Someone Like Me case studies

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Read case studies from our BEH staff:

 

 

Ray McBrien

 

Barnet CAMHS is defined as a moderate to severe mental health service.

I currently work as an CAMHS Access Clinician. My colleagues and I work as the front door to a CAMHS service, reviewing referrals coming into CAMHS.  We undertake triage calls to gather more information and liaise with other services both in CAMHS and externally that supports in our decision making.

During this process, we consider if the reason a young person being referred is appropriate for CAMHS and what may be offered. If it’s an urgent case or if there’s a crisis, we undertake urgent calls and liaise with the crisis services within CAMHS, so that they may offer immediate support. If it is a generic intervention that is required, following a triage call, they will be added to the waiting list for an appointment in the assessment clinic.

We liaise with the Royal Free Hospital and Tavistock CAMHS as we receive referrals for them and with our Tier two colleagues in the Barnet integrated clinical services (BICS). This is a service for young people who are presenting with mild to moderate mental health difficulties and may not meet the threshold for a tier 3 CAMHS service.

Work life balance

Prior to coming to BEH, I specialised in eating disorders at Great Ormond Street, five days a week. My days involved travelling into and out of London, so I was leaving home early and returning home late. I have three young children and I realised that I was starting to miss out on key aspects of family life. After a long period of reflection, I decided it was time for a change. I applied for my role because the service is closer to home.

Career journey

I qualified as a mental health nurse13 years ago and I believe that one of the greatest things about nursing is just how broad it can be and the varied availability of development opportunities.

Prior to GOSH I was at the Royal Free Hospital specialist eating disorder service. I spent years specialising and wanted to move back into a broader and more generic role within mental health nursing. My current role means that I am supporting young people with varied mental health difficulties, as well as being able to utilise my previous experience in eating disorders services. 

Skillset

There are key aspects that really motivate me in my current role, one aspect is the need for reflective problem solving.

We receive referrals and the initial question is what does this young person need? What are they asking for and dependant on age, what do parents want? What does the young person want? It’s drawing all these things together because at times what parents feel is needed, and what the young person wants can be at odds with what services feel would be the most supportive approach.

I enjoy the process of reviewing, liaising, gathering information and coming to an outcome which is the most holistic and collaborative. I want a young person to feel that they’ve been helped, they’re on the right path and the family are being supported. 

One important aspect of this role is that as part of being the front door to CAMHS we are often speaking to parents who have never had any involvement with mental health services before. They may feel they’ve never been listened to or heard in the context of their child’s mental health. I like to be able to give guidance from that first moment.

A simple example is when someone close to the young person has died and the child has been affected. A GP might refer straight to CAMHS and so we guide the family towards the services that are more appropriate who provide bereavement counselling. Parents are thankful for advice that is pointing them in the right direction. It helpful to know that they are getting what they need rather than just being taken into a mental health service and put on a waiting list.

Teamwork

I work with a good team. I started my role during COVID. All our meetings and discussions and most of my assessments were online but we really gelled as a team.

In the Access Team there are two main clinicians who triage calls; me as a mental health nurse and my colleague, who is a social worker. I think our backgrounds really compliment the work we’re doing, and it’s well joined up.

I work best under pressure and Access is fast moving as there are always referrals coming in and the frequency and urgency for some has increased, so we are always very busy.  

Holistic approach

Sometimes I am the first person someone will speak to in CAMHS. I can manage stress and difficult situations, so it’s important that their first impression of CAMHS is helpful, is calm, and thoughtful.

I take a holistic approach to supporting a child, we don’t just see the diagnosis or behaviours without seeing the child at the centre. We consider the difficulties that a child may be experiencing and think broadly about their future, moving from primary to secondary school and taking GCSEs. Bringing this reflective thinking - about what that young person needs now and, in the future, - makes a difference to the young person’s life, but also to the family and the parents’ lives as well.

I very much take a ‘what can we do for this person’ approach.  If their needs do not meet the CAMHS criteria, then what are we recommending? We will discuss in the team, make calls and complete a closing letter outlining the our recommendations.

I will often say to parents that if they have any queries or questions, they can always myself or CAMHS. I ensure that they have Crisis details as well to make sure that they do have someone to speak to when they are concerned about their children regarding any risk.

