Good practice example 7 -African Caribbean FamilySupport Project (ACFSP)in NottinghamElements <strong>of</strong> good practiceThe African Caribbean Family Support Project(ACFSP) is a dedicated NHS clinical psychologyservice for children <strong>and</strong> young people, aged 0-19years <strong>of</strong> African, African Caribbean <strong>and</strong> DualHeritage origins, part <strong>of</strong> a larger Child <strong>and</strong>Adolescent Clinical Psychology Department.The service is for those experiencing <strong>the</strong>following sorts <strong>of</strong> difficulties: behaviourproblems; anxiety; bereavement; racism;bullying; ethnic identity issues; eating difficulties;family relationship difficulties; children withspecial needs <strong>and</strong> developmental difficulties, eg.autism.Partnership working includes a support groupfor White mo<strong>the</strong>rs <strong>of</strong> children with DualHeritage; a Connexions mentor; a forum for <strong>the</strong>psychological needs <strong>of</strong> refugee <strong>and</strong> asylumseekerchildren <strong>and</strong> young people <strong>and</strong> a forumfor <strong>the</strong> emotional well-being <strong>of</strong> Black <strong>and</strong>Dual Heritage children.Good practice example 8 -Antenna in North London1A Tier 2 service forBME young peoplecan work well if basedin <strong>the</strong> community <strong>and</strong>targeted on aparticular BME group.It can <strong>the</strong>n developprovision in aculturally appropriate<strong>and</strong> culturally sensitivemanner, in a waythat explicitlyacknowledges <strong>the</strong>importance <strong>of</strong> issuesrelated to culturalidentity <strong>and</strong>experiences <strong>of</strong> racism,using culturallyappropriate resources<strong>and</strong> <strong>of</strong>fering families<strong>the</strong> choice <strong>of</strong> aBlack worker.2 Good practicedepends on workingclosely with parents<strong>and</strong> carers <strong>and</strong> ina way that isnon-stigmatising.Barriers to <strong>access</strong> maybe overcome throughdeveloping meaningfullinks in <strong>the</strong> community<strong>and</strong> voluntary sector<strong>and</strong> encouraging selfreferral<strong>and</strong> referralsfrom non-statutoryorganisations.3 The careful matching<strong>of</strong> young people tovolunteers, <strong>and</strong> <strong>the</strong> timeallowed for thisrelationship to develop,promotes trust <strong>and</strong> <strong>the</strong>basis from which towork throughissues whilst doing‘fun’ activities.4 It is good practice, inorder to maintain<strong>access</strong>ible <strong>and</strong>acceptable targetedservices for BMEyoung people, thatTier 2 services such asthose describedabove are representedon local CAMHplanning groups.5 Good practice includescareful monitoring <strong>of</strong><strong>access</strong> <strong>and</strong> outcomes<strong>of</strong> provision for BMEyoung people, <strong>and</strong> in<strong>the</strong> ACFSP may beindicated by anincrease in referrals toClinical Psychology <strong>of</strong>Black children from6% prior to its settingup, to 16% <strong>of</strong>total referrals afterthree years.6 These services can,through consultation,develop greaterunderst<strong>and</strong>ing <strong>of</strong>,<strong>and</strong> more work withparticular subgroupssuch as Dual Heritagechildren <strong>and</strong><strong>the</strong>ir families.Initially funded by <strong>the</strong> King’s Fund <strong>and</strong>Department <strong>of</strong> Health, Antenna is now astatutory service <strong>of</strong>fered by Barnet, Enfield <strong>and</strong>Haringey Mental Health Trust. AntennaOutreach Service was set up in 1999 to <strong>of</strong>fersupport for young people aged 16-25 who areBlack African or Black African Caribbeansuffering from mental health problems. Theservice operates throughout <strong>the</strong> week from9am- 5pm, <strong>of</strong>fers a 24-hour helpline 365 daysper year <strong>and</strong> a limited service at <strong>the</strong> weekends.It is essentially based on a communitydevelopment model.Antenna works with a wide range <strong>of</strong> services foryoung people across North London, includingyouth services, schools <strong>and</strong> drug services <strong>of</strong>feringa range <strong>of</strong> social, psychological <strong>and</strong> medicaltreatments to young people. The project <strong>of</strong>ferssupport to parents <strong>and</strong> carers <strong>and</strong> <strong>the</strong>re is anoutreach service <strong>of</strong>fering home visiting support.O<strong>the</strong>r services include home tuition <strong>and</strong>opportunities for voluntary community workthrough local churches.A key aim <strong>of</strong> Antenna’s work has been to buildcontact <strong>and</strong> develop networks between peoplewith mental health problems <strong>and</strong> <strong>the</strong> rest <strong>of</strong> <strong>the</strong>Issues <strong>of</strong> concern1Targeted Tier 2services for <strong>the</strong> BMEcommunity are not<strong>of</strong>ten included inlocal CAMHSstrategic planning.2 If