FCAMHS nominated for 2020 RCPsych Awards

18 August 2020

We're proud to announce our Forensic Child and Adolescent Mental Health Service (FCAHMS) has been nominated in the 2020 RCPsych Awards.


The service, which covers North London, is nominated in the Psychiatric Team of the Year: Children and Adolescents category.

Forensic CAMHS (FCAMHS) is a free specialist forensic CAMHS service designed to provide consultation to professionals who are working with young people about whom there are concerns in terms of neurodevelopmental, mental health, or risk of harm to others and who may or may not be in contact with the youth justice system.

Winners will be announced at a ceremony on November 19.

Dr. Gabrielle Pendlebury, Clinical Lead for the FCAMHS service writes about the important work of this innovative team:

"Forensic services were traditionally distant and difficult to access for young people. FCAMHS acknowledges that young people who present with complex needs are particularly difficult to engage and are a highly vulnerable group, often experiencing early trauma, repeated loss, attachment issues, learning difficulties and mental health problems.  Traditional services struggle to engage this population. Numerous documents have highlighted this dilemma and suggested ways of addressing it (Future in Mind, What Good Looks Like, Health Services in the Justice System and Five Year Forward) and FCAMHS has utilised the key points in these documents to tailor a service that could and does meet this population’s needs. FCAMHS is an innovative service that is accessible at the point of contact, it is a liaison outreach model with advice line available 9-5 Monday to Friday via portman.fcamhs@nhs.net, which means that advice can be sought from an experienced forensic practitioner, prior to a formal referral.

"Our aim has been to not only provide consultation but also to empower clinicians already working with these young people. This has been achieved by raising the understanding of these young people through various projects; linking with pupil referral units and schools, running groups around sexually harmful behaviour, initiating and maintaining reflective practice to improve the quality of care and reduce burnout amongst staff.

"The complexity of the cases that we support means that there are often many professionals involved and it is not unusual for us to be asked to adjudicate on contentious care pathways and precious funding schemes.

"As a team, we have focused on collaboration through training and publications (@TaviPortPubs & @PendlesGabriel) to form links with other healthcare professionals/ third sector organisations and carers. We successfully engaged organisations by offering reflective practice, training and advice to support networks and encourage collaborative working through a flexible and easily accessible service.

The Port poster"We have hosted events demonstrating our work and way of working. We have submitted posters on our work, spoken at conferences and engaged in national debates regarding issues relevant to this population and the individuals that work with them . A particular success has been the uptake of reflective practice for sectors that may not have previously has this support, culminating in the following initiative ‘Supporting Youth Workers: A Reflective Group Consultation Approach’.

"Each member of the team has been encouraged to have a degree of autonomy that allows them to take responsibility for, and find value, in individual projects. This broad interface has widened the influence of the team. At the same time, the service is true to the specification, resisting pressure to revert to the traditional model and able to provide advice and consultation in a timely manner to bring clarity to complex situations and therefore decrease risk.

"The liaison outreach model is highly efficacious in comparison to the traditional forensic model. It allows for early intervention and multidisciplinary working, allowing for intervention prior to involvement with Police or Social Services. Feedback from CAMHS clinicians is that having the oversight of an FCAMHS member has allowed them to implement positive risk-taking strategies that allow the young person to remain at home or in school. This reduces the risk of clinicians were using defensive rather than defensible approaches, due to anxiety around making clinical errors in these high-risk cases.

"We have formed a partnership with the Brandon Centre – an organisation that provides multi-systemic therapy: evidence-based community interventions for young people with conduct disorder. In 2019 we worked collaboratively to keep patients in the community that would have otherwise required long term in-patient stays or been at risk of incarceration due to escalating offending behaviours.

"The use of psychodynamic theory, twinned with systemic approaches, has been successful in supporting networks and young people with sexually harmful behaviour, allowing for effective formulation and understanding of the different pathways to offending and long-term trajectories of these young people compared to adults."

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