Trialing and improving a CAMHS and Education Liaison Team in HSS Western Australia'

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Trialing and improving a CAMHS and Education
Liaison Team in HSS Western Australia.

• Getting Better Together
• Conference
• London, November 2006
• GRANT WHEATLEY

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(No Transcript)
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Hospital School Services W A

• Teachers present in WA hospitals since 1943.
• In 1998 other joint Health and Education programs
  were amalgamated into Hospital School Services.
• 2005 Health and Education sign formal agreement
  regarding operation of HSS.

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DEPARTMENT OF EDUCATION TRAINING
HOSPITAL SCHOOL SERVICES
ANDREW RELPH CENTRE
FAMILY PATHWAYS
WAY CENTRE
PMH WARD LIAISON PROGRAM
FAMILIES AT WORK
RPH EDUCATION CENTRE
VISITING TEACHER PROGRAM
CELT PROGRAMS
COMMUNITY HOSPITALS PROGRAM
COMMUNITY HOSPITALS PROGRAM
SOUTH METROPOLITAN CAMHS
RPH
GENERAL PRACTITIONER/ SCHOOL/ PARENTS
NORTH METROPOLITAN CAMHS
NORTH METRO AREA HEALTH
SOUTH METRO AREA HEALTH
COUNTRY AREA HEALTH
WOMENS AND CHILDRENS HEALTH
DEPARTMENT OF HEALTH
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HSS Priorities 2006/7

• Focus on student transition.
• Research into the value adding of the
  educational services of HSS.
• Educational Policy clarifying students home
  schools and HSS interaction.
• Negotiating HSS presence in the new childrens
  hospital for WA.

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HSS Staff and Students

• 50 FTE teaching and non-teaching staff. Supported
  by approximately 40 Volunteers.
• Services are provided for an average of 120
  students daily
• 1/3 Psychological medicine
• 1/3 Long term/chronic
• 1/3 Short term medical
• 350 students a week
• 3000 students per year

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Review 2004

• Investigation of
• The necessary criteria and processes in the
  identification of psychiatric disabilities
• The gaps in current DET service delivery and the
  interface between DET and the Health Dept and
• Service models and processes Australia wide that
  have been found to be effective and would be
  suitable within the WA context.

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Review Process

• Meetings with SIDE HSS personnel, Staffing
  directorate, Student Services Area Managers and
  the Health and Wellbeing Planning group.
• Focus groups
• School Psychologists
• Teachers and administrators
• Clinical Psychologists and Psychiatrists
• Health Department representatives

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Identification

• To promote communication and collaboration in
  Western Australia the terminology used in the
  Health Department Mental Health Policy (2002) the
  terms
• severe mental disorder , and
• mental health problem are now used by DET.

•  

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Process for additional classroom support

• For additional classroom support the criteria for
  students with severe mental disorder are an
  extended and severe impairment in one or more key
  descriptors areas of
• Self Care
• Adherence to social norms
• Self direction and control
• Personal injury property damage
• Social interaction
• challenging behaviour and safety with others
• AND

•  

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Process for additional classroom support
Diagnosis by a qualified child psychiatrist of
a severe mental disorder OR Pending diagnosis
signed by the Student Services Area Manager.

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Schools Plus Process
Level of educational need determined at the
school site and appropriate intervention
accessed (Curriculum Access Plan documented)
Decision made by standing committee with
Consultant Psychiatrist
Schools Plus Questionaire submitted to Service
Area Level
Verifier
Unsuccessful
Successful
Additional Support
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Gaps in WA DET services

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Inpatient Programs vvvv Day Programs vv
Students with severe mental disorder
Consultancy/Outreach XX
Professional development v
Students with mental health problems
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Recommendation 5

• Funding is allocated to establish a Department
  of Education and Training, Severe Mental Disorder
  consultancy and collaboration team to liaise with
  CAMHS clinics and to support rural and remote
  schools.

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CELT, WA.

