John Sinclair, Team Leader, Child and Adolescent Mental Health Services, Highland Council

Teen girl does homework at computer

Enquire talked to John Sinclair, a Primary Mental Health Worker, who is Team Leader at Highland Council’s Child and Adolescent Mental Health Services (CAMHS).

Here he explains how CAMHS are provided and what his role involves.

How are CAMHS provided?

Here is a really simple diagram which explains how CAMHS services are usually structured.*

CAMHS are normally provided through a four-tier model from Tier 1 – universal services (such as GPs or schools) to Tier 4 – highly specialised interventions (such as inpatient units). 80% of children and young people who experience mental health problems will receive a service from a Tier 1 service; however Tier 1 services require a great deal of support in order to fulfil this role.

What does the role of Primary Mental Health Worker involve?

Primary Mental Health Workers bridge Tier 1 to 3 services, providing early stage mental health assessment and interventions. We do this by working with, and providing consultation, supervision and training to, universal services. The role also involves direct clinical input to children, young people and their families where this is needed.

The main focus of primary mental health work with children and young people is to help community based professionals (such as GPs, social workers, teachers etc) to recognise children and young people with emerging mental health problems. Part of our role is to build the skills and resources of local community and specialist services. This should make sure we have joined-up, co-ordinated services that respond to local need.

What other responsibilities do you have as Team Leader in Highland?

I have responsibility for the professional leadership and management of the Primary Mental Health Workers Team. I also work to develop a more consistent service across Highland to effectively meet the needs of children and young people.

I am also involved in developing policies, pathways and protocols and attend a lot of management meetings to help promote and develop the team. This supports more collaborative working with other professionals.

As team leader I provide much less direct work than I used to. However I still provide a great deal of consultation alongside other members of the team.  I also try to support and develop individual staff through regular discussion, supervision and meetings.

Can you give us an example of a typical day?

A typical day is pretty hard to describe! As well as all the tasks I mentioned previously, on a weekly basis I will be involved in prioritising young people for treatment (called Triage) alongside my colleagues in the outpatient CAMHS. Triage aims to make sure the correct cases are seen by relevant professionals in a timely fashion.

How does your work make a direct difference to the lives of young people, and their families?

Mental health problems often occur during a young person’s school years. Obviously school staff will be supporting young people during this time so we provide a regular consultation slot in schools, where school staff can discuss concerns they may have about pupils they are working with. If we can help contain the school’s anxieties and give practical advice to help manage any difficulties, this is often enough to support and manage the child or young person. When we see staff whom we have advised implement strategies for a child or young person and it works, we know we have built some capacity, knowledge and understanding that has helped that child but will also help other children and young people.

What is the most rewarding part of the job?

Definitely seeing the team provide early intervention which prevents a child or young person developing more significant mental health problems. If unattended to, a child or young person’s difficulties can often follow them through into adulthood.

It’s fantastic when the team receives praise from children, young people, families or professionals. It’s great to know we are making a difference.

What do you think are the main challenges of your job?

The Primary Mental Health Workers Service has 11.2 full time equivalent staff based throughout the Highlands, which occupies a third of the land area of Scotland and includes the most remote and sparsely populated parts of the United Kingdom. We have the 7th highest population of the 32 authorities in Scotland so as you can imagine this bring with it a particular set of challenges. My job is broad with various different components and, as a result, can be very demanding which can be stressful.

What is the most valuable lesson you’ve learned in your job?

My role relies on building and maintaining effective relationships with all the professionals that surround a child or young person. If we get this right and all work together, we can generally meet the needs of the child, young person and family.

* from the Health Advisory Service 1995 report Together We Stand


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