National Deaf CAMHS is a multi-disciplinary mental health service set up to meet the needs of children and young people aged 0-18 who have a severe to profound hearing loss, have d/Deaf parents, or have British Sign Language as a first language, and experience emotional and/or behavioural issues. As part of this, the service works with d/Deaf parents who typically may have struggled to engage with services. National Deaf CAMHS seeks to further the understanding of the impact deafness, language development and communication may have on mental health.
National Deaf CAMHS is a multi-disciplinary mental health service set up to meet the needs of children and young people aged 0-18 who have a severe to profound hearing loss, have d/Deaf parents, or have British Sign Language as a first language, and experience emotional and/or behavioural issues. As part of this, the service works with d/Deaf parents who typically may have struggled to engage with services. National Deaf CAMHS seeks to further the understanding of the impact deafness, language development and communication may have on mental health.
Access
The Northern Arm of National Deaf CAMHS can be accessed from one of their bases according to which is geographically appropriate (Manchester, York, or Newcastle). The teams also run outreach clinics in the community and work into schools directly. To facilitate access across a wide geographical area, sessions can be held via Skype, Facetime, or Duo. Any professional can refer, but given the regional nature of the service, a local professional contact is required for support. Consultation is a regular part of the service’s work; taking telephone consultations as well as setting up more formal consultation clinics in either specific locations or specific groups. Deaf children with significant mental health difficulties are supported to receive inpatient care through the national inpatient service at Corner House, London.
Assessments
The service offers specialist adapted complex assessments, diagnostic assessments, and interventions. National Deaf CAMHS (Northern Arm) regularly offers Full Team Assessments which are typically (but not exclusively) used to explore autism spectrum disorder (ASD). Assessing ASD is far more complex for deaf children and as such deaf children are often misdiagnosed or undiagnosed. The service has developed highly specialised and adapted assessments and interventions for families with children with ASD. There is also currently a large-scale research project underway in York University by Professor Barry Wright, to validate the adapted ADOS (Autism Diagnostic Observation System) for deaf children. To ensure assessments are precise and children, young people and their families and carers receive the correct support, the service also provides advice and support when a child or young person may require local mainstream specialist children and young people’s mental health services.
Co-production and participation
National Deaf CAMHS (Northern Arm) has an ongoing quality improvement plan around co-production and participation. Over a 3-year cycle, each of the regional teams organises a service user group to focus on one area. The teams in Manchester and York have developed animation DVDs (‘Communication Street’) with deaf young people to explore their identity and experience of being deaf in a hearing family. Our annual involvement groups focus on different areas of the care pathway which has led to developments around risk assessments documents and changes to our appointment processes.
Collaborative working
The specialist nationally commissioned service is embedded within local trusts to ensure it is accessible in the same way as other children and young people’s mental health services. The service co-works with local CAMH teams and local professionals to ensure better outcomes for families.
Workforce
The service is made up of a bi-lingual and bi-cultural team of d/Deaf and hearing staff who are fluent (or learning) British Sign Language. Hearing clinicians work together with d/Deaf colleagues, who can provide understanding on d/Deaf experience and culture to ensure access and engagement. Team interpreters are core team members.
Service evaluations
National Deaf CAMHS (Northern Arm) regularly conducts audits and through analysis of experience of Service Questionnaires on discharge and feedback from both service users and other professionals we aim to develop further. The Northern Arm of the service received an ‘Outstanding’ rating following their recent CQC visit, particularly in relation to their multi-disciplinary working, patient engagement, and care, on the basis of universal positive feedback from children, young people, and their families.
What makes this service an example of positive practice?
It is important to understand deafness in the context of cultural and linguistic minority as opposed to disability. Using this as a starting point allowed the team to shape a service which better met the needs of deaf children, young people, and their families, increasing engagement and leading to positive outcomes. In setting the service in the appropriate cultural context, and focusing on communication as a key factor, clinicians can deliver outstanding services. By operating as a multidisciplinary team, hearing and d/Deaf staff are continually learning from each other and families receive a service which meets both their mental health needs and wishes (as deaf people). National Deaf CAMHS has a strong research culture and is committed to working closely with other service providers, to not only provide high-quality care, but facilitate shared learning.
Further details
Commissioning
NHS England regional commissioners
Providers
NHS
Workforce
The service is made up of the following members of staff: psychiatrists, clinical psychologists, CAMHS community nurses, service manager, operational manager, team managers, administrators, mental health practitioner, specialist deaf outreach workers, deaf family support workers, deaf service consultant.
Some roles cover the whole of the North (e.g. service manager, consultant psychologist, deaf service consultant, operational manager), others are specific to the Newcastle, York, or Manchester teams. All teams have a core make up of staff as highlighted in bold.
Population size
7.9 million
Caseload
Receive around 140 referrals a year. The mean number of contacts is 16 (range 4-26) with a mean time on an active caseload of 10 months
Specific specialist assessments e.g. ADHD
In-reach, inpatient and residential
Access and advice – consultation lines, triage and signposting
