What is a CAMHS Social Worker?
ASK ME ANYTHING
These questions came from an executive team within the NHS. The purpose of the questions are to share what a CAMHS Social Worker does, with other non-CAMHS Social Workers. Written specifically for a blog that the NHS will use to promote awareness of the important role that Social Workers play in Mental Health Services, I’m excited to present the first article in my Ask Me Anything series.
What does a CAMHS Social Worker role entail?
A Child and Adolescent Mental Health Service (CAMHS) Practitioner (insert discipline: Social Worker) is responsible for holding a clinical caseload of young people and/or their parents and families who have been referred to the CAMHS service. The Social Worker’s caseload accumulates in one of two ways.
Firstly, through the allocation of an initial assessment. We are allotted a number of initial assessments to complete, as per our contractual hours. For example, a fulltime CAMHS Social Worker will undertake ten initial assessments per quarter. This assessment forms the basis of our core work at CAMHS. An initial, comprehensive biopsychosocial assessment of the young person (YP) usually takes place over two hours, with their parent or guardian present. We have a very helpful in-house template to guide our questions and enough time to hear from all members of the family who are present. What typically follows the initial assessment is either an extended assessment - because there’s more to unpack, a straightforward recommendation for a possible intervention, or a clinical decision to bring the case to the CAMHS multi-disciplinary team (MDT) meeting. Either way, since we facilitated the initial assessment, no matter which route follows, we are now the current case-holder for this client.
Secondly, having been through the process of the initial assessment with any member of the MDT, an indicated intervention has been discussed with the young person and their family – and they have agreed to the plan. Next the plan is brought to the wider MDT in our weekly MDT meetings, or in discussion with our line manager, and an outcome is decided. The case is then placed on the team waitlist, for the next available Social Worker who can provide the indicated intervention. These cases, that make up our caseload, are usually referred to in the team as allocated “clinical treatment cases”. They’re allocated based on the Social Worker’s (cue Liam Neeson’s voice)… particular set of skills. This is where the CCAMHS role gets super fun, as cases are allocated to you based on your niche skills, background and experience.
Another part of the role is to participate in the rotating job of the “Duty clinician”. A fulltime Social Worker will clear their individual clinical schedule, about one day per month, and be the official Duty clinician for the day. The main responsibilities are to be available to our community networks by phone for the business day and to participate in the daily referral screening meeting. Crucially, the Social Worker will run a critical eye over the new referrals into the service, alongside senior colleagues (made up of a CAMHS Psychiatric Consultant or Clinical Team Lead) and a member of the wonderful admin staff. The purpose of the referral screening meeting is to discuss the suitability of incoming referrals to the service and make a collaborative decision about what’s next.
What motivated you to pursue a career in CAMHS Social Work?
CAMHS has been a service that I have wanted to contribute to since 2015, when I had my first taste in a Family Mental Health Support Service. I came into identified Mental Health services from a diverse background of working in Residential Youth Work, the Out of Home Care (OOHC) sector, and Early Intervention and Prevention (child protection) roles as a Social Worker.
All of these former experiences informed my belief that if we work with children and young people (CYP) and their families at a point in their lives where the mental health issues are emerging - and catch them at this critical time, then we have the best chance of providing sustainable and positive long-term outcomes all together. I’ve witnessed the extraordinary change that CYP’s and their families have been able to implement with the support of a mental health service. Unlike a purely safeguarding role, where we work with one key goal in mind (to address the safeguarding concerns), working in CAMHS allows a Social Worker to put into practice the breadth and depth of their skills and venture beyond only managing the risk. Using a safeguarding job as the rolling example here, in CAMHS we might only need to wear that hat 15% of the time on a particular case, rather than it being in the forefront of our mind for the entirety of our work with a family and on 100% of our caseloads. In a role like CAMHS, Social Workers are valued for their safeguarding expertise, sure, but there is room for more – we get the chance to grow our craft and expand on our skills in fresh new ways. We get to work with the CYP and family when the risk has been eliminated and true change can take place. It’s incredibly rewarding.
