Reimagining the future of paediatric care after COVID-19

Last month, the RCPCH published an interesting report Reimagining the future of paediatric care post-COVID-19 – a reflective report of rapid learning‘. The report is the first in a series of reports from the Paediatrics 2014 Project.

“This report, published on 26 June 2020, is the first in a series from the Paediatrics 2040 project that will inform RCPCH’s vision for the future of paediatrics in the UK. We summarise our learning from this period of rapid change, focusing in particular on the elements of new practice that we want to keep and take forwards into the future…

To read the report, click the link below:

https://www.rcpch.ac.uk/resources/reimagining-future-paediatric-care-post-covid-19-reflective-report-rapid-learning

Journal Article: Care for children and young people with eating disorders

This article was published in the journal ‘Clinical Child Psychology and Psychiatry’ (June 2020) and may be of interest:

Paediatric medical care for children and young people with eating disorders: Achievements and where to next

Lee D Hudson and Simon Chapman

No other diagnoses epitomise the need for dual consideration of mental and physical health more than eating disorders. Anorexia Nervosa (AN) for example has the highest mortality rate of any mental health disorder, and half of deaths are thought to be due to physical complications (Sullivan, 1995). For this reason it is crucial for acute paediatrics and eating disorder teams to work closely over the assessment and management of these disorders, particularly in the early stages when physical risks are often highest.

This is not as easy as it sounds: mental health and physical health teams are often geographical distant from each other, have different ways of working, and may even view and speak of risk in different ways. Despite this, as for many countries, in the United Kingdom (UK), the journey to provide better paediatric care for children and young people (CYP) with eating disorders has been a gradual one, albeit with a number of recent victories. As two paediatricians working with CYP with eating disorders and eating disorder teams in the UK, we summarise the important developments of the past 10 years in the UK, and look to future steps…

To read the full article, click on the link below:

https://journals.sagepub.com/doi/pdf/10.1177/1359104520931573

Ourtime: resources for professionals talking to children about parental mental illness

Our Time helps young people dealing with parental mental illness. We make sure they get the support they need and have their voices heard.

This website has a lot of resources for Parents, Young People, Schools and Professionals

To find out more, click on the link below:

https://ourtime.org.uk/suitability-resources/professionals/

PAEDIATRIC MENTAL HEALTH: A NURSE’S PERSPECTIVE

CCCU BSc Child Nursing alumna Kim Cunningham discusses the unique mental health care needs of children, and her experience as a hospital lead for the ‘We Can Talk’ initiative.

I studied paediatric nursing at Canterbury Christ Church University (CCCU) and during my time as a student nurse I came across lots of children and young people with mental illness admitted onto the paediatric ward. Quite often they were just there for a short time, whilst assessed and discharged back to the community. However, sometimes those with more complex mental health needs, their admission stays were for a few days and sometimes weeks, whilst awaiting an inpatient bed.

https://www.canterbury.ac.uk/health-and-wellbeing/nursing-midwifery-social-work/child-nursing/paediatric-mental-health-nurse-perspective.aspx

We Can Talk: Free Online Training

The We Can Talk website offers training, advice and resources for hospital staff working with children and young people’s mental health

The project has:

  • Co-produced (with hospital staff, young people and mental health experts) a competency framework in children and young people’s mental health
  • Developed, piloted and evaluated a co-designed (and co-delivered) one-day training linked to the competencies to improve the knowledge, skills and confidence of any member of staff who sees children and young people in their role (clinical and non-clinical).

These offer brilliant, free, online e-learning that teaches hospital staff how to talk to young people who come in with a mental health crisis.

They are perfect for any doctor or health professional who struggles to know what to say and do with CAMHS patients in ED and the ward.

Take a look, you won’t regret it. It even gives you a Certificate and / or CPD points….

For more information https://wecantalk.online

The Importance of Human Contact Today

During the interval of a recent concert by the Orchestra of the Age of Enlightenment, Dr Dickon Bevington, Consultant Child and Adolescent Psychiatrist, gave a thought provoking, and topical talk:

The Importance of Human Contact today, about Mentalization, Attachment and Kindness.

