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POD: Changes planned to help children in crisis 'locked up' with adults

POD: Changes planned to help children in crisis 'locked up' with adults

Thursday 30 September 2021

POD: Changes planned to help children in crisis 'locked up' with adults

An extensive recruitment campaign for specialists, as well as works to make Robin Ward and Orchard House more age-appropriate are on their way as part of a move to improve local mental health services for children and young people in distress.

Patricia Winchester, CEO of mental health advocacy charity MyVoice Jersey, revealed the upcoming changes just days after young people told Ministers of their "traumatising" experiences of local mental health care in the Youth Parliament.

A female student described her time on Robin Ward - the hospital's paediatric ward, which is only set up to deal with physical ailments - was "traumatising".

One young man, meanwhile, explained how his stay in adult mental health facility Orchard House alongside adults "a lot more mentally ill" considerably affected his mood and recovery process. He said a "main priority" for the Youth Parliament was to have Ministers understand and correct this. 

It followed concerns raised by Ms Winchester earlier this month about the “inappropriate admission of children in the adult unit” - something she says never used to happen when she first started in her role but is now "no longer an exception".

Speaking on today's Bailiwick Podcast, she said: “If that were to happen in the UK, it would be considered a very serious incident and investigations would have to take place.

"In the years that I've been working with Orchard House, going back to 2006 or 2010, the admission of a child was really quite exceptional. It's now become, to my mind, too routine, it's no longer the exception. It's considered acceptable because there is nothing else.”


CLICK TO LISTEN: Ms Winchester explained how children's mental health can suffer as a result of being around severely unwell islanders on this week's Bailiwick Podcast.

However, Ms Winchester said she has been “reassured” that, following a meeting between the  Directors of Child and Adolescent Mental Health Services (CAMHS), the Health services and the Children Services, changes are on their way to improve young people’s experiences of mental health services.

“My understanding now is that they are actually going to be addressing quite a few of these problems and working towards a solution,” she said.

This will include improvements to the “physical environment” to make it more appropriate, as well as the recruitment of staff with specialist mental health skills.

 “The issue with Robin Ward is you might be 17 and be surrounded by very young who have physical illnesses, that can be a difficult environment there,” Ms Winchester explained. “The staff at Robin Ward again, whilst they do their best, they're trained in physical health care, not mental health care. So, you've got an issue where the environment isn't right and neither are the staff mixes.

“It's really important if you have a child who is under the care of Child and Adolescent Mental Health that when they are an in-patient, they are supported with those skilled staff and again, rather like paediatricians have different skills to adult doctors, specialists who are working with children's mental illness is really important and we should have that.”


Pictured: "You've got an issue where the environment isn't right and neither are the staff mixes," Ms Winchester said about Robin Ward.

At Orchard House, where Ms Winchester has been calling for the facilities to be used “differently with some imagination”, the team is also thinking about ways to adapt the ward to keep children separate, should they be admitted there.

“I think there's been a reluctance to keep children separate because of a feeling that they might miss out on activities and so on,” she explained.

“But actually the sorts of activities that children should be participating in should be specially catered for them; so where they have two lounges or three lounge areas, then one of those should be dedicated to children.

“It should be the case that again, when they are in Orchard House, they are supported by skilled young people's mental health nurses and clinicians, not adult clinicians. They're looking at how they can do it differently with what we've got at the moment."


Pictured: At Orchard House, the facilities could be adapted to ensure children are kept separate from adults.

In addition, the Government is currently looking at setting up “a small therapeutic children's home … to provide specialist support on-Island as an alternative to off-island care”, which Ms Winchester said would be “very beneficial”.

“So really we are looking at a three-stranded approach and I think that's what it will take,” she said.

“It's not going to be an easy ‘one size fits all’, and it's not going to be an easy fix. There's a lot of work still to be done, but I am reassured that they are putting a lot of effort into it now, and working collaboratively rather than competitively, which is important.”

Ms Winchester understands that the redesign of CAHMS is due to be signed off “imminently” and will be followed by an “extensive recruitment campaign”. While she acknowledged it might be a challenge, due to already existing recruitment issues, she said it was important to move from a system based on locums.

“If you’re a locum, it costs the island a lot more,” she said. “In some ways, you might have less commitment to the island because you're not here for the long term, it just provides a lack of continuity and stability to how we shape and form the teams of skilled experts.

"We really want people to come over for permanent jobs that have a vision and could see that vision through rather than plugging a gap. That's not to be disrespectful to locums, some of them do excellent work, but we're now in the position where we need something firmer in place to move us forward, so that's going to be happening.”

Asked for further detail on the planned upgrades, a Government spokesperson responded this morning: "HCS and CYPES are working together to develop more preventative services for CAMHS and improvements with the in and out of hospital pathway."


Express spoke to Ms Winchester about her concerns over the admission of children to Orchard House, but also why she is hopeful that change may be coming...

Locked up with adults

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Posted by Stephen Mccrimmon on
Let’s have the Young people who use these facilities and services at the heart of any new developments at the very beginning! Too many adults think know what these young people need but we need to listen to them and develop from there.
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