Access to CAMHS

These should be focused and concise, delivering the key messages at a steady pace to give young people with autism adequate time to process them.   Language should be kept simple and free of clinical jargon.  Key messages should also be reflected visually to aid understanding and reinforce their importance.   This could be done via a combination of on-screen text, drawings and animations.  Using the second person for narration and avoiding an excessive focus on the experiences of others will help autistic individuals to engage with and identify the information as relevant to them.

Transcripts should always be provided for any videos used on a CAMHS website to ensure that the information they contain is accessible to all.

Below are two high quality examples of this type of resource:

‘Your Visit to CAMHS’ (West London Mental Health NHS Trust)

‘What is CAMHS?’ (Cornwall Partnership NHS Foundation Trust)

To be suitable for all these forms should be highly visual, using images and drawings to illustrate and clarify the questions being posed, and colours to group different types of information. They should contain enough information to provide a full understanding of a young person’s needs and to enable individualised planning, but without being overwhelming to complete.  The information contained should be a mixture of medical, social and personal.

Below are several high quality examples of this type of resource:

‘My Traffic Light’ (Central Manchester University Hospitals NHS Foundation Trust)

‘My Care Passport’ (Dorset Healthcare University NHS Foundation Trust)

‘Homerton Hospital Passport’ (Homerton University Hospital NHS Foundation Trust)

Photo tours should show all areas which a young person coming to CAMHS will encounter, including, where applicable:

• the approach to the building
• the main entrance and reception
• the lifts and stairs
• the CAMHS reception and waiting area
• a representative selection of therapy rooms

The use of panoramic or 360^o photos can help young people to immerse themselves in the environment and get a better understanding of how it will feel to be there in person.  This approach is illustrated by the example, given below, of a trust which offers virtual tours, based on 360^o images, of all of its CAMHS clinics.

Virtual Tours (Sussex Partnership NHS Foundation Trust)

Click here to see a virtual tour example

Video tours should be focused and concise, delivering the key messages at a steady pace to give young people with autism adequate time to process them.   Language should be kept simple and free of clinical jargon.  In each area of the building or department the video should explain to young people what will happen there and what may be different when they attend e.g. the waiting area may be busier or there may be a different member of staff on reception.  An example of the effective use of this approach is given below.

‘What to expect when you visit CAMHS’ (Bolton NHS Foundation Trust)

Knowledge and Skills

NHS Greater Glasgow and Clyde (NHSGGC) made the decision to include Speech and Language Therapists (SLTs) as integral members of their multi-disciplinary CAMHS teams. This supports integrated SLT and mental health care planning for young people with autism. As a result they can make individual adaptations to therapies, provide autism-friendly information and communicate clearly about consent.

SLTs also provide specific autism learning activities and individual consultation to colleagues in CAMHS, working with them on joint assessment and care planning. NHSGGC have particularly focused on developing an understanding of stress and anxiety in autism, offering flexibility in their approach and developing clear communication.

Managing Appointments

NHSGGC appreciate that attending CAMHS, especially for the first time, can be particularly stressful for young people with autism. They are flexible in their approach and they will:

• offer parents the opportunity to attend first to discuss their child’s difficulties without the young person being present
• allow the young person to visit to see the building and the waiting room prior to their appointment
• offer to see young people at home or in school if it would be too difficult for them to attend the clinic
• endeavour to offer a regular appointment time where it would be helpful.
• offer appointments for people with autism at quieter times
• ask any new member of the team who is due to see a young person for a particular piece of work to come into a session and meet them face-to-face before their first appointment together.

Environment

NHSGGC are fortunate to occupy a purpose-built building and were able to have a say in its design. They incorporated a low stimulation zone into their waiting area, which includes a secluded, padded area tucked under the stairs and a low light bubble wall. They also have a smaller upstairs waiting room which tends to be quieter and can offer this to young people with autism. They discourage busy colourful displays on the walls to reduce the sensory stimulation of the waiting room and therapy rooms.

Therapy adaptations

NHSGGC try to provide a high level of visual support in both assessment and intervention when working with young people with autism. For example, they use Talking Mats in a range of ways and have found this to be very successful in supporting the assessment of mental state, in helping young people grade their emotions on an ongoing basis throughout therapy, and supporting their ability to communicate clearly about their emotions. They have also used social stories successfully and have found The Incredible 5 Point Scale a very helpful resource. They use personalised visual supports as an adaptation to therapeutic intervention, diary keeping, care planning and target setting.

Who’s who in CAMHS