The role of primary mental health workers in child and adolescent mental health services in Scotland
| Published date | 11 December 2009 |
| Date | 11 December 2009 |
| Pages | 21-25 |
| DOI | https://doi.org/10.1108/17556228200900029 |
| Author | Margaret Conlon |
| Subject Matter | Health & social care |
21
The Journal of Mental Health Training, Education and Practice Volume 4 Issue 4 December 2009 © Pier Professional Ltd
The role of primary mental health
workers in child and adolescent
mental health services in Scotland
Abstract
It is estimated that approximately 10% of children
and young people in Scotlan d have mental
health problems (Scottish Government, 2008),
resulting in a rapidly increasing need for child
and adolescent mental health services (CAMHS).
Primary mental health work ers (P MHW) h ave
been identified as one of the key professional
groups within a multidisciplinary CAMHS team
to progress the agenda of early intervention and
identification of mental health problems among
children and young people. One discrete aspect
of the PMHW role is the facilitation and delivery of
consultation services to a wide range of agencies.
Consultation, in this context, is understood as a
community activity for disseminating knowledge,
creating understanding and facilitating non-CAMH
professional s to sup port children and young
people with psychological difficulties ( Scottish
Executive, 2005). This paper discusses a small-
scale study that aims to deconstruct the concept
of consultation and explore the professiona l
expertise and service requirements necessary for
effective delivery. It concludes that complex and
multifaceted skills are required if a consultation
is to be meaningful and effective. Consequently,
and despite competing discourse, there remains a
strong debate for retaining the role of the PMHW,
specifically for the delivery of early intervention and
health promotion activities, such as consultation.
The study took place in Scotland, but UK-wide
data is drawn on to provide a more comprehensive
picture.
Key words
consultat ion servic es; primar y mental health
worker; ch ild and adol escent menta l health
services
What is consultation as defined by child
and adolescent mental health services?
Consultation services aim to build workforce capacity
in primary care services through the early identification
and intervention of vulnerable children and young
people (Scottish Executive, 2005). Core features of the
activity include the percolation of salient information,
knowledge and understanding of mental health issues to
all individuals who are either professionally or personally
in direct contact with children and young people (Gale et
al, 2004; McDonald et al, 2004). Effectiveness of the service
is primarily dependant on strong partnership working
with agencies such as teachers, social workers and health
visitors. Caplan (1970) defined consultation in mental
health as either client-centred or consultee-c entred.
Schein (1988) identified three consultancy approaches:
the expert model, the doctor/patient model and the
process model. Neither of these interpretations appeared
to be a good fit with the PMHW-led consultations. Weiner
and Rodwell’s (2006) interpretation was closer describing
consultation activity as taking a number of different
forms, including formal, structured and telephone. The
consultation service in this enquiry, typically, did not
include children and families, but focused instead on the
concerns of professionals, most of whom were located in
tier one services.
Throughout Scotland, consult ation services hav e
become an established component of CAMHS. However,
anecdotal evidence indicates that the development has
been geographically idiosyncratic and largely reactive,
with little strategic planning or use of specific working
models. To date, exploration and research that focuses on
CAMH consultation services has been confined to a study
focusing on impact on referral patterns (Neira-Munoz
& Ward, 1998). The limited work on the precise nature
and content of the PMHW remit (Bower & Gask, 2002;
Department of Health, 2004) goes some way towards
signalling the complexities and diversity of the role. Gale
Margaret Conlon
Lecturer, School of Nursing, Midwifery and Social Care, Edinburgh Napier University
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