The CAMHS service for the North Kensington Community
The NHS Grenfell Trauma Service for Child and Adolescent Mental Health Services (CAMHS) is a new service which has grown out of the existing local Parkside CAMHS service, in response to the huge and unprecedented need for support for the children and young people of the local community following the fire at Grenfell Tower in June.
On the day of the fire, a number of our CAMHS staff were available to people in the local area, helping out with practicalities and helping parents think about how to explain what happened at Grenfell Tower to their children at time when levels of distress were quite high. We shared a worksheet: “Supporting children after a frightening event” (https://www.cnwl.nhs.uk/wp-content/uploads/After_The_Event.pdf) and were available to help people deal with practical basic issues. Most of the NHS staff team lived or worked in the local area for a number of years and feel a strong sense of connection to people here.
Since the fire, Grenfell CAMHS service has seen over 200 young people up to December 2017.
There is a broad range of services available in the community for young people ranging from listening and counselling services, to leisure activities and art and drama therapy which allow young people an opportunity to express their feelings or distract themselves.
Things like massage, meditation or yoga might also help some young people to relax. The NHS however, offers specialist assessment and treatment for a range of specific conditions that might affect someone’s mental health and emotional wellbeing. Thing includes difficulties managing anger, anxiety, low mood, sleeping or eating difficulties and trauma. Treatments offered are based on research, which tells us ‘what works’, or what has been successful in reducing symptoms in other young people. Two of the treatments offered for trauma are trauma focused cognitive behavioural therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). You can read more about these treatments here:
EMDR helps children process distressing traumatic memories, to reduce their lingering influence and help clients to develop effective coping mechanisms. TF-CBT addresses traumatic experiences and helps children overcome the avoidance of their trauma-related memories, beliefs and feelings. This is done though gradual exposure work so that children can regain a sense of control over the trauma; this mean they will be able to think or talk about the trauma without feelings overwhelmed, and to remove the stigma or shame that might be associated with the trauma. The process might involve retelling and reprocessing details of the events which when repeated has been shown to reduce and extinguish the emotional and behavioural responses associated with the traumatic memory.
Tailoring a service for children
The NHS has expertise in helping people in distress and is accustomed to working across the week, 24 hours a day if needed. This approach was central to the Multisystemic Therapy (MST) intervention delivered by CNWL in previous years, and our team has used this evidenced-based model to transfer knowledge of ‘what works’ for young people.
We know that:
Young people might worry that they are ‘going crazy’. They are not. We have helped children, young people and their parents understand that following such a traumatic event, people will have a variety of responses, all of which are absolutely normal. The young people we are seeing are those who are:
- Not wanting to go to school
- Feel angry for no particular reason
- Feel hopeless or sad
- Don’t want to be left alone
- Have difficulty sleeping
- Experiencing flashbacks
Why we are screening
To help us assess young people’s symptoms we can either ask children directly or, for younger children, ask their parents or carers questions which will help identify exactly what kind of help is needed. It’s a bit like a doctor asking you to describe your symptoms before giving you a prescription – we will ask about your symptoms before figuring out what will best help you.
Some young people are experiencing very understandable reactions to a devastating experience of trauma and loss. We know that there are really good therapies and strategies that we can give to children and families to help them to cope with those feelings.
- Young people can find it difficult to talk about their problems and so we make talking as easy as possible, and offer other ways of dealing with difficult emotions. This has led us to form close working partnerships with voluntary sector providers such as Place2Be, Child Bereavement UK and art therapy provision in schools and in the community. We speak to young people to help them figure out what works for them.
- For some young people, their faith and culture has provided much support; others struggle to make sense of the tragedy.
- There are other things that can help including a good diet and exercise. Our CAMHS and me website has links that young people might find interesting: . (See the CAMHS and Me website: http://camhs.cnwl.nhs.uk/young-people-adolescents/mental-health-tips-coping-strategies/.)
“I received a call from a young person on Boxing Day who was telling me how much she was enjoying the Christmas break and that she didn’t want to be seen for an assessment the next day or talk about Grenfell during the festive period. This is understandable. For many young people, the summer holiday was marked by a tragedy and the Christmas break provided the first ‘stopping point’ to think about what has been happening to their family, friends and community. I told her this was fine we talked about the movies she had been watching. She asked to be seen at school in the New Year and we have arranged to meet at school at the end of the day.”
This marks a newly evolving face of CAMHS, aiming to do ever more outreach and be ever more flexible – we would like to meet children and young people at locations convenient to them, at times convenient to them and when they are ready – and that can take a few attempts and that’s okay!
Our team can work from school, from our base at St Charles’ Hospital or Parkside Clinic as well as range of community venues and hotels.
There is a huge amount of amazing work with children by community leaders, schools, GPs, children’s services and various charities and other organisations around the Grenfell area.
However, from children’s point of view, adults are usually who they turn to for help and guidance, and many of these adults are also in need of support. Young people have described seeing the distress of adults they know well, cry openly and easily. This is unusual for them to see; we often try to protect children from our most intense emotions and this serves as a reminder that Grenfell is not a trauma that has happened to a few individuals, this is a trauma that has affected an entire community.
Our job is to be here and support the community in their recovery. This means continuing the support to schools; undertaking even more screening this year and extending the screening programme to all schools in the borough. We hope to see you at the forthcoming schools’ events, where we will be present to answer any questions that young people and their parents or carers might have.
The NHS is here for everyone, at the heart of the community, which is what the NHS has always been about.
Dr Jai Shree Adhyaru, Counselling Psychologist (Team Lead, Grenfell Trauma Service for CAMHS)
Dr Sara Northey, Clinical Psychologist (Joint Clinical Lead, Grenfell Trauma Service for CAMHS)