Helping children through tough times
Published at: 16 Aug 2018
Growing up can be a tough time for anyone, but for some youngsters, it’s particularly challenging.
GV Health's Child and Adolescent Mental Health Services staff step in during times of crisis to care for children and adolescents from zero to 18 years of age, focusing on family-centred, individualised care which empowers and encourages the involvement of family members in their child’s mental health journey.
CAMHS Manager Sally Thomas managed GV’s Primary Mental Health service for a decade before starting with CAMHS in 2017.
“Our service treats the most severe and complex mental health disorders in children and adolescents,” she said.
“We provide tailored services for infants, primary school aged and adolescents, with moderate to severe, complex and disabling problems..”
Ms Thomas said the busy service paid particular attention to children who were at high risk, and worked with patients who experienced issues ranging from PTSD and trauma to suicidal thoughts and severe depression.
Prior to Ms Thomas’ arrival, CAMHS underwent a redevelopment process - involving extensive community consultation - which redesigned the team’s model of care, making it more responsive to patient and community needs.
CAMHS’ Clinical Director Dr Vibhay Raykar was the driving force behind the process.
Dr Raykar, who is also one of the team’s child psychiatrists, oversees clinical governance within the team and provides support to its clinicians.
“The redevelopment of CAMHS’ model of care meant we had to figure out how to use our resources more efficiently,” Dr Raykar said.
“We’ve tweaked how we function, allowing us to better engage with patients and the community.”
Ms Thomas says the redevelopment has allowed the service to recruit new and highly skilled staff, allowing it to provide an improved service to the Goulburn Valley.
The CAMHS team also provides specialised mental health support and ongoing therapeutic intervention, including early infant, kinder and primary school, where disorders like school refusal, ADHD, severe anxiety and trauma may be common.
A large component of the team’s approach to treatment is working with the support networks around the child, which means working closely with parents, schools, GPs, paediatricians and other community institutions.
Clinician Nicole Ryan works with patients throughout their journey with the service.
“Working with young people is fantastic,” she said.
“Treating people across a range of ages means you also get to work with different family members and services in the community, like schools. Being able to interact across a broad range of areas is great."
Ms Ryan is involved in a Child Parent Psychology (CPP) therapy pilot program being trialled by CAMHS.
“It’s quite new – we’re the first CAMHS service in Australia to embrace it,” she said.
“We’re looking at using CPP with certain groups in the community in order to get better outcomes.”
“CPP is an evidence-based treatment developed in San Francisco,” Dr Raykar said.
“We’re training clinicians and a paediatrician to work with children under five who have had exposure to trauma, helping them build their relationships with carers and lead a meaningful life into the future.”
Senior Clinician Grant Searle explained how there had been increased demands on the CAMHS team’s resources.
“I worked here from 1999 until the end of 2006, when you could actually predict your workload based on school terms,” Mr Searle said.
“At the end of term, families would go on holidays, encapsulate the kids and our workload would drop off, giving us time to catch up.”
Mr Searle says that the advent of social media means that the service is now in demand consistently throughout the year.
“We’re flat out, non-stop, more or less. A child can be bullied and harassed online from all angles at any time, day or night.”
“Social media is a double-edged sword,” Youth Psychiatrist Dr Tejas Golhar said.
“There are so many helpful aspects in terms of creating connections online, but it also means bullying can come home with the child, with no breaks.”
Senior Psychologist Helen Hansen, who consults regularly with family care and child protection agencies, said part of the team’s role was helping children learn how to be protective of their own emotional wellbeing.
“We find that social media use means that children need to be even more aware of how to put up some boundaries if someone is bullying them,” she said.
Dr Golhar said the service’s referral rate had gone up substantially in the last five years.
“We categorise a patient’s needs based on acuity,” he said.
“’B’ needs response in a couple of hours, ‘C’ is when you need to respond within eight hours, ‘D’ is within 72 hours and so on.
"The proportion of high risk cases have gone up quite a lot.”
The CAMHS team covers a geographical area of roughly 175,000 square kilometres, stretching from the Murray River down to the northern Melbourne growth corridor, which is one of the fastest growing regions in the country.
The service, which is based in Shepparton and has an office in Seymour, is staffed by a highly dedicated team of psychiatrists, psychologists, social workers, mental health nurses and an occupational therapist.
Clinicians provide outreach services both to outlying community centres and to families homes when needed.
“We have some big future plans,” Dr Raykar said.
“We’re very focused on increasing our capacity in terms of early intervention and targeting treatment for kids under five so that, as they grow up we are better prepared to meet their needs.”
GV Health CAMHS cares for the highest proportion of children under the age of 12 in the state.
“We have a diverse range of skill and experience across the department, which allows the team to offer the kids a better, more targeted service,” Ms Ryan said.
“The thing that puts a smile on my face is getting the great feedback from parents and families,” Ms Thomas said.
“Seeing the kids get better, going back to school, playing sports and enjoying relationships with their families again.”
Dr Golhar summed up the CAMHS team’s overall motivation.
“We’re helping kids remain children,” he said.