commissioned atall, funding forservices such as <strong>the</strong>secommunity <strong>and</strong> to help young people to develop<strong>the</strong> skills that allow <strong>the</strong>m to take part inmainstream activities. An active young people’sgroup performs music <strong>and</strong> gives presentationsabout mental health issues at both local <strong>and</strong>national events. The project has been highlycommended by <strong>the</strong> Department <strong>of</strong> Health <strong>and</strong>has won a Modernisation Award for its activities.Antenna has identified <strong>the</strong> following as key tois usually on a projectbasis so that <strong>the</strong>ycannot be sustained,<strong>and</strong> it is unlikely thatmainstream serviceswill benefit from <strong>the</strong>learning <strong>and</strong> experiencethat has been gained.3Services targeted at aparticular BME groupmay mean that <strong>the</strong>needs <strong>of</strong> a differentgroup are not takenaccount <strong>of</strong>; forexample, in <strong>the</strong> ACFSP,over three years <strong>the</strong>proportion <strong>of</strong> referralsfor Asian families fellfrom 8% to 4%.what has made <strong>the</strong> project successful to date:a commitment to training <strong>and</strong> supporting itsstaff; a focus on developing good engagementskills; <strong>the</strong> service having a clear vision <strong>and</strong>expectations, backed by good clinical,administrative <strong>and</strong> medical systems; <strong>the</strong>development <strong>of</strong> effective community networks<strong>and</strong> avenues for information sharing.12
Tier 3 CAMHSIn providing for local BMEyoung people, specialistCAMHS Tier 3 teams havelargely recruited workersfrom <strong>the</strong> relevant localcommunities or developedexpertise in working withinterpreters.The CAMHSteams in Bradford <strong>and</strong>in North Kensingtondemonstrate good practicein this respect.Good practice example 9 - Bradford CAMHS bilingual health workersBilingual health support workers are a part <strong>of</strong> <strong>the</strong>clinical team with <strong>the</strong>ir own pr<strong>of</strong>essional status.Their role is not limited to interpreting <strong>and</strong> linkwork. Bilingual health support workers alreadywork within several differing perspectives such astranscultural developmental frameworks <strong>and</strong>different <strong>the</strong>oretical perspectives.They carry out <strong>the</strong> following work: Interpreting. Link work – in addition to interpreting, <strong>the</strong>irrole is to identify <strong>and</strong> underst<strong>and</strong> <strong>the</strong> needs <strong>of</strong><strong>the</strong> client <strong>and</strong> support <strong>the</strong>m to make informedchoices about services. Advocate for <strong>the</strong> family - <strong>the</strong> workerrepresents <strong>the</strong> family’s interests <strong>and</strong> speaks onbehalf <strong>of</strong> <strong>the</strong> user. Cultural broker - acting as a culturalconsultant for <strong>the</strong> service <strong>and</strong> giving meaning to<strong>the</strong> client’s responses as well as being <strong>the</strong>channel for communication. Bilingual worker - takes on a <strong>the</strong>rapeutic rolewith <strong>the</strong> family. There are occasions when <strong>the</strong>worker has been able to make progress with <strong>the</strong>mo<strong>the</strong>r, although CAMHS have not been able toengage. Networking <strong>and</strong> outreach – bilingual workersact as consistent links between CAMHS,community groups, voluntary groups <strong>and</strong>individual families. This link enables CAMHSworkers to engage with <strong>the</strong>se groups <strong>and</strong> fur<strong>the</strong>rfacilitate positive working relationships. Directory <strong>of</strong> o<strong>the</strong>r agencies - <strong>the</strong> move <strong>into</strong>Primary Cares Trusts has enabled each teamwithin CAMHS to focus on its “own patch” interms <strong>of</strong> o<strong>the</strong>r resources within <strong>the</strong> community.Each team has its own directory <strong>of</strong>voluntary/community agencies, places <strong>of</strong>worship etc. <strong>and</strong> <strong>the</strong> names <strong>of</strong> agencies <strong>and</strong>contact persons who provide a culturallysensitive service. The bilingual workers havehelped to add to <strong>the</strong> directories through <strong>the</strong>irlinks with o<strong>the</strong>r groups.The bilingual health support workers wereinvolved in an audit <strong>of</strong> referrals <strong>of</strong> Black <strong>and</strong>minority ethnic children that showed: Referrals not reflecting <strong>the</strong> clinical need in <strong>the</strong>community - staff in <strong>the</strong> service have been awarefor a long time that <strong>the</strong> percentage <strong>of</strong> referralsreceived by CAMHS did not reflect <strong>the</strong> clinicalneed in <strong>the</strong> minority ethnic community.(continued on page 14)13
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