NHS Tayside will no longer accept most new referrals for children’s autism and ADHD assessments.
The health board announced changes to its Child and Adolescent Mental Health Service (CAMHS) neurodevelopmental pathway on Wednesday.
The service will not accept new neurodevelopmental referrals – for conditions such as ADHD and autism – unless a child has an existing mental health problem.
NHS Tayside says the role of CAMHS is to assess and treat children and young people with “significant and impairing” mental health concerns.
The move has received huge backlash with many fearing an impact on families and schools.
The Courier has taken a look at how the changes to NHS Tayside’s CAMHS could affect locals.
What are the changes to NHS Tayside’s CAMHS and when will they be enforced?
NHS Tayside’s CAMHS service provides two pathways of care.
The first is to assess children and young people with mental health conditions while the other is for those with neurodevelopmental (ND) conditions.
The health board has “refined” criteria children must meet to be referred to the ND pathway.
This means children and young people with “co-existing” mental health conditions will still be accepted by CAMHS.
Children and young people who do not have a mental health condition will not be eligible for referral to CAMHS.
NHS Tayside says those patients can access “other forms of support and intervention”.
The changes are being enforced with immediate effect.
Who is eligible for NHS Tayside’s CAMHS following the changes?
The only patients eligible for NHS Tayside’s CAMHS will now be those with existing mental health conditions.
The service also has a pathway to assess children and young people for mental health conditions, the eligibility for which remains unchanged.
CAMHS provides specialist assessment and treatment for children and young people up to age 16, or 18 if they remain in secondary school.
Referrals to CAMHS can only be made by professional staff working with the child or young person.
A patient will usually only be referred for specialist help if there are concerns regarding serious mental health such as a mental, behavioural or emotional disorder resulting in “serious functional impairment”.
A child or young person may also be referred if they fall within the Looked after Children category and there is a concern about mental health that may lead to the breakdown of placement.
What is a neurodevelopmental condition and what is a mental health condition?
NHS Tayside lists several conditions available for treatment under the CAMHS neurodevelopmental pathway.
These are Attention Deficit Hyperactivity Disorder (ADHD), Attention Deficit Disorder (ADD), Autism Spectrum Disorder (ASD), Intellectual Disability (formerly referred to as Learning Disability) and Tics and Tourette’s syndrome.
CAMHS also provides support for concerns regarding “serious mental health” under a separate pathway.
This is defined as: “Mental, behavioural or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activity.”
These include acts of self-harm or thoughts of suicide, eating disorders, extreme distress, persistent anxiety and persistent mood disturbance.
Children and young people suffering from persistent, obsessive or repetitive behaviours and unusual behaviour, confusion, “voices” or other “abnormal experiences” can also be treated.
What happens to children already on the NHS Tayside CAMHS waiting list?
The health board currently has 4,500 children and young people under the ND pathway, with 2,500 waiting for a first appointment.
NHS Tayside says that if it were to continue seeing all patients, anyone added to the waiting list would likely age out of the service before being seen.
The health board says the changes do not affect children already on the CAMHS waiting list and only apply to new referrals.
However, these patients will continue to be triaged based on clinical need using the refined criteria.
The health board says those on the waiting list will be reviewed by a senior clinician in the coming months to determine whether they meet the criteria for CAMHS.
Contact will be made with those on the waiting list to advise them if their status will change and what support is available.
I’m concerned my child has a neurodevelopmental condition – what do I do now they can’t be referred?
NHS Tayside says a formal neurodevelopmental diagnosis isn’t needed to access many forms of adaptations and support, including those in schools.
The CAMHS clinical teams have been working with several partner agencies to “shift focus from diagnosis to needs-based support”.
This includes developing ways to provide support without specialist clinical assessment.
Every child and young person is entitled to have a “named person” – a specific person they can approach for help or support.
If a child is in school, their head teacher or guidance teacher can also arrange a plan of support based on their needs without a diagnosis.
There are also resources including courses, podcasts and websites on the NHS Tayside CAMHS website.
A two-week online programme to help parents understand and support their children is available as well as online drop-in sessions.
Conversation