Since 2015, I haven’t left identified Mental Health services. I went from a Family Mental Health Support Service in the Non-Government sector, to working for Health (the Australian equivalent for the NHS) in an inpatient hospital setting on the Acute Adult Mental Health ward, to outpatient Community Adult Mental Health. These later career experiences in specialist mental health roles, helped me shape my understanding of how we view and treat mental health in the biomedically dominated system, and how crucial it is that Social Work be a strong presence alongside our multi-disciplinary colleagues in public health, for people who need support.
I am passionate about staying in CAMHS because of the potential it offers its clients. I love the child and family work element (a particular speciality for me), which I see as a key component to making meaningful change. I appreciate that I get to put into practice my rich experience and specialist trainings, which differs from other Social Workers and so offers diversity to our clients. I am grateful to be a valued member of an extraordinary group of professionals – both in my own MDT and across the wider CAMHS Social Work crew. I am ever motivated by the incredible clients on my caseload who I have the privilege of walking alongside. I am also motivated to grow my career in CAMHS by way of leadership opportunities and further professional development training.
What are the development opportunities that are available in the NHS?
Having been in my CAMHS role for just over a year now, I can attest to the array of professional development opportunities that are available in the NHS. Aside from the important mandatory onboarding training to get you started, there are rousing prospects for further development. I have just completed a foundation level Non-Violence Resistance (NVR) training, supported by the Trust, that I am already returning to the team in individual treatment cases. NVR is a group that is offered in CAMHS several times across the year, and this training gives me the chance to co-facilitate the group alongside other trained staff. I am also excited to speak to my supervisor next week about the opportunity to complete my Family Therapy training, with the assistance of the Trust. I have colleagues in the team who have benefited from this funding, and have gone on to complete a series of specialist mental health trainings and post graduate University degrees.
Aside from the bursary available for furthering education, there are also targeted Social Work incentives such as our monthly Social Work Forum and Reflective Practice Group. Last year, the Social Work cohort across CAMHS all attended the Community Care Live event together and currently, there is a recruitment drive for experiences Social Workers to supervise newly qualified Social Workers coming into CAMHS. We are extremely fortunate to have an amazing team of Social Workers in key roles across the Trust right now, who are dedicated to growing and nurturing our discipline within CAMHS, and championing our profession at the executive level. A testament that Social Workers are both valued and have career progression pathways here.
What advice would you give someone who may be considering a career in CAMHS Social Work?
Do it! If you are passionate about working with CYP and their families in a meaningful way, then CAMHS is for you. If you want to grow your holistic assessment and therapeutic intervention skillset, then CAMHS is for you. If you want to learn from and contribute to a MDT of professionals, then CAMHS is for you.
If you’re just starting out as a newly qualified Social Worker, CAMHS is a place that will grow your assessing skills, systemic thinking and knowledge of mental health presentations and interventions. There’s a range of family work involved and you’re never working with the same presenting issue or emerging mental health presentation. Each case is different, keeping the work engaging and challenging. Currently on my caseload, I have no two clients who are the same age, ethnicity, or who have the same looking family make-up as the next. Of that caseload, I am currently providing a clinical intervention to half of these cases, and the range of support I am offering also looks completely different to the next.
Lastly, don’t be daunted by the words “Mental Health”. Historically, our society have thought of and so treated Mental Health as a stigmatised illness or disorder that requires medical assessment and pharmaceutical intervention, often away from other support and in isolation. Thankfully, we’ve come a long way since those days, and Social Workers have driven change for the better - working with CYP’s and their families to address what’s behind the mental health presentation. Social Workers are so invaluable to the CAMHS service because of our extensive range of theoretical frameworks, unmatched assessment skills and systemic way of thinking. We know, for example, that “anxiety” (or insert any word that is labelled as a mental health presentation / illness / disorder) exists on a spectrum, and on that spectrum, our environment contributes significantly to whether “it” (the experience of anxiety) increases or decreases. Social Workers are the original masters at considering a person in the context of their environment, and as such, we are uniquely positioned to help our clients address such challenges and increase their resilience, so that spectrum can creep upwards. Mental health is simply another contextual factor, for us to consider. Often in my work, I find that the mental health presentation is the symptom of an underlying issue we can address with the CYP and their family, therefore quelling the manifestation of the mental health presentation. Voila!
We’re so well placed to work in CAMHS. CAMHS needs us. The Trust and our Social Work leadership team recognise this, which is why they’re asking those of us already here - what is missing, why aren’t more of you applying?