Child and adolescent mental health services (CAMHS) in England and Wales face a decade of major challenge and major opportunity; challenge in the Children's National Service Framework objective of providing comprehensive mental health services to the 18th birthday and opportunity in the promise of 10% year-on-year increased funding to facilitate this. Politicians, planners, commissioners and providers will need to collaborate as never before if this aspiration is to become reality. Richard Williams and Mike Kerfoot endeavour to provide a road map for that journey.
Contributors drawn from academic, clinical, health economic, policy and management backgrounds provide a theoretical and practical framework within which to develop services. In some chapters liberal use of figures, flow charts and tables complements the text. The book comprises four sections - how/where planning takes place, planning for what, lessons from abroad, and delivery.
Sometimes drawing on homespun wisdom, other times using highly reasoned philosophical and ethical argument, the initial section describes the context within which decision-making and planning occur.
A clinical section reviewing the requirements of young people with particular disorders or needs follows. Inevitably each problem receives only summary treatment and chapters overlap considerably. Forensic services and substance misuse services stand out as exceptions, perhaps reflecting the underdeveloped nature of current services in these areas.
‘Lessons from abroad’ are personal reflections upon Europe, Australasia, North America and developing countries.
The final section focuses upon service development. ‘Priority setting’ and ‘Achieving change’ provide practical checklists against which commissioners and clinicians can assess their services. There is considerable emphasis upon interventions at a primary care level but little regarding development of ageappropriate in-patient provision (five indexed references in total), despite the problems often encountered by clinicians and commissioners in accessing such a bed in an emergency - a situation likely to intensify as the 18th birthday becomes the watershed between CAMHS and adult mental health services.
Does the book achieve its aims? Would I purchase it? I will certainly use it in discussion with our managers and commissioners and with trainees in preparation for the service world they will inhabit. Whether it achieves its aims will be measured by how CAMHS evolve over the next decade.
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