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Children and Young People's Mental Health: A Framework for Promotion, Prevention and Care

GLOSSARY

Child and Adolescent Mental Health Services (CAMHS): Child and adolescent mental health services (CAMHS) is sometimes used to embrace the range of services across agencies that contribute to the mental health and care of children and young people. These are sometimes referred to as universal or Tier 1 services and include those services whose primary function is not mental health care, such as general practice, schools and social services. The term is also used to describe specialist CAMHS, which mainly comprise professionals who have specific training in children and young people's mental health, and which provide specialist mental health assessment and treatment. Specialist CAMHS are sometimes referred to as Tier 2, 3 or 4 services. They include generic multi-discipline teams, single professional teams, targeted teams (e.g. for looked after children and young people), "outposters" (i.e. people who are CAMH-trained and employed, but who work in non-CAMHS settings), and specialist care teams (e.g. day patient, inpatient, intensive outreach).

The following table is adapted from the English National Service Framework⁶⁰ and describes the different Tiers of CAMHS which are sometimes referred to. These were first published in Together We Stand⁶¹ and have been misinterpreted by some to represent a hierarchical model of service relationships. However, the English National Service Framework notes that "in reality, there will be some children and young people that may require services from a number, or even all of the tiers, at the same time".

Mental Health: The SNAP report acknowledges that there is no single accepted definition for mental health. It explores a number of concepts and adopts the following description, from the 1997 International Workshop on Mental Health Promotion to emphasise that mental health is both personal and social: "Mental health is the capacity of each and all of us to feel, think and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual wellbeing that respects the importance of culture, equity, social justice, interconnections and personal dignity."⁶²

Mental Health Problems: Together We Stand⁶¹ describes mental health problems as "difficulties and/or disabilities in the realm of personal relationships, psychological development, the capacity for play and learning and in distress and maladaptive behaviour. They are relatively common, and may or may not be persistent".

Mental Disorder: When mental health problems are persistent, severe or complex, and interfere with a person's day-to-day functioning, they are often defined as mental disorders. In some severe cases, the term psychiatric or mental illness is used. The SNAP report notes that the practice of making use of diagnostic labels has risks attached, particularly in terms of stigma.

Primary Mental Health Workers: Sometimes also called "Mental Health Link Workers". Throughout this document, reference is made to "Primary Mental Health Workers (PMHWs)". This role was described in Together We Stand⁶¹ and was recommended as a way of improving the relationship, communication and collaboration between specialist mental health services (CAMHS) and the wider network of services working with children, e.g. schools, youth and community services, Primary Care, etc. Primary Mental Health Workers tend to operate in Tiers 1 and 2. In some parts of the UK, including Scotland, this has led to the establishment of PMHW posts. In other areas the role has been developed, but delivered in a variety of ways. In some cases, workers are employed specifically to deliver primary mental health work, whilst in others, this work is achieved though an extension of pre-existing professional roles. The CAMH Workforce Group will offer further advice about this in due course.

Public Health Nurses: In 2001, Nursing for Health⁶³ recommended that a new discipline of public health nursing should be developed, bringing together health visiting and school nursing into a single discipline with a shared educational programme and a common focus on addressing the health needs of identified communities. The title" public health nurse" encompasses both health visiting and school nursing and in time is expected to replace the titles "Health Visitor" and "School Nurse".

Sure Start Workers: Sure Start Scotland⁶⁴ provides targeted support for families with very young children (aged 0-3 years). It aims to:

• Improve children's social and emotional development
• Improve children's health
• Improve children's ability to learn
• Strengthen families and communities.

Services are developed around existing provision and on the basis of the identified needs of each family. Funding for Sure Start is channelled through local authorities, but they are expected to work in partnership with other local service providers, including health services and the voluntary sector, to devise local solutions to meet identified local need.

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