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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.

  • 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

  •  Tools to improve young peoples’ access to education, social care and leisure
  • Crisis resolution, crisis prevention and safety planning
  • Evidence-based psychological therapies, including cognitive behavioural therapy (CBT), family therapy, dialectical behaviour therapy (DBT), mentalization based therapy and parenting workshops
  • Skills groups to develop emotional regulation capacity, mindfulness, interpersonal skills, social skills, facilitate behavioural activation and cognitive restructuring
  • Physical health checks and monitoring


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 between the ages 12 and 18, who need support re-integrating into the community and/or whose needs are greater than what can be supported in Tier 3 CAMHS
  • Residents of South London and Maudsley Boroughs (Croydon, Lambeth, Lewisham and Southwark)
  • Referrals are made via the SLAM CAMHS bed management service

Outcomes

  • Reduced risk of future hospital (re)admission(s), through enhanced therapeutic engagement between the young person and community services
  • Supported re-integration into the community from inpatient services
  • Reduction in self-harm episodes and suicidal ideation, especially during the period of maximum risk (the week following discharge from inpatient care)
  • Improved independence, such as independent travel and shopping
  • Improved community engagement, including with school, college and extracurricular activities
  • Improved young person and carer satisfaction and family functioning

 

Care Options

When ETS receives a referral, our first step is to arrange a comprehensive assessment by liaising directly with the young person, their parents or carers, and other relevant professionals involved in their care.

Assessments are conducted flexibly to ensure comfort and accessibility for each young person. Depending on individual preferences and clinical needs, they may occur at home, in community settings, alongside other professional services, or in inpatient environments. You may visit the ETS hub as part of the assessment.

We invite the young person to share their experiences, challenges, and perspectives during the assessment. We will also ask targeted clinical questions to understand their mental health needs thoroughly as well as identifying strengths and protective factors. Consent is essential; young people must willingly agree to engage with ETS and actively participate in the assessment process.

Following the assessment, we communicate our findings and decisions and propose the next steps clearly to the young person, their parents or carers, and the wider professional network involved in their care.

Types of Care

ETS care packages include intensive case management, home treatment, day treatment or any combination according to need. The intensity of work and duration of treatment varies, 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 local CAMH service is arranged, using the Care Programme Approach.

  • Intensive Case Management: Each young person is assigned a care co-ordinator and support worker(s) who assist the individual and the family in accessing mental health treatment programs, facilitates coordination between the systems involved, and links to community resources.
  • Home Treatment: Needs-based assessments and psychological and practical help can be provided at the young person’s home.
  • Day Treatment: A structured programme is available on site which comprises 1:1 support sessions and therapeutic groups, including: art group, sensory group, cooking skills, DBT group/support circle, and parent group.
  • Access to an Education Provision: Young people requiring educational support can access the Bethlem and Maudsley Hospital School (located on site).
  • Outreach Work: Members of the care team may visit young people in the community or on the ward to meet their individual needs.

ETS aims to engage family members and carers in all aspects of the young person’s care. Ultimately, ETS interventions aim to improve caregivers parenting practice and the family emotional climate, and provide psychoeducation and advice tailored to the individual young person’s needs. Each treatment plan is designed in collaboration with the young person and their carer(s).

Care Team — Staff at ETS work in a collaborative way with young people and their family or carer(s) to support their path to recovery. We provide a multidisciplinary approach to assessment and treatment informed by evidence-based practice. We work closely with young people’s community CAMHS team and other professionals involved in their care and recovery, to ensure continuity of care.

Consultant Psychiatrists – The ETS consultant psychiatrists are friendly and approachable doctors who are experts in helping young people with mental health difficulties. They provide psychiatric assessments and treatment for young people including providing medication management. Working in partnership with the young person, parents/carers, and other professionals at ETS, they help develop effective and mutually agreed care plans to support the young person’s recovery.

Care Co-Ordinators – A Care-Coordinator at ETS can be a Nurse, Psychologist, Youth Intensive Psychological Practitioner, Social Worker or Occupational Therapist. They help young people access mental health treatment programs between their ETS care team, community CAMHS team and other services and provisions. Together with the young person and their family or carer, they will create a care plan and safety plan to support keeping the young person and others safe. They work together with other professionals in their care team such as their consultant, occupational therapist, psychologist and support staff, using a young person-centred approach.

Occupational Therapists – The Occupational Therapists (OT) at ETS provide valuable support by equipping young people with the tools and techniques necessary to effectively manage stress and achieve a fulfilling work-life balance. They understand the importance of making meaningful connections and getting the balance of activities right so the young person can develop, achieve and enjoy everyday life. OTs support recovery through therapeutic activities and groups, such as sensory and art group and living skills groups such as cooking and gardening.

Social Workers – The Social Workers contribute social and safeguarding expertise to care planning, alongside the multidisciplinary ETS team, providing extra support to help keep young people safe. They help young people and their families access the care and support they need to live a safe, healthy life. They promote a holistic approach, considering the young person and their family’s specific needs and support them in the context of their environment.

Psychology Team – The psychology team consists of two Youth Intensive Psychology Practitioners (YIPP) and a Clinical Psychologist. They support the young person to develop coping strategies, track progress through outcome measures, and help formulate and plan care to provide personalised support. They offer 1:1 time with young people, providing a space to explore their experiences and develop strategies tailored to their needs. They also facilitate group sessions, including a psychology informed group which offers a safe space for reflection, emotional support, and skill-building.

Support Workers – ETS support workers support young people in the day hospital service and with outreach in the community. As part of the care team, they support personalised care planning and help young people work towards their recovery goals. This may be helping them with practical daily living tasks, delivering therapeutic treatment interventions such as behavioural activation or exposure work, and help them explore and learn new skills and hobbies. While on site, they support young people to attend education and help run day programme activities and groups, such as art, cooking, outdoor and games groups.

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