As the cuts continue to bite, the various agencies that work with vulnerable children have become more and more stretched. Multi-agency working has become ever more difficult to achieve. Fortunately there is a standard letter, which I’ve seen increasingly in use by these agencies. Feel free to copy this letter and use it in correspondence between social services, CAMHS, GPs, schools, Youth Offending Services and voluntary agencies. Lots of other professionals already do.
One of the mantras that mental health services are supposed to live by is that there should be joined-up working between the NHS and social services. How’s that working out with children and adolescents?
In adult services, clinicians and social workers both work in Community Mental Health Teams (CMHTs). The CMHT will often have CPNs and social workers sharing offices, so that they can work closely together. In Child and Adolescent Mental Health Services (CAMHS) that’s not a given. Under the pressure of the cuts, quite a few areas have seen a loss of social workers. Social services departments who’ve been told they have to shed posts will often cut the staff over at CAMHS rather than the ones in their own office.
At the same time, both CAMHS and social services are under caseload pressures. Their resources are shrinking, but their caseloads aren’t. The talk in both camps is how to focus on their “core” clients, and who should be seen by other agencies.
Relations between CAMHS and social services have historically been fairly poor. As the gulf widens, this relationship can only get worse. The risk is that it can turn into a game of pass-the-parcel with children. As soon as one service accepts responsibility for a child, the other service steps back.