About Dr Dickon Bevington:

Dr Bevington is the Medical Director at the Anna Freud National Centre for Children and Families and a Consultant Child and Adolescent Psychiatrist in Cambridgeshire and Peterborough NHS FT where he leads CASUS, an outreach service for complex substance using youth. He is also a Fellow of the Cambridge and Peterborough CLARHC, a collaboration based in Cambridge University dedicated to developing leadership and research in health and social care.

Dr Bevington’s consultant career started in adolescent in-patient psychiatry, but he now concentrates on developing and delivering innovative home-based or street-level out-reach interventions for complex, co-morbidly burdened young people who are socially excluded, using mentalization to underpin both the therapeutic and the organisational approach to this work. In this respect, together with Dr Peter Fuggle, he is the co-lead for the Adolescent Mentalization-Based Integrative Treatment (AMBIT) project.

Dr Bevington trains and lectures internationally on MBT and AMBIT, and has published a number of papers and chapters in the eld of mentalization and multimodal outreach approaches, most recently with Dr Fuggle. He is also co-author of “ What works for whom: a critical review of treatments for children and adolescents” which is a review of all treatment trials in the past 10-15 years across the world.

Take a look at the Anna Freud Centre website for more information about this field of Child Mental Health.

For a great resource for on-line learning, click on link below: https://www.annafreud.org/mental-health-professionals/anna-freud-learning-network/

Staying Sane in the Times of Covid-19

An article by Dr Emma Blake, Consultant Paediatrician, now Chair / Convenor of PMHA

Well, in these crazy times – with universal maelstroms – all of us are trying to cope with our personal whirlpools. Being a front line medic, whilst coping as a “full time” parent and teacher; trying to keep yourself, your kids and everyone else around you sane – it’s not manageable, is it?

I wish I had all the answers. Medice, cura te ipsum. Heal thyself. But no-one knows the cure for Covid-19, no immunisation – even against the anxiety and psychological impact of it. As a paediatrician, mother of four, with “shielded” vulnerable relatives; suddenly homeschooling three children and trying to get a “gap-year” son trapped in Vietnam back to the family;  I, like the rest of us, am trying to juggle all the balls whilst wearing minimal / flimsy PPE.

At the PMHA (Paediatric Mental Health Association) we are trying to find resources to support parents who are doing the best they can to care for their children’s health, education and emotional needs at home. A popular PMHA Facebook post (which has currently reached over 9.6 million people!) suggests taking the pressure off ourselves with regard to home-schooling or children; to try to take the stress out of the situation as much as possible.

Enjoy the time together – “cuddle up and read, read, read” etc. The best way to de-stress kids is to de-stress ourselves (often easier said than done). Obviously older kids (GCSEs and A Levels) need more structured work (thank you teachers!), but the principle is the same – our kids will remember what this felt like at home. They will remember the emotions and relationships.

We are seeing an increase in mental health presentations to paediatric wards – when we are doing our best to keep people safe at home. However, not all young people are safe at home. Abuse is escalating, domestic violence and parental mental health / substance abuse difficulties are worsening. As paediatricians, we need to be more aware of mental health and safeguarding issues, more than ever. The most vulnerable children are more hidden from view – and we are waiting for a tsunami (not only from Covid-19 ventilated elderly – but also young people who have had to cope with the “perfect storm”at home).

In addition to our Facebook page; the PMHA, along with Serena Haywood (St Georges) and Simon Chapman (Kings) have also developed a website – Indoor Explorers – to try to bring together resources to support parents at this difficult time.

If you have any useful resources for parents or professionals at this time – please share them with us at ContactPMHA@gmail.com

Dr Emma Blake,
Child Mental Health & General Paediatric Consultant,
Designated Doctor for Safeguarding Children, Isle of Wight,
Vice Chair PMHA and Chair of Child Mental Health (CSAC) at the RCPCH

Lockdown learning and play

Opportunities for unstructured play in the early years
are really important, says Ramchandani

A while back, The Guardian published this interesting article discussing learning at home through play in the context of the Coronavirus crisis…

“Learning at home does not have to look like school and probably shouldn’t, says Britain’s first play professor. With coronavirus closures offering opportunities for home learning, and many parents more on hand during the lockdown, play can come into its own, says Paul Ramchandani, Lego professor of play at the University of Cambridge…

https://www.theguardian.com/education/2020/apr/21/dont-turn-your-home-into-school-lego-prof-of-play-on-lockdown-learning