Nursing Children and Young People in Specialist CAMHS Inpatient Settings

Abstract

In this chapter, Tim McDougall looks at the development of inpatient specialist units for children and young people with mental health problems. As with outpatient and community services a process of evolution of services is evident, rather than a planned approach to why nurses are needed on wards and units, again reflecting the ‘taken for granted’ nature of thinking about nursing input. In the light of recurrent tragedies and their impact on children and young people, the absence of a clear strategy to develop nursing skills and the specialist approaches to inpatient care which are common for other nursing areas seems odd, and potentially dangerous for those in our care. Although guidelines do exist, there is little understanding of the use of key skills and knowledge, such as developmental understanding, use of therapeutic relationships in difficult situations, continuous risk and safety planning, and self-care and support for staff. The lack of a standardised recognised training has contributed to this, and to the circularity of difficulties in staff recruitment and retention in a challenging environment.