I’m always mindful that although I’m the first person they might speak to, after my discussion they potentially have a six-month waiting time before they are seen again so it is important that they feel supported and listened to.

When reviewing referrals for older adolescents who will be turning 18 quite soon, it may be that our recommendation is that an IAPT service would be more appropriately placed to support them, and I offer advice and guidance on how to self refer, letting them know that if they do have difficulties with the referral process they can call me.

Professional opportunities

I think that the greatest thing about CAMHS is the diversity of disciplines - the specialisms that we have, the experience that you get - and the ongoing opportunities for learning, self-development, and professional development.

I think the greatest thing about Barnet CAMHS in particular, is it’s continually developing. It continues to evolve to meet the needs of service users. This in turn opens up development opportunities within the service.

CAMHS is a very broad name for several different specialist teams, but these teams work well together. There is a feeling of being united for the young people.

There are elements of flexibility as well. I’m very mindful of the changes that needed to make to meet the demands of COVID and I think that Barnet CAMHS has manged that incredibly well. Despite the ever-increasing referral rates as well, we are always reviewing and meeting the needs of service users, putting them first. 

What makes you proud? 

I think it is the ability to adapt and evolve and change with the ever-growing pressures that mental health services and specifically CAMHS services are presented with. It’s the opportunities that staff have, when working in CAMHS, to develop a career within CAMHS.

I am occasionally disheartened by the waiting times, but I think what also makes me proud that there are services that we can offer for young people and their families.

It’s taking that holistic approach. For example, we may consider a child or adolescent with neurodevelopmental issues and the specific assessment they need, carefully taking into consideration their emotional and mental health needs ensuring that they are fully supported. Being able to think broadly to ensure that support is tailored to the needs of the young person or family.

Someone Like Me

Someone who is passionate about young people’s mental health, who takes a caring, compassionate, and thoughtful approach to supporting them.

It’s putting the young people and their families at the forefront of our decision-making processes.

My work involves supporting with their current difficulties but also being motivated to support young people in making changes, in developing the mental health tools and building blocks supporting them through adolescence and on into adulthood.

The world is ever-changing and it’s becoming more and more difficult for today’s children to navigate.

Our work is reflective, it’s ongoing and it’s non-stop.

 

Dr Amit Biswas

I’m a consultant child and adolescent psychiatrist and I work in a tier four specialist adolescent patient unit, Beacon Centre.

Organisational culture and values

There are three parts to my role. I have a leadership role as the clinical lead for the team, I have a clinical role and I have a teaching, development, and training role - by creating a living learning environment for the trainees and other consultants.

I have been here for a year following a six-month locum post. I wanted to join BEH because I felt that I could create a difference to young people and their families. I also felt that my values are very aligned to trust values and the values that we want to create at the Beacon Centre.

My personal values are kindness, compassion, service, respect, gratitude, and integrity. These clearly align with BEH’s vision of positivity, working together, and compassion.

We work with young people who cannot be treated in the community because of their serious mental health issues, such as psychosis, complex trauma or developmental and mental health disorders, or high-risk activities such as self-harm or aggression.

As a whole team approach, we try to understand what the problems are, what we can do to for the young person to keep them safe, to treat them and to integrate them back into the community and home as soon as possible.

Our approach to treatment is what I personally call intelligent kindness. We are skilled professionals and clinicians – from family therapists, medics, doctors and nurses, occupational therapists to art and music therapists. We keep the young people at the centre and with intelligence and skill we bring authentic kindness and kinship.

We are creating a sense of family outside the young person’s family, without a hierarchy. At every step of the way we champion the young person’s voice. We plan their care and treatment with them and their families, to keep admission as short as possible.

Another personal reason I joined was to take up a challenge and bring the teams together to increase the emotional temperature.

With teams from ground level up to our leadership, we’ve co-created an environment with the least restrictive practice and open conversations. We live the values of diversity and equality.

I am very proud to say that within six months of joining we’ve been rated as good in all sectors by the CQC. In December 2021 we got the best team award and QI project award. We’re changing the culture and it is supported by management and by our team. I’m very grateful for that.

