Development of a new 0-25 children and young people’s mental health services in Birmingham, UK

Presentation First Author: 
Max Birchwood

Introduction: The first UK Early Intervention service (EIS) was introduced in 1994 in Birmingham, the progenitor of such services in the UK. Its maturity enabled Collaboration for Leadership in Applied Health Research & Care (CLAHRC) to address questions concerning its position in the care pathway of young people with first-episode psychosis (FEP) and its impact on duration of untreated psychosis (DUP). Our significant findings revealed young people whose first contact was with a generic mental health team experienced long DUP and delayed access to EIS. Objective: Our work heralded the need for restructuring of mental health services (MHS) for young people. Results: Onset of severe mental health problems often begins before the age of 25, however, our TRACK study (Singh et. al.,) highlighted how many young people fall prey to the current distinction between child and adolescent mental health services (CAMHS) and adult mental health services (AMHS), at age 16 or 18. This transition should be a purposeful process of change from child-oriented to adult models of care, but in reality it is problematic. Practice/Policy Implications: We argued the case for change in British Journal Psychiatry - Youth Mental Health: appropriate service response to emerging evidence, proposing the current CAMHS/AMHS distinction, at age 16 or 18, does not fit easily with increasing knowledge about the course of mental health problems in young people and asked ‘How should we design services for young people to promote prevention and service engagement, and to improve outcomes?’ This question now forms part of wider government strategy, including an investment of £120 million to improve MHS for children and young people, parity of esteem, provision of treatment for FEP within 2-weeks of MHS referral and introduction of waiting time standards. Conclusion: Prof Birchwood was a member of the DoH task group supporting this strategy; a recent consultation by South Birmingham Clinical Commissioning Group to replace the existing 14-25 mental health service with a new 0-25 service has now been secured by Birmingham Children’s Hospital. The new service will be the first of its kind. Referred to in the DoH document ‘Future in mind: promoting, protecting and improving our children and young people’s mental health and wellbeing’ , it will be “watched with considerable interest”.

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Date of Presentation: 
10th Oct 2015
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