Throughout my study’s in psychiatric nursing and previous study in social care, I established many opinions of developmental theories presented in viewing mental distress, Freud’s psychosexual theory was somewhat ungraspable to me which possibly prevented me from developing my knowledge on his theories. Bandura’s social learning theory and Bowlby’s attachment theories resonated more with my thinking. In entering acute adult psychiatric services, I feel any possible lens of viewing mental distress, the how and why people may present with mental health difficulties and reasons for symptoms became less evident for me. The medical model of diagnosis, medication and management of mental distress ...view middle of the document...
Looking at the history of the Child and Adolescent mental health services in Ireland, where it started, where it is now, where it should be, I began to challenge and question my view of what level of distress warrants assessment and intervention from CAMHS. Looking at trauma and the effects on a child’s mental health, it is evident that exposure can lead to an increased susceptibility to developing a mental disorder. Murphey et al. (2013) identify the importance of early identification of mental distress and access to services. Clinicians are vital to identifying mental distress, so adopting mental health into primary care settings, schools and social services is of vital importance, especially for young people who have been subjected to trauma.
I question the ongoing dilemma in my practice, if primary care interventions were more readily available and early interventions/ education provided would the young person attending the CAMHS service with ongoing issues of self-harm and suicidal ideation precipitated by emotional regulation difficulties and incidents of bullying, be attending at all. Damodaran and Sherlock (2013) reflect the current two tier operating system in Irish CAMHS stating that some service users may not have any diagnosed mental health disorder but are attending due to ongoing emotional or psychological distress, highlighting the need for more in-depth primary care services which could cater for mild social, emotional, psychological difficulties.
Some positive development has occurred such as Jigsaw services in five areas throughout Ireland have been established which endeavour to provide support to young people whom experience psychological distress (Illback et al. 2010). The introduction of the new CAMHS standard operating procedure endeavour to promote consistency among all teams with regards to service provision, acceptance criteria and guidance on all other areas of service provision (HSE 2015). Looking at the evidence my outlook has changed, taking into account my first natural instinct to advocate for a referral to be accepted because they “won’t be seen by primary care psychology services for a year”, in that time their presentation/ distress could be more significant, I now take into account the bigger picture that primary care services will not be developed unless clear service need is identified and I focus on the importance of the need for CAMHS to be available to those whom present with moderate/ severe difficulties, and not being overwhelmed with inappropriate caseloads leading to excessive waiting lists, leading to the child with moderate/ severe difficulties being forced to wait for assessment and intervention. Coyne et al. (2015) identify in their study the frustration of parents in some cases waiting 18 months for the young person to be followed up by CAMHS.
Looking at my view of the mind, how I interpret children’s mental distress/ illness and the proposed means of treatment has somewhat evolved,...
