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CAMHS Enhanced Treatment Service

How our service can help you

The Enhanced Treatment Service (ETS) is for young people aged 12-18 who are presenting with a serious mental illness which has resulted in a hospital stay. We offer an alternative pathway for young people who have been admitted for in-patient treatment.

Our service aims to reduce overall length of inpatient stay and improve the quality of care by offering intensive home treatment, hospital day care and case management to the young people who reside in Southwark, Lambeth Lewisham and Croydon as well as support cases nationally.

We offer the young people and their families a detailed assessment and evidence based individual, group and family treatment in the least restrictive environment minimising disruptions to education, family life and leisure.

We work in collaboration with a range of agencies to improve the quality of care. Our professionals lead research into new models of care both in the UK and internationally.

This is a specialist service, available to people from across the UK.

  • Service Type: Child and Adolescent Mental Health Services (National and Specialist) Treatment type: Outpatient
  • Contact the service

    Site Location: Maudsley Hospital Phone Number: 020 3228 3983 or 020 3228 3990
  • Disabled Access:
    • Wheelchair accessible building
    • Ground floor therapy rooms
    • Accessible toilets on all levels
    • Lift access to the 1stfloor.
  • Address: Mapother House
    Maudsley Hospital
    De Crespigny Park,
    London,
    SE5 8AZ
  • Business Hours/Visiting Hours:

    Monday -Saturday 8am-8pm

  • Other essential information

  • Conditions: Anxiety, Attention deficit hyperactivity disorder (ADHD), Autism, Bipolar disorder, Conduct disorder, Depression, Dissociative disorders, Eating disorders, Learning disabilities, Obsessive compulsive disorder (OCD), Psychosis, Self-harm

Interventions

  • Interventions to improve young peoples’ access to education, housing, social care and leisure
  • Crisis resolution and crisis prevention
  • Evidence-based psychological therapies, including cognitive behavioural therapy, family therapy, mentalization based therapy and parenting workshops
  • Skills groups to develop emotional regulation capacity, mindfulness, interpersonal skills, social skills, facilitate behavioural activation and cognitive restructuring
  • Art psychotherapy, sensory assessments and work, sports therapy and occupational therapy
  • Improve school or vocational performance, engage with recreational activities and develop a functional support network on the basis of the family members, peers, members of the community and professionals


Case management follows the following four steps:
 

  1. Assessment of need
  2. Care planning
  3. Implementation of the care plan
  4. Regular review within the framework of the care programme approach (CPA)


Home treatment forms an integral part of this approach including mental state monitoring, administering medication, monitoring of side effects, providing psycho-education and delivering a range of evidence-based individualised psychological therapies, based on the initial formulation. Case management also includes individualised interventions aimed at improving young peoples’ access to education, housing, social care and leisure. Optimal crisis resolution and crisis prevention forms an important part of the Enhanced Treatment Service (ETS) treatment model.

ETS therapists contribute to the establishment and running of the expanded day care provision. They facilitate skills training groups aimed at developing young peoples’ emotional regulation capacity, mindfulness, interpersonal skills, social skills, facilitate behavioural activation and cognitive restructuring. Young people have access to a range of other treatments including art psychotherapy, music therapy, occupational therapy as well as education provided by the hospital school.

It is well recognised that family members play a crucial part in the young person’s recovery. ETS aims engage family members in all aspects of care. When indicated by the case formulation, pragmatic family therapy is undertaken. ETS interventions aim to improve caregivers parenting practice, improve family emotional climate and provide psycho-education and advice tailored to the individual young person’s needs. Each treatment plan is designed in collaboration with the young person and their family members.

ETS targets wider systems in young peoples’ lives to promote recovery. The interventions specifically target those factors in each young person’s social network that are contributing to their difficulties. ETS aims to optimise the peer network, improve the young person’s school or vocational performance, engage young people with positive recreational activities and develop a functional support network on the basis of the family members, peers, members of the community and the professionals young people interact with.

ETS treatment is delivered in a variety of settings that include the young peoples’ natural environment, such as their home, school, or elsewhere in the community.

Eligibility criteria

  • Adolescents age 12 to 18 years old
  • Residents of Lambeth, Southwark, Lewisham and Croydon (or residents elsewhere if an assessment/consultation only is required)
  • Alternative to inpatient treatment – referrals are made via the South London and Maudsley Child and Adolescent Mental Health Service bed management service

Outcomes

  • Reduction in self-harm and suicide during the period of maximum risk – the week following discharge from inpatient care
  • To enhance therapeutic engagement between young people and community services, also to reduce the risk of future (re)admission
  • Improved independence
  • Better community integration, including with school and college
  • Housing support
  • Accessing extracurricular activities
  • To improve young person and carer satisfaction and family functioning
  • The Enhanced Treatment Service has good links with borough based Tier 3 child and adolescent mental health services (CAMHS) and other related services providing care for the young people who require a period of inpatient management

Care Options

Outpatient

Care option: Assessment and treatment

Unit: Per package of care

Description: The nature of the work includes intensive case management, home treatment, day care or any combination of the three according to need. The intensity of work provided is flexible, up to a maximum of five weekly contacts. The duration of treatment varies according to individual need, but it is intended that cases are only managed for as long as specialist Tier 4 care is required. Once a case has reached the point where Tier 3 treatment can safely be resumed a planned handover to the locality CAMHS service is arranged, using the Care Programme Approach as required.

A comprehensive operational policy covers the following issues:
 

  • Risk assessment process including management of serious untoward incidents (SUI)
    Action following missed appointments/absence
  • Protocol for responding to self-harm events
  • Frequency and nature of telephone support


The Enhanced Treatment Service (ETS) team operates 8am to 8pm Monday to Saturday.

When a new case is referred as an inpatient for enhanced treatment an assessment is undertaken and as soon as the clinical profile is consistent with intensive community treatment the young person and their family is offered enhanced treatment in consultation with inpatient professionals and Enhanced Treatment Service staff and the relevant Tier 3 service.

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