I am very passionate about my clinical role and making a difference to young people in everyday life and their families.

Whole professional self

I am also keen on teaching. I teach globally on mindfulness. I am a wellbeing champion on the North London collaborative and I’m the London lead for wellbeing at the Royal College. 

We know that unless staff are in a good place and look forward to work, we can’t retain or recruit people. So, we’ve created a wellbeing QI project and have weekly wellbeing conversations, supported through reflective practices and supervision, to increase joy at work.

I don’t just want to reduce symptoms. Our concept is holistic recovery.

Forward thinking working practices

We look into all aspects of a young person’s life - social, biological, physiological, emotional, educational, and behavioural - to create a holistic sense of recovery.

For example, if a young person hasn’t been in school for two years, we don’t just look at treating depression and mental health. We look at education, family, independence, and sensory work. So that when they are integrated back, we prevent future mental health difficulties,

I believe that we have created a culture within an organisation which is very forward thinking.

One of our big agendas is equality and championing diversity and inclusion. We have practices of openness, the right supervision and learning agendas. We have places where we can talk and have fun. It’s important to be together and we have created spaces together to work as a team and as a family. So, the culture is positive.

The management team has given us the freedom and choice to do things at the ground level the way we want. At the same time, they have an oversight but are not interfering.

Our vision in Beacon is that from good we want to be excellent and outstanding within the next six months. We have passion with compassion. I feel very proud of our team and feel very supported by the management.

Someone like me

I come from a BAME background and bring my own culture and diversity to my role, and I feel included. As a consultant and a lead clinician I hold authority but at the same time, I’m given the freedom and choice to flatten the hierarchy and to co-create and collaborate and make everybody a leader.

I can align my personal vision and values with the Trust vision and it is going well together at this moment.

Our work is intelligent, kind, respectful and dignified.

 

Dr Navin Chandra

I’m a child and adolescent psychiatrist and lead the Generic CAMHS team at Edgware. I help children and young people with emotional difficulties and neuro-diverse conditions, such as autism and ADHD.

An improving service

I did part of my training at BEH and decided to return to the Trust in June 2020. I have found the management is thoughtful, listens and is looking for ways to innovate and improve the service. The leadership team works with staff in a compassionate, practical, and pragmatic way.

I am encouraging people to join Team BEH because;

  • Our management team listens and will make sure that your job doesn’t have excessive demands.
  • You have responsibility and autonomy to do your job with robust supervision.
  • You can develop in your role with a manager to support you.
  • You can be innovative to improve the quality of the service.
  • We have fantastic opportunities to take part in ground-breaking research e.g. Barnet CAMHS is working with Camden and Islington, the Anna Freud Centre and the Tavistock and Portman Clinic on important research into ‘mentalisation based treatment’.

At BEH you will contribute to improving the lives of young people and their families.  Your input can change the life of a whole family. All these things make me very proud to be part of this service.

Job benefits

I get to work with kids - who are always curious, clever, insightful, cheeky, playful and who can be rebellious. Each child is different. So that’s why I want to do my work.

I am also mindful that 75% of mental health problems start in children from 14 years upwards. If we do a good job and improve children’s resilience, they will meet their potential and have a bright future.

Our work is compassionate, seeking solutions, optimistic and positive.

Someone like me

I’m an immigrant, who comes from a BAME background. And I work with colleagues from across the world - Peru, South Africa, Spain, Sri Lanka, and the Philippines.

We are people who come from different places. And we are treating a diverse population.

So, we are aware of the importance of language and culture. We are thoughtful about the nature of people’s problems from different parts of the world. If we are not aware, we are curious to understand.

So, ‘Someone like me’ could be talking about a patient, or someone who works in our administration team.

Everybody is aware of their strengths, their limitations and are curious about learning more. About people, their stories, what it means and what it represents.

We want to help and offer solutions to kids who are presenting with problems and their families. By using their language and culture to make life better for them in Barnet - and in England.

Conny Kerman

 

I am the family therapist lead in Barnet CAMHS. I’ve been at BEH for 17 years.

