Dr Cecilia MoyesConsultant Child and Adolescent Psychiatrist

CAMHS Intensive Outreach Guernsey

Aims to provide rapid, flexible, supportive care to children , young people and their families presenting with severe mental health difficulties

Aims to prevent problems escalating and reduce the number of children requiring hospital care or specialised placement off island.

Multidisciplinary (and multigenerational!) team across disciplines of psychiatry, clinical psychology, nursing and social work

Team is flexible to maximise access and works in a variety of environments including home visits, school visits, meet ups in public places – coffee shops etc . Also routine hospital /clinic appointments

Various models of treatment employed including dialectical behavioural therapy , cognitive behavioural therapy , systemic family work

Treating severe depression/ suicidal ideation/psychosis/eating disorders/any other mental health symptoms requiring rapid assessment and intervention

Paperless records system including electronic documentation of texts and e-mails

Therapeutic engagement of adolescents

Highly effective

Liked by young people and their families

Ease and accessibility

Assists in containment of high risk

Also particularly helpful to reach young people with autistic spectrum conditions

Prior agreement that no replies to young people’s texts / e-mails other than between hours of 08.00 and 19.00

Weekend contact only with those young people already being supported by the service . Plans are reviewed on Fridays before weekends.

Hi, it’s Susie

from CAMHS. Just

texting to remind

you that you have

an appointment

with me at 12

o’clock tomorrow

at Bell House.

Hello, the weekend

was good thanks.

There were some

difficult parts but

I managed to stay

calm and everything

was fine!

It is really

positive that you

overcame the

difficult parts.

We could talk

about it more when

I see you next?

Thank you for

sending your e-

mail.I can see that you are very upset by everything happening at school. What do you dislike about coming

to CAMHS?

You can’t help me

okay so there is no

point trying

Beneficence

Avoidance of harm

Autonomy

Fidelity

Justice

The primary purpose is to support patient care

Pose a possible new source of risk to patients

Privacy and confidentiality must be maintained

Data integrity

Indiscriminant use of ‘cut and paste’ ?

Misinterpretation by taking data out of original context. Examples of ‘texting’ entries

Digital skill gap in teams

Supervision issues. ‘Authorised’ vs ‘entered’ entries

Continued audits of data integrity essential

Ongoing training, clinical and IT supported

Digital systems are rising at an exponential rate

The challenge of creating useful, meaningful and accurate health records will require clinicians and administrative personnel to work closely with information management and technology professionals in order that high ethical standards are maintained

Beware of the tail wagging the dog?

cmoyes@hssd.gov.gg