Creating Links Between Mental Health Services for Adults and those for Children and Adolescents
| Date | 01 June 2004 |
| DOI | https://doi.org/10.1108/13619322200400016 |
| Published date | 01 June 2004 |
| Pages | 20-23 |
| Author | Tony Gillam |
| Subject Matter | Health & social care |
Creating Links Between Mental
Health Services for Adults and
those for Children and Adolescents
Tony Gillam
Clinical Team Manager
South Worcestershire Early Intervention
Team
Focus on…
he fields of adult mental health and
child and adolescent mental health care have long
been entirely separate. The related area of parental
mental health has equally been neglected.
Remarkably, interest in the links between these areas
did not gather momentum until the last few years of
the twentieth century. For example, 1998 saw the
publication of Crossing Bridges (Mayes et al, 1998) – the
same year that a conference was held in London called
Interfaces Between Child and Adult Mental Health. The
conference led to the publication of Family Matters by
Reder et al (2000), which explains the interest in the
interfaces derived from growing public and
governmental concern for children. The ‘momentum
generated in clinical and academic circles has been
maintained by concerns about child abuse and
adolescents’ problems which have gained public
attention and become priorities for central
government’.
The Children Act 1989 provides the key legislative
basis for childcare work. It introduced the concept of
significant harm to describe the impact of adverse
experiences on children, requiring all professionals
(including those primarily involved with adults) to
attend to the quality of parental care. Concern was also
growing about an association between parental mental
health problems and severe and fatal abuse. This link
was confirmed by Falkov in 1996. The growing
interest in child/adult interfaces can be seen as arising
primarily from concern about the risk to children
rather than from any concern for the wellbeing of
parents with mental health problems.
This article will focus on the interfaces between
child and adolescent mental heath services (widely
known as CAMHS) and adult mental health services
(AMHS). It will profile an example of good practice in
this area and suggest that effective liaison between
TCAMHS and AMHS is pivotal to the welfare of adults
(particularly parents), children and families.
Growth of liaison between CAMHS and AMHS
Alongside the growth in community care, the
movement for de-institutionalisation, the growing
concern for children’s welfare enshrined in the
Children Act 1989 and the increase in the numbers of
mentally ill people becoming parents, there have been
other changes which have led to a greater
rapprochement between CAMHS and AMHS. Maitra
and Jolley (2000) mention a resurgence of interest in a
psychosocial approach to mental health problems and
the requirement of the Care Programme Approach
(introduced in 1991) that adult services address a
broader range of both clinical and social functioning.
Complementary to the movement in adult services is
what they see as the gradual reintegration of the three
main streams of interest in the field of child mental
health: the psychiatric, the psychoanalytic and the
developmental/educational.
Maitra and Jolley argue that: ‘The growth of newer
disciplines (such as family therapy) has led to
increasing interdisciplinary dialogue, widening the
focus in contemporary child mental health teams to
include the biomedical, interpersonal and social
contributors to childhood disorder’. Perhaps over-
optimistically, they believe that the apparent distance
between CAMHS and AMHS has begun to diminish
and a dialogue is taking place based on a common
language and a shared biopsychosocial model.
Far from speaking a common language, many
might consider that one of the obstacles to
CAMHS/AMHS liaison is the different terminology
used by the two groups. For example, Macdonald
(2002) uses an entire article to explain what is meant
by tiers 1, 2, 3 and 4, and other CAMHS jargon. No
20 The Mental Health Review Volume 9 Issue 2 June 2004 ©Pavilion Publishing (Brighton) 2004
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