Behaviour Resource Service

Behaviour Resource Service

Dr. Ciaran Kelly, Child and Adolescent Psychiatrist, BRS

Julia Waldman, Principal Researcher, BRS Evaluation Study, Dept. Social Work Studies, University of Southampton

Behaviour Resource Service

Outline of Presentation• Brief Overview of BRS• Characteristics of the service users• Multi – professional issues• Inter-agency issues• Influencing individual and systems changes• General comments

Behaviour Resource Service

Behaviour Resource Service• Multi agency service: Health, Education & Social

Services, major investment (over 1 million pa to run).

• Jointly planned, funded, staffed.• Residential and community teams.• Children and Young People with complex needs,

causing greatest concern to society (Tier 4 service).• CAMHS Beacon Site.

Behaviour Resource Service

Assessment & Interventions

• Undertake comprehensive assessment addressing: mental & physical health, ‘health’ of personal, professional and social support systems – within residential or community context

• Develop individualised intervention plans, which focus upon:– Assertive outreach to support engagement

– Co-ordinating Networks

Behaviour Resource Service

The characteristics of the service users

• In first 2 years worked with 93 young people (& 38 in discrete LAC service)

• 37% were boys aged 11-13 years and overall 70% boys• high prevalence of known risk factors including parental

mental ill health, lone parent and reconstituted families, difficulties with school disaffected with professional intervention, ½ of research sample have convictions, low in protective factors,

• Approximately half LAC at referral

Behaviour Resource Service

The Multi-profession team(s) – benefits and challenges

• Establishment of a new multi-agency team

• Working together for holistic case perspectives

• Developing the cross-boundary worker

• Balancing assessment and intervention

• Recruitment and retention of nursing and clinical psychology staff

• Differing priorities of residential and community teams

• Provision of appropriate supervision

Behaviour Resource Service

Inter-agency working – strengths and issues

• Sustained involvement of problem-solving management group of senior managers from all 3 agencies

• Influencing new working arrangements within local services

• Management of non co-terminus agency boundaries• Development of pooled budgets• User involvement –level of energy on statutory

partnerships should leave room for voluntary sector and user involvement

Behaviour Resource Service

Influencing change

• Engagement –res. unit via staff ratios, unit size and behaviour management approach, community via form of assertive outreach

• Improvements for some children in placement stability, education inclusion and reconviction rates

• High levels of service satisfaction amongst parents and young people• Some children with severe mental illness require specialist provision and

assessments support funding decisions• Difficulties of attribution• Intractable difficulties of boys with anti-social behaviours and

experiencing disaffection • Placement availability impacts on transition and needs-led choices• Case closure and re-referrals– long-term support needs

Behaviour Resource Service

General comments• Information management – within service and across

agencies

• What happens to the leadership role within an inter-agency democracy (as distinct from management and firefighting functions)

• Mainstreaming – situating innovation within a context of services experiencing change and facing resourcing issues