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Thursday 25 September - Session information

1.30pm to 3.00pm parallel sessions – three options, please choose one to attend

Session 1:

Digital psychosocial intervention for adolescents with depression and anxiety on the waitlist for CYPMHS - Prof Tamsin Ford (Chair)

• Evolving Digital Therapy from a Brief Psychosocial Intervention - Professor Ian Goodyer

  Brief Psychosocial Intervention (BPI) for mood disordered adolescents was adopted by NICE Uk as an approved treatment for moderate to severely depressed adolescents attending CYPMHS. With the growth in referrals and no likely increase in clinical staff to cope with rising demand a valid digital therapy for support / Intervention may reduce waitlist cases and/or prevent decline in mental state in those needing face to face treatment. Here I describe the translation of BPI concept and principles into a digital format.

• Fitting the Dr in your pocket: the landscape for a digital BPI (Brief Psychosocial Intervention) - Dr Raphael Kelvin

  Where have we been, and where are we going with CYPMHS? How do we now meet the burgeoning needs of our children and young people’s mental health? Bearing in mind the 10-yr health plan, policy before and the current regulatory landscape for digital mental health tech, I will illustrate how we are planning the translational science to deliver a self-service digital version of BPI. Perhaps becoming one of ‘The Drs in your pocket’.

• Introducing Brief Psychosocial Intervention (BPI) in a NHS CAMHS setting - Dr Matthew Hodes

  Recent years have seen increased demand for accessible evidence based interventions for adolescent depression. This talk outlines some of the key steps in establishing BPI in a NHS Trust. These include the development of the depression pathway, gaining management support for BPI and a training programme, implementing the training and embedding the therapists in service settings. Data on outcomes of BPI and consideration of its role for those with ASD are discussed. Some opportunities and challenges in maintaining provision of BPI are presented.

• Digital psychosocial intervention for adolescents with depression and anxiety - Dr Anne-Marie Burn

Session 2:

Prescribing and discontinuing medications in early psychosis

Prof James Scott, University of Queensland, Australia

Despite well-established evidence to improve clinical care for people with early psychosis, current prescribing practices do not align with treatment guidelines. A practical clinical framework to support evidence-based prescribing for people with early psychosis will be presented. Key principles within the framework include: (1) medication choice informed by adverse effects; (2) metabolic monitoring at baseline and continuously; (3) comprehensive and regular medication risk-benefit assessment and psychoeducation; (4) routine early consideration of long-acting injectable formulations (preferably driven by informed patient choice); (5) identification and treatment of mania with lithium; and (6) early consideration of clozapine when treatment refractory criteria are met.

Session 3:

Health, justice and values;  embedding, ethical thinking and practice

Dr Jeremy Burn, Dr Hannah Wishart and Dr Michael Jewell. Dr Heidi Hales (Chair)

In our workshop here last year we trialled a vignette survey in which participants explained their decision-making around whether the child in each vignette needed secure care. We have analysed over 100 responses to 5 different clinical vignettes and will present the findings, with analysis of what factors impact upon the recommendations made by professionals and discuss how this furthers our understanding in how we respond to the needs of children with risk behaviours.

3.30pm to 5.00pm parallel sessions – three options, please choose one to attend

Session 4:

Child psychiatrists  - the need for leadership, innovation and sustainability

Dr Elaine Lockhart (Chair), Dr Anupam Bhardwaj and Dr Dush Mahadevan

Over the past 20 years the prevalence of childhood mental illness has increased, the number of referrals to specialist services has rocketed, the number of consultant child psychiatrists has stalled. At the same time there has been a mushrooming of mental health awareness and different supports offered in other health and community services. The recent STADIA study found that many children and young are not accepted into specialist services even when they meet clinical criteria for mental illness using a structured tool, the DAWBA and only 10% within services received a formal diagnosis. Child psychiatrists can't see all children with mental illness and our services are still hard to reach for those who are most socially marginalised. This symposium will explore how child psychiatrists can support all aspects of their team’s functioning and their engagement with their communities through working differently. We will talk about how providing consultation within our services and our communities helps build a better understanding of where the greatest need is and empowers others to join in this work, with examples from collaborative work within primary care and schools. Finally we talk about the need for service transformation and the role of psychiatrists as clinical and strategic leaders, educators and advocates for children. We will reflect on how many colleagues in health, education, social care and the third sector recognise their role in supporting children who are struggling with their mental health and may develop mental illness, but who lack confidence and competence to do this. 

Session 5:

Eating disorders: from community based research to improving services - Prof Tamsin Ford (Chair)

• Prevalence of Eating Disorders in Children and Young People in England: findings from the MHCYP Survey and the OxWell Student Survey - Dr Clara Faria

  The main aim of this presentation is to provide an overview of the latest research regarding eating difficulties and eating disorders (EDs) screening and prevalence estimates in the community. I will be presenting findings from two datasets - the first is a large population based English cohort (the Mental Health of Children and Young People National Surveys) and the second is a large cross sectional school based survey (the OxWell Student Survey).

• Respect, Safety, and Discovery: a new way of working with young people with treatment-resistant eating disorders and RISH - Dr Robyn McCarron

  Whilst most young people with eating disorders recover in the community, a subset of complex young people deteriorate in the face of traditional evidence-based interventions. These young people are at high risk of sustained restrictive interventions, dependence on nasogastric feeding, and iatrogenic harm. Over the past year the Darwin Centre for Young People has developed a new therapeutic model for working with young people with treatment-resistant eating disorders and RISH. Grounded in values of respect, safety, and discovery, the model uses core processes of contracting, containment, exploration, and individuation to create hope in sustainable change and a life worth living.

• Eating disorders - Dr Benjamin Geers
• Eating disorders - Dr Katherine Holland

Session 6:

Developing clinical care pathways for psychiatry care in children with rare disorders: examples from UK Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD) and CHI Crumlin Clinics for 22q11DS, Romano-Ward Syndrome, and SCID - Prof Fiona McNicholas (Chair)

• Integrated Care for 22q11.2 Deletion Syndrome - Dr Veselina Gadancheva

  22q11.2 Deletion Syndrome (22q11.2DS) is a microdeletion syndrome with a prevalence of 1 in 2,000–3,000 live births. It is characterised by multisystemic clinical features, significant individual variability, a high prevalence of neurodevelopmental disorders, and diverse psychiatric comorbidities, including psychosis.
  This presentation describes the development of a liaison psychiatry clinic for children with 22q11.2DS, integrated into a paediatric hospital care pathway. As part of the service, additional support has been made available to parents and young people with 22q11.2DS through mental health psychoeducation, parenting groups, and social support groups.
  The challenges associated with transition to adult services are also being explored.

• Developing clinical care pathways - Dr Laura Bond
• Developing clinical care pathways - Dr Sinead Murphy
• Developing clinical care pathways - Prof Paramala Santosh

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