Personal career journey

I’ve done several different roles at the Trust. For the first five years I worked with adults in Chase Farm and moved to CAMHS where I’ve been for 12 years.  

I chose to work at BEH when I had just qualified and lived locally. I do believe that this is a bonus. In our team, the people who live locally have stayed for the longest.

My role is a combination of different responsibilities.  I work as a family therapist with families where there is a child or a young person who has emotional, behavioural, or mental health difficulties.  I also do CAMHS work with children and young people, on their own and with their parents.  I run a clinic for families with four trainees and I supervise seven staff. I’m also responsible for developing the family therapy service alongside the family therapy leads in Enfield and Haringey.

Listening to patients

The part of my role that gives me joy is running the family therapy clinic. I work with trainees who are ambitious and want to develop their professional practice.

In the family therapy clinic, I am behind the screen, observing the family with three students, whilst one student sees the family.

After the consultation we give a reflection on what we think. Initially it feels a bit unusual, almost weird - but after a few sessions the families really like it - because they have four people thinking about their dilemmas.

So that for me is a lovely combination of work. I’m thinking about a family and young person’s dilemma - where are their strengths and where could they develop. As well as thinking about the student who sees the family - how can they ask more useful questions and what could they do differently.

So, it’s a mixture of training people as well as doing clinical work – that’s my joy of the week.

In family therapy we help families to improve their relationships with each other to a point that reduces the stress. They learn to appreciate themselves as well as each other and recognise the difficult situation they’re in.

Family therapy is a mixture of listening and of giving hope, strength, and support. Sometimes people need skills, but I think it’s not only that. People often already have a lot of skills but there has been trauma and oppression which contributed to where they are now.

Access to therapy without the barrier of cost

It is meaningful to work with people who can’t afford private therapy. I help people who would never be able to afford to pay, even if it was £5 or £10 because they can hardly pay for their heating or their food. So, for me the equality factor is huge - I want to provide care to a wide range of people.

And I think the other important benefit of CAMHS is that you work in a multi-disciplinary team. The teamwork and the multi-disciplinary thinking and development is something you only get in the NHS.

Training and development for trainees

I’m at that stage in my life where I like to support colleagues to develop. We had a trainee who joined us from HR with no therapeutic experience. She worked with us for four years and left as a really good family therapist. I saw her developing over those years and it was beautiful.

There’s space to offer trainees a great experience and hopefully we can increase the number of people we train. People often say, ‘if a job comes free in your team, I would really like to work with you’. I genuinely think trainees have a good experience.

Someone like me

I like to contribute to the professional development of colleagues in my team, so they have more satisfying work. I like to help families and young people to feel less distressed by low moods, anxiety, depression, and arguments. I’ve worked in the field for 36 years of my life - as a social worker and as a therapist - and I’m proud to say that staying compassionate will always stay one of my highest values.

Dr Katherine Kennet

 I’m a consultant child and adolescent psychiatrist. I work in Oak Lane, which is one of the Barnet CAMHS sites, covering the east side of the Borough. I joined the trust in this role in August 2021, so I’ve been working here for almost six months.

I work in a team for young people’s mental health, looking at their worries, their concerns, and developmental issues. The young people have a range of disorders such as depression, anxiety, OCD, and trauma. Some have social communication difficulties like autism or ADHD and sometimes family difficulties.

Why BEH?

I did my training around North London and was a junior doctor in my current team. This was my first consultant role, so it was important for me to be in a team of capable and thoughtful senior clinicians. This is a big part of it of why I want to work here.

I also really like the Borough. We have quite a diverse population in terms of affluence. I find it rewarding to work with families where there isn’t that much resource and I like advocating for those families. I find you can make a real difference. Barnet is quite well balanced, so you have people from across the socioeconomic spectrum. You get different challenges from families from different backgrounds.

I love working with young people and their families. Young people are refreshing, even if they’re unwell. I think their way of seeing the world is not hardened by what they’ve experienced.

The role

I coordinate the multidisciplinary team to think about really challenging cases. It’s about making sure we get the most out of everybody’s experience and viewpoints, including the newest or less experienced members of the team, appreciating that everyone has something unique to give and using that for our challenging cases.

