Proposed new CAMHS Structure

Pauline McEntee, Director Primary and Population Health, WCHN

Women’s and Children’s Health Network

Background

Women’s and Children’s Health Network

Background

> In June 2012, SA Health Portfolio Executive reaffirmed the decisions to establish: • a single state-wide Child and Adolescent

Mental Health Service (CAMHS) for children and adolescents aged 0 to 15 years of age; and

• youth mental health services (YMHS) for older adolescents and young adults aged 16 to 24 years of age.

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Model of Care

Women’s and Children’s Health Network

Model of Care

> A Draft state-wide CAMHS Model of Care has been developed

> Feedback was received from unions, stakeholders, staff and consumers and carers. The feedback has been sorted into themes.

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Model of Care

> General feedback about language, too long versus not enough detail

> Support for; • Working with the child, young person in the

context of their family • Working with schools to support children and

young people • Aboriginal, children under the guardianship of

the Minister children and young people being prioritised

• Flexibility regarding transition of young people when they turn 16 years

• Subspecialty within teams eg early years

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Model of Care

> Concerns/suggestions regarding; • Interface with the youth system of care that is

not yet developed • Omission of concept of developmental need of

child as critical criteria • Considerable anxiety about changing agencies

when young people are still school age vs concern about hanging on to young people that should be in the youth mental health system

• Omission of bio from bio psychosocial model of assessment and treatment

• Under emphasis of no wrong door approach

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Model of Care

• Other specific groups that should also be prioritised eg children and young people from low socio economic areas, same sex attracted young people.

• Should be additional subspecialty areas in teams eg Comorbidity, disability, trauma

• Clinical supervision also including professional supervision and reflective practice.

• Inclusion of a flow chart would be useful to understand the client pathway

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Model of Care

> Questions regarding; • The interface with primary care services who

are to provide support to children and young people with mental health issues

• There are a range of other services that it is important that CAMHS interfaces with and develops partnerships eg youth health services, Medicare Locals, Headspace

• How resourcing issues will be addressed • How workload review will occur.

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Model of Care

> The feedback is currently being considered for incorporation into the document. Some of the feedback relates to implementation of the model so will be utilised in the development of the implementation plan.

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Proposed Executive Structure

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Proposed CAMHS Executive Structure > The proposed CAMHS Executive

Structure aims to emphasise the clinical voice in the organisations’ decision making structure.

> Director CAMHS > Operations Manager for Country and Day

services > Manager Operations for Community

Teams > Nursing Director

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Proposed CAMHS Executive Structure > The new CAMHS Executive Forum will

also include as membership • the Medical Clinical Director for

CAMHS • One Allied Health principal position • Aboriginal Senior Leadership position .

> These 7 positions will assist the

organisation to meet the objectives of CAMHS within the broader health service region.

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Executive Members

Operations ManagerCountry & Day

Services

Operations Manager

Metropolitan Services

Operations Manager/Nursing

DirectorInpatient Services

Aboriginal Mental Health Lead

Allied Clinical Health

RepresentativeClinical Director

Snr Consultant Projects &

PartnershipBusiness Manager

APY LandsNorthern Country Hil ls Murray Lands Outer Southern CountryVictor HarborBISASECAboriginal Programs

MarionOnkaparingaPort AdelaideParadiseElizabethC&L TeamDPMEPISYouthLink

Operational RoleBoylan Ward (EMHS)HMH (PIMHS)

Strategic Aboriginal Cultural Lead representative on Executive.

Organisation All ied Health Representative on Executive

Senior Psychiatry and Medical Lead representative on Executive.

Assistant Finance Support

Org Lead/Sponsor Quality and RiskWork Health SafetyChild ProtectionGOMIncredible YearsEarly Years

Org Lead/SponsorQuality and RiskWork Health Safety269 Juvenile JusticeData ManagementHeadspace LeadCALD

Org Lead/SponsorQuality and RiskWork Health SafetyEating DiscordersNat. Disabil ity Insurance Scheme

Org Lead/SponsorQuality and RiskWork Health SafetyAboriginal Wellbeing Group (AWG)Leadership in Divisional Cultural Service Development. Cultural Community Li i

Org Lead/SponsorQuality and RiskWork Health SafetyLeadership in Divisional Clinical DevelopmentCredentiall ing

Org Lead/SponsorQuality and RiskWork Health SafetyCredentiall ingLeadership in Divisional Clinical Development

Org Lead/SponsorQuality and RiskWork Health Safety

Org Lead/SponsorQuality and RiskWork Health Safety

Approx FTE 115 Approx FTE 110 Approx FTE 50 (Line reporting only)

Approx FTE 0.5

DRAFT LINE & OPERATIONAL MANAGEMENT ORGANISATIONAL CHART - CAMHS STATEWIDE SERVICES - 26082013

Cons

umer

and

Car

er In

volv

emen

t

WCHN Chief Executive Officer

Executive Director, Primary Population Health

Divisional Director, Statewide CAMHSOrg Lead:

Completion of CAMHS merger & evaluationStrategic Development & Implementation

Liaison & relationships with other organisations.

