CAMHS Triaging - “Comfortable with Being Uncomfortable”

Addressing mental health and its related complexity and safeguarding concerns, involves making decisions under conditions of uncertainty and urgency (Lephron and Patel 1995). This is in part due to partial or inaccurate information which needs to be processed / formulated rapidly with clear guidance for the family and the referrer.

Extrapolating information and predicting risk and advising accordingly is a crucial competence to the role. 

For these reasons, Triage has been compared to the work of air Traffic controllers. Clinicians are involved in making complicated real world difficult decisions using pattern recognition, then proceeding based on judgement, experience and context. Pushing the boundaries of professional practice and dealing with “messy problems” (Moon 2007) (Smith 2013).  

The nature of the work requires reflective capability to “think outside of the box” and recognise the personal emotional impact of the work in managing high level risk. The issue if not addressed has potential to hinder Judgement and decision making. Additionally, rigid reliance on assessment tools and policy can hinder effectiveness and possibly heighten risk.  

Significantly, a robust triaging process with capable, confident and reflective practitioners can reduce waiting lists and support a smoother running of the service. An additional advantage is to instil systemic resilience into to the community.