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SAFER-YMH care bundle for CAMHS Crisis and Liaison services

An investigation into the acceptability of the SAFER-YMH care bundle for transitions out of CAMHS Crisis and Liaison services

Why the research is needed

When a young person requires support from specialist Child and Adolescent Mental Health Services (CAMHS) this will often involve different teams at different times, with the young person moving from one team to another. CAMHS Crisis and Liaison teams are designed to give short term, intensive, support to young people experiencing mental health crisis and aim to reduce the need for hospital admission. However, when the time comes to be discharged by these teams it can be a point of increased risk and vulnerability, where young people and their families can lack support and information about ongoing care. Improvement of movements between teams and services will improve care experiences for young people, families, and professionals.

What is already known about the subject

The NHS Improvement SAFER MH bundle was developed for adults to improve discharge from hospital and the move to community services. This has been adapted for use in young people being discharged from mental health admissions by a team at the University of Manchester into the SAFER-YMH care bundle.

Who we will be working with

Our study team is made up of researchers from the University of Nottingham, the University of Manchester and the University of Birmingham, clinicians and a PPI representative. During the study we will work with a range of people including clinicians (CAMHS Crisis and Liaison workers, community CAMHS workers and general practitioners), NHS managers, NHS IT teams, commissioners, young people and parents.

How patients and the public are involved

We have a PPI representative with lived experience as part of our study team who will be involved in developing and reviewing all study materials and will be part of monthly reviews of the study’s progress. Young people with experience of CAMHS Crisis or Liaison care, and their parents/ carers will also form two of our focus groups who will give their opinions on the acceptability of the SAFER-YMH care bundle for use in transitions out of CAMHS Crisis and Liaison teams and suggest how this may need to be further adapted for this purpose.

What we will do

A researcher will present the SAFER YMH bundle to groups of people e.g. young people, CAMHS Crisis clinicians etc. For each group we will do a presentation on what the SAFER-YMH bundle involves and we will ask them whether they think this would be an acceptable thing to apply in practice by the CAMHS Crisis and Liaison teams and whether they feel it needs to be adapted in any way before introducing it in practice. We record these groups and we will adapt the care bundle based upon what the feedback was. At the end we will have a version of the bundle which will be presented to service leads and commissioners for further feedback.

What the benefits will be

Discharge from CAMHS Crisis and Liaison teams to the right community teams and services will be safer, quicker, and smoother. This will benefit patients and their families because they will feel their transition is well planned, as well as knowing who to contact for support during the transition process, it will also ensure young people are not lost from care services during the transition between teams which can be unsafe. For clinicians, this will ensure that transitions are safer and easier, reducing some of the stress in their job and freeing up time for patient care.

When the findings will be available

At the end of this study, we will put together a summary of the findings which we will send to everyone who has been involved in the project. We will write the findings into an academic paper which we will publish for people to freely access through the internet. We will also publicise our findings through social media such as twitter and presentations in relevant forums.

How we are planning for implementation

Our intention is that this study will find an acceptable way in which the SAFER-YMH care bundle could be used to improve transitions out of the CAMHS Crisis and Liaison teams. By the end of the study, we hope the tool will be ready for a trial of implementation. We plan to introduce this care bundle in a small area and measure the difference that it makes so that we can see whether this is something which should be introduced across the whole country.


James Roe,