• 2004, 2 teachers in CAMHS clinics in the Perth
  Metropolitan area.
• 2005, 4 teachers, each teacher has offices in two
  CAMHS clinics ( 8 of 12) in the Perth
  Metropolitan area.
• Independently reviewed in 2005.
• Permanent posts end 2006???
• Steering committee now exists across CAMHS and
  Education as platform for future collaboration.

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CELT Role

• Consultancy to CAMHS officers regarding
  educational matters.
• Liaising with schools regarding individual
  students.
• Linking with Educational Psychologists.
• Providing professional development with DoH
  officers to schools and district offices.
• Providing support to rural and remote schools
  with the school maintaining the case management
  role.

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Proposed Outcomes

• Effective collaboration with schools regarding
  individual SMD students.
• Multi-agency work with CAMHS and other agencies
  to support SMD students.
• Facilitation of student transition back to
  school, ongoing study or career path.

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Collaboration with schools

• Improved co-ordination of case conferences.
• More effective strategies implemented.
• More common ground found between Schools, CAMHS,
  Family and Student.
• Curtin University research paper 2006

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Multi-agency work

• Prompt responses across agencies.
• Increased collegial support across agencies.
• Greater understanding of educational context and
  expectations by CAMHS officers.
• Curtin University research paper 2006

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Student Transition

• Greater understanding of family and student
  relationship with schools.
• Improved advocacy for family and student by CAMHS
  to achieve school outcomes.
• Effective transition plans achieved.
• Curtin University research paper 2006

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Churchill Fellowship 2006

• Travel to UK, Sweden and Canada to
  investigate
• The necessary criteria and processes in the
  identification of psychiatric disabilities
• The interface between Education and Health in
  psychiatric services and
• Service models and processes that would be
  suitable within the WA context.

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Identification

•  

• ICD 10 officially used but DSMIV
  preferred as working
  document.
• All concerned with the negative effects of
  labelling children and adolescents.
• ISSUE Can Education and Health successfully
  collaborate to identify who receives additional
  classroom support?

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Interface

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• All systems working towards closer relationships
  between involved agencies
• England/Every Child Matters (2004).
• Scotland/Towards a Healthier Scotland (1999).
• Sweden/Education and Health are managed by the
  local commune.
• Canada/Section 23 of the Education Act allows
  educational provision to
• programs public and private.
• Grassroots collaborative models are very
  effective in creating better interface but
  separate budgets can create issues.
• ISSUE What operational principles can take a
  program beyond reliance on strong formal and
  situational leadership ?

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Service models

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• Hospital School model (UK)
• Education in CAMHS model (Scotland).
• Private corporations and education (Canada).
• CAMHS as consultants to schools (Sweden).
• ISSUE Should we stop reinventing the wheel?

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CELT, WA.

• 2004, 2 teachers in CAMHS clinics in the Perth
  Metropolitan area.
• 2005, 4 teachers, each teacher has offices in two
  CAMHS clinics ( 8 of 12) in the Perth
  Metropolitan area.
• Independently reviewed in 2005.
• Permanent posts end 2006???
• Steering committee now exists across CAMHS and
  Education as platform for future collaboration.

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OLT, Glasgow.

• 1999, Teacher appointed on a 2 year secondment to
  CAMHS Clinic.
• Independently evaluated after 1 year.
• 2002, Permanent post.
• 2006 six teachers in place.

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CELT Role

• Consultancy to CAMHS officers regarding
  educational matters.
• Liaising with schools regarding individual
  students.
• Linking with Educational Psychologists.
• Providing professional development with DoH
  officers to schools and district offices.
• Providing support to rural and remote schools
  with the school maintaining the case management
  role.

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OLT role

• Integration and re-integration programs for
  non-attendance.
• Organising and attending case discussions.
• Advocacy/mediation.
• ADHD monitoring/in-class support and observation.
• Home visits.
• Exposure work.

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Likely Recommendations

• Establish an interagency committee for the
  identification of students requiring additional
  support in classrooms.
• Establish a set of protocols between DET and
  other WA agencies involved with students with
  psychiatric issues.
• Advocate for the inclusion of a section of the WA
  Education Act that mandates educational provision
  for students with mental health issues.
• Initiate a rural support and research mental
  health position.