Complex Cases in Medway: Local Systems for Supporting Young People who need both Social Care and Mental Health Services
Task
TONIC were asked by Medway Council and the Clinical Commissioning Group to review the interface between Child and Adolescent Mental Health Services (CAMHS) and Social Care in relation to complex cases for young people in need of both services.
TONIC helped collect and bring together the insights and experiences of many different people and organisations involved when accessing or leaving specialist mental health services for children and young people, including service users and their families.
TONIC’s Approach
TONIC undertook an integrative review as part of the system review of children and young people accessing specialist mental health services across Medway. The aim of this approach was to summarise both empirical and theoretical literature to gain an in-depth understanding of the services. This integrative review consisted of several stages including a review of relevant literature, qualitative data collection and data analysis and triangulation. To conduct this review, TONIC undertook 18 stakeholder interviews and 6 interviews with young people and their families. In addition, TONIC conducted a review of case field audit notes and a review of the online support offer.
Outcome
Using visual methods, TONIC clearly summarised both stakeholder and young people's views on the current system. These included using direct quotes from young service users who expressed their views on what was missing from their experience accessing services in Medway.
These views informed 5 key recommended areas for action to improve social care and mental health services in Medway. These stressed the importance of a coherent definition on what constitutes a “complex case” in order for all stakeholders to understand their roles and responsibilities. These also highlighted the need to place the young person and their family at the centre of the approach to ensure a trauma-informed and comprehensive support service. In addition, the importance of an integrated governance approach was emphasised to bring together mental health and social care staff to grow capacity and support young people and their carers.
“Medway Council has worked with TONIC on more than one project over the years most recently they conducted some research into models of care for women who repeatedly have babies taken into care. Besides being professional and always delivering on time and on budget, TONIC have a way of always delivering added value. Their research was insightful and changed the way in which we had been designing our pathway. The report was easy to read and made the findings and recommendations very clear. They worked with professionals across the country to understand other models of care but also engaged successfully and considerately with local women who had been through the process of their children being taken into care. As part of the added value they provided links with user groups in other parts of the country that were willing to work with us locally to ensure we got the service right.”
Public Health Principal and Head of Public Health Programmes Medway Council