One of the cool things about child mental health is you don’t treat a young person in isolation. A big part of what I do is bring people together. There’s a whole network of people including parents or caregivers, siblings, teachers, social workers, youth workers and therapists working in your team.

The niche that I fill is prescribing and diagnosing because those are the remit of doctor as opposed to other mental health professionals.

Another part of my role is to provide consultation to the team. If there’s a tricky case or something a bit unusual or something that person hasn’t seen before, then I’m there to be consulted. That’s a role I take seriously, and I like having a space for people to come to me and think about what we can do for young people and their family.

Long term importance of the role

If you’re in CAMHS there is a reasonable chance you’re going to be in the care of mental health services for a while. I hope that when young people and their families see me, we’re setting them up for a positive long-term relationship. I try and hold the young person at the core of everything I do, so they feel listened to and empowered to say if something isn’t working.

In CAHMS we are at the beginning of someone’s mental health journey and it’s often the first time they’re meeting services. So, to be able to support somebody in a way that doesn’t feel scary and they’re able to say, ‘That’s not quite right. Let’s do it a different way’. That is important to me.

My hope is that young people feel heard and feel able to start their journey of getting better. My hope is that people look back and think, ‘Actually that was helpful’.

When a child is very unwell in a family it feels devastating. It is all-encompassing and it feels hard. Often the nature of mental health is that change is very slow and painful, and I see my role as being able to hold my nerve and the family’s nerve and provide reassurance by saying: ‘It may not feel like things are getting better, but do you remember two months ago this is what you said…?’

The hope is that you provide a different tangent so that things can go in a different way.

Seeing the outcome

In mental health you only work with people when they’re struggling. When they start to get better you tend to step back. But when you do see young people doing well it is phenomenal.

When I was in this team as a junior doctor, I worked with a young person who was out of school and wasn’t doing very well. I recently bumped into her and she’s now an adult, in a relationship, working and having a good life. She said, ‘I hope you don’t mind, but I wanted to say hello because you were my doctor’. To see somebody who was unwell - and is now well - and hearing that I’d played a small but significant part of her recovery was incredibly heart-warming.

We don’t often see that, but the hope is that the trajectory we see when people start to improve, carries on.

Importance of CAMHS

Working with children’s health is a phenomenal thing to do. You are given the opportunity to make a difference in someone’s life that they’re never going to forget.

You’re giving them a space that’s unique, to just think about themselves, their wellbeing, and their mental health. You have a responsibility to do everything you can to help them, to advocate for them, to help them to think in a different way using skills that you have that many people don’t have.

The strength of CAMHS is the multidisciplinary team approach – of family therapists and psychotherapists, the psychologists and CAMHS clinicians. We’re all trained in a very different way so, when I’m struggling with something, my mind is blown by other people’s different way of seeing the same situation. There’s something lovely about being greater than the sum of the parts.

We need social workers, family therapists and CAMHs nurses, because we need different experiences. The young people aren’t in isolation. They’re part of a network - like a family unit or a social care unit - and I can’t understand that without my colleagues. I think I’d be doing a negligent job if I wasn’t taking these aspects into consideration and consulting my colleagues. In this way you get a richer experience, and this is a very important thing to be able to give to young people.

I think it’s an incredibly thoughtful and caring team who work incredibly hard for the families and young people we serve. I feel confident that whoever is picking up the phone or answering my question, will do their absolute best for the young person. I think it’s a positive thing that I can trust my colleagues to be really caring and to hold the young person and their family at the core of what we’re doing.

Someone like me

I wanted to come to a Trust where I could bring all aspects of my professional self. I want time to do my policy work for the Royal College of Psychiatrists. I want to continue with my child and adolescent psychotherapy training. I’m also an actor and a director for fun. It’s something that’s welcomed and celebrated and there’s space for it.

BEH welcomed these aspects of me with open arms.  They agreed that having an enriched professional life is going to make me a better doctor.

I think that’s what Someone like me means to me. It means not just being someone who comes in and does the work and leaves. It’s about bringing all aspects of myself and feeling supported to do the creative pursuits that don’t necessarily fit the classic role.

Our work is inspiring, interesting, and compassionate. I feel inspired by those around me and the young people we support.