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Tier

1Ti

er 2

Tier

3Ti

er4

Tier

5

Tier

6

DRAFT CAMHS Mental Health Governance Structure - 06082013

Executive Director, Primary Population Health

Mental Health Executive Committee(Fortnightly)

MENTAL HEALTH EXECUTIVE COMMITTEECAMHS Director (Chair)Ops Mgr Country & Day Services Ops Mgr Metro Nursing Director/Ops ManagerAboriginal Mental Health LeadAllied Clinical Health RepresentativeClinical Director

Business Manager (In attendance)PA to Director (Support)Snr Consultant Projects & Partnerships (Exec Officer)

COMBINED LEADERSHIP COMMITTEECAMHS Director (Chair)Members of Operations CommitteeMembers of Clinical Caucus

PA to Director (Support)

Clinical Caucus(Monthly)

Operations(2 Monthy)

Combined LeadershipCommittee(Quarterly)

CLINICAL CAUCUSChair to be electedCAMHS Director Aboriginal Mental Health Lead Clinical DirectorAllied Health Clinical Representatives (each discipline)Nursing Director/Ops ManagerSnr Consultant Projects & Partnerships (Exec Officer) Expression of Interest for other members (x 4)

12 plus EO

OPERATIONSChair - Ops Mgr (rotate quarterly)CAMHS Director Ops Mgr Country & Day Services Country & Day Services Clinical Reps x 2Ops Mgr MetroMetro Clinical Reps x 2 Nursing Director/Ops Manager Inpatient ServicesInpatient Clinical Reps x 2Snr Consultant Projects & PartnershipsBusiness Manager

PA to Ops Mgr (Support) rotate quarterly

Ops Mgr Country & Day ServicesManagers from all teams (fortnightly or monthly)

2 clinical reps

Ops Mgr Metro ServicesManagers from all teams(fortnightly or monthly)

2 clinical reps

Nursing Director/Ops ManagerInpatient Services

Managers from all teams (fortnightly or monthly)

2 clinical reps

Team Meetings(6 teams)

(weekly/fortnightly)

Team Meetings(9 teams)

(weekly/fortnightly)

Team Meetings(4 teams)

(weekly/fortnightly)

WCHN Chief Executive Officer

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Clinical Caucus

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Clinical Caucus

> To further support Clinical Leadership, the proposed CAMHS structure will include a Clinical Caucus.

> As an extended arm of the State-wide Mental Health Clinical Network, the CAMHS Clinical Caucus will be responsible for the provision of clinical advice and leadership

> The CAMHS Clinical Caucus will elect a Chair and one member who will both be the CAMHS representatives on the State-wide Mental Health Clinical Network

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Professional Structure

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Professional Structure

> The proposed professional structure aims to ensure that all professional staff within the organisation have clear lines of access to professional supervision and support.

> Principal level professional positions across the organisation will provide professional leadership and expert clinical practice both within their designated profession and across the organisation.

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DRAFT PROPOSED PROFESSIONAL REPORTING LINES CHART - CAMHS STATEWIDE SERVICES - 210813

Medical Consultants / Registrars/RMO's Consultants Clinical Director WCHN Exec Director

Medical

EN & RN1

AHP1 Social Worker

AHP 1 OT

AHP 1 Psychologist

CN, ACSC, RN2

AHP2 Social Worker

AHP 2 OT

AHP 2 Psychologist

CSC, CPC, EF, RN3

AHP3 Social Worker

AHP 3 Psychologist

Proposed Nursing Director 5.3

Proposed AHP4 Social Worker

Proposed AHP 3/4 OT

Proposed AHP 4 Psychologist

WCHN Exec Director Nursing & Midwifery

WCHN Regional Director, All ied Health

AS02/Ops Aboriginal

Worker

AS01Administration

AS03/Ops Aboriginal

Worker

AS02 Administration

AS04/OpsAboriginal Wellbeing

Worker

AS03 Administration

AS05/Ops Aboriginal Wellbeing

AS04 Administration

AS06 Cultural / Wellbeing / Principal Aboriginal

Mental Health

AS05 Administration

Nurse Practi tioner/RN4

AHP 1 Speech Pathology AHP 2 Speech Pathology Proposed AHP 3/4 Speech Pathology

Proposed AS07 Aboriginal Mental

Health Lead

Cultural Lead / WCHN Director

Aboriginal Services

ADMINISTRATIVE REPRESENTATION

CULTURAL REPRESENTATION

AS06 Administration

AS07 Administration

AS08Administration

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Information sessions and next steps

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Information Sessions

> A number of information sessions will be run over the next 2 weeks to inform staff of the proposed structure

> All unions are invited and welcome to attend any of these sessions

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Feedback

> Feedback is sought on the proposed structure by Friday 20th September 2013

> Feedback can be provided online via mentalhealthfeedback@health.sa.gov.au

> All feedback will be considered.

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Next Steps

> Following consideration of feedback, further consultation will occur as to further review of the proposed structure/ implementation of the proposed structure.

> Human Resource Principles developed in consultation with the relevant unions, will guide the implementation of the new structures.

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Questions?

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