evaluation across the five CAMHS Hubs learning sites, the pilot Model of Care will then be reviewed and optimised by the National Steering Group for CAMHS Hubs. Plans will then be put into place to support the mainstreaming and upscaling of CAMHS Hubs within HSE Mental Health Services.
It is envisaged that there will be a phased development of the CAMHS Hub model in line with resources available and access to existing services available in each of the learning site areas, such as access to Out of Hours CAMHS On Call, access to Day Hospitals and access to CAMHS inpatient beds.
The Department said Phase 1 of the CAMHS development involved Intensive Community Support in collaboration with the CAMHS Community Team for those at high risk in crisis, five day Monday to Friday Service for two to four weeks’ duration with scope for exceptional cases of a second assessment at four weeks and extension to a maximum of eight weeks, based on clinical judgement and need.
Phase 2 would provide Intensive Community Support, in collaboration with the CAMHS Community Team for those at high risk in crisis. This would be a seven day service for two to four weeks duration – dependent on uplift of staff required to provide a seven day service).
Phase 3 would be an Integrated Approach to Intensive Community Support. This would be a seven day Service in collaboration with the CAMHS Team for those at high risk in crisis, with emergency weekend service and additional services such as Physical Health Monitoring dependent on uplift of CAMHS Hub team, access to Out of Hours CAMHS on Call, access to Day Hospital and access to CAMHS inpatient beds
Referral to the CAMHS HUB Team will only be made from a Community CAMHS Team. It is not directly accessible by Emergency Departments in Acute Hospitals or other first line responder services. It is not an alternative to a CAMHS Crisis/Liaison service but fits within the continuum of services required in the comprehensive service provision for children and young people with moderate to severe mental health difficulties.
