Do young people's risk assessments need to change in light of COVID-19?

Tuesday, 04 August 2020

The lockdown has opened up a whole new set of challenges for many young people who were already struggling. It’s also created a new set of young people who will likely require support due to the additional stress and anxiety brought about through the social and economical impact of the pandemic.

The additional mental health support now required places an enormous demand on Child and Adolescent Mental Health Services (CAMHS). However, in many parts of the country, CAMHS continue to be under-funded, understaffed and left struggling with the pressure of the increasing demand.

Just a couple of days ago, I Googled CAMHS and found lots of comments from concerned parents about their recent experiences. Just some of the comments I saw included: “At my wit’s end”, “We desperately need help, but we are being ignored”, “My daughter had her assessment started but not finished” and “We have only had one call back from the numerous times we have called”.

Having the right tools

These comments got me thinking about transformative change and what needs to happen for these vital services to be readily available and sufficiently robust for our young people and their families. It seems reasonable to assume that change will not be coming via an increase in staff and resources, so what else can we do to help change things?

One thing would be to re-evaluate all of the tools and processes used within these services and root-out inefficiencies. By doing so, more time could be spent supporting as many young people as possible.

Keeping people safe is, of course, the number one priority here, so looking at risk assessment processes within young people’s services seems a good place to start.

Over-assessing vs under-assessing risk

A common approach, when faced with increased demands and a higher risk of someone ‘falling between the cracks’, is to double-down on bureaucracy in an attempt to mitigate against untoward-incidents occurring. Unfortunately, in practice, this usually results in ‘over-assessment’ of those at highest risk, while leaving others on an ever-growing waiting list without any support.

Another school of thought is that we consign all of our risk forms and documents to the dustbin and take a blank sheet of paper approach. The problem here is that an unstructured approach has been proven in the past to be fundamentally unconducive to the safe and effective management of risk.

As always, it’s about balance

In my experience, CAMHS practitioners are looking for more of their time to be freed-up to support the young people they work with by reducing paperwork. However, they still want access to assessment forms and processes that will help best inform their decisions and stand up to scrutiny if a serious incident occurs.

As we start to come out of lockdown, it does feel to me that there is an opportunity for change and I am hopeful that CAMHS teams across the country are looking at ways to streamline their processes to help cope with the ever-increasing demand.

There are already risk assessment and management tools out there that are well balanced between being structured but also quick and straightforward to complete, so I think it’s more than possible to make some fast and practical improvements in the area. By doing so, I believe it will go a long way towards helping improve these vital services so that young people can get the support they need to get their health and lives back on track.