Cathy Street - Academia.edu (original) (raw)
Papers by Cathy Street
Psychological Medicine, 2021
Background Poor transition planning contributes to discontinuity of care at the child–adult menta... more Background Poor transition planning contributes to discontinuity of care at the child–adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC). Methods A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and shari...
Social Policy & Administration, 2001
The introduction of market principles into public services in the s meant that British local ... more The introduction of market principles into public services in the s meant that British local authorities were required to develop complaints procedures. In the case of services for children and families, the Children Act required the appointment of an "independent person". This article describes the findings from a research study conducted in . A total of nineteen independent people from a range of London boroughs participated. It was found that young people themselves rarely use this system designed to protect their rights. As "sole traders" in adversarial situations between social services personnel and complainants, the independent people were constantly negotiating their position. Depending upon the issue, they are required to move skilfully between conciliation and formal investigation. The findings will be useful to local authorities using independent people, and to the independent people themselves who are largely unsupported in their roles.
BMC Pediatrics, 2020
Background Mental health disorders in the child and adolescent population are a pressing public h... more Background Mental health disorders in the child and adolescent population are a pressing public health concern. Despite the high prevalence of psychopathology in this vulnerable population, the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) has many obstacles such as deficiencies in planning, organisational readiness and policy gaps. All these factors contribute to an inadequate and suboptimal transition process. A suite of measures is required that would allow young people to be assessed in a structured and standardised way to determine the on-going need for care and to improve communication across clinicians at CAMHS and AMHS. This will have the potential to reduce the overall health economic burden and could also improve the quality of life for patients travelling across the transition boundary. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Health Care) project aims to address t...
Children and Youth Services Review
Abstract Background Local government public sector children’s services working with vulnerable ch... more Abstract Background Local government public sector children’s services working with vulnerable children in England are faced with challenging cases involving potentially harmful digital/online risks. All services have a duty to safeguard. Educators and key professionals in children’s services such as in social care, mental health, youth justice, voluntary sector advice centres or policing may be involved. Yet little is known about how these services identify, assess, refer and respond to such cases. Aim This study aims to explore how local services working with children and young people, including social care, health and the police, address cases with digital components among children and adolescents and how equipped they are to do so. Methods Using semi-structured interviews, this study interviewed 14 participants within 10 services such as mental health, social care, youth justice, teenage pregnancy prevention, voluntary sector online youth counselling, school nursing and children’s education inspection and safeguarding services. Interviews were transcribed and thematically analysed. Results A narrowly focused awareness of online risk was noticed among all participants, reflecting an emphasis on a singular target (e.g. Child Sexual Exploitation - CSE). This led frontline staff to omit exploration of wider online risks or antecedents of grooming. The outcome therefore was a lack of data on harms other than CSE or sharing of explicit images, and limited knowledge of a wider range of fast changing risks to children, which could inform prevention. Assessment tools seemed generic and focus heavily on CSE or social media; some omitted online risk unless safeguarding issues were raised. Furthermore, multi-agency collaboration was hampered by simplistic or no referral mechanisms for evidence involving online risks. Finally, it was also apparent that there is a lack of structured and mandatory training programmes around online risk and children and young people’s digital lives. Conclusion Online risks need careful consideration within children’s services’ cases and to be more systematically embedded within practice. The findings are crucial in guiding services towards modernising their methods, advancing their training and assessment tools to enhance multi-agency collaboration in cases involving vulnerable children.
Frontiers in Psychiatry, 2022
BackgroundIn mental health, transition refers to the pathway of young people from child and adole... more BackgroundIn mental health, transition refers to the pathway of young people from child and adolescent to adult services. Training of mental health psychiatrists on transition-related topics offers the opportunity to improve clinical practice and experiences of young people reaching the upper age limit of child and adolescent care.MethodsNational psychiatrist's organizations or experts from 21 European countries were surveyed 1/ to describe the status of transition in adult psychiatry (AP) and child and adolescent psychiatry (CAP) postgraduate training in Europe; 2/ to explore the amount of cross-training between both specialties. This survey was a part of the MILESTONE project aiming to study and improve the transition process of young people at the service boundary.ResultsTransition was a mandatory topic in the AP curriculum of 1/19 countries (5%) and in the CAP curriculum of 4/17 countries (24%). Most topics relevant for transition planning were addressed during AP training i...
Modified critical appraisal criteria for empirical studies (from Hawker et al., [28]). A validate... more Modified critical appraisal criteria for empirical studies (from Hawker et al., [28]). A validated critical appraisal tool for empirical studies. (DOCX 15Â kb)
Table S6. Child and adolescent psychiatry training in Europe - Available data detailed for each c... more Table S6. Child and adolescent psychiatry training in Europe - Available data detailed for each country (2). (XLS 39 kb)
Table S5. Child and adolescent psychiatry training in Europe - Available data detailed for each c... more Table S5. Child and adolescent psychiatry training in Europe - Available data detailed for each country (1). (XLS 41 kb)
Table S4. General and adult psychiatry training in Europe - Available data detailed for each coun... more Table S4. General and adult psychiatry training in Europe - Available data detailed for each country (2). (XLS 40 kb)
Children and Youth Services Review
Abstract Background Local government public sector children’s services working with vulnerable ch... more Abstract Background Local government public sector children’s services working with vulnerable children in England are faced with challenging cases involving potentially harmful digital/online risks. All services have a duty to safeguard. Educators and key professionals in children’s services such as in social care, mental health, youth justice, voluntary sector advice centres or policing may be involved. Yet little is known about how these services identify, assess, refer and respond to such cases. Aim This study aims to explore how local services working with children and young people, including social care, health and the police, address cases with digital components among children and adolescents and how equipped they are to do so. Methods Using semi-structured interviews, this study interviewed 14 participants within 10 services such as mental health, social care, youth justice, teenage pregnancy prevention, voluntary sector online youth counselling, school nursing and children’s education inspection and safeguarding services. Interviews were transcribed and thematically analysed. Results A narrowly focused awareness of online risk was noticed among all participants, reflecting an emphasis on a singular target (e.g. Child Sexual Exploitation - CSE). This led frontline staff to omit exploration of wider online risks or antecedents of grooming. The outcome therefore was a lack of data on harms other than CSE or sharing of explicit images, and limited knowledge of a wider range of fast changing risks to children, which could inform prevention. Assessment tools seemed generic and focus heavily on CSE or social media; some omitted online risk unless safeguarding issues were raised. Furthermore, multi-agency collaboration was hampered by simplistic or no referral mechanisms for evidence involving online risks. Finally, it was also apparent that there is a lack of structured and mandatory training programmes around online risk and children and young people’s digital lives. Conclusion Online risks need careful consideration within children’s services’ cases and to be more systematically embedded within practice. The findings are crucial in guiding services towards modernising their methods, advancing their training and assessment tools to enhance multi-agency collaboration in cases involving vulnerable children.
Frontiers in Psychiatry, 2022
BackgroundIn mental health, transition refers to the pathway of young people from child and adole... more BackgroundIn mental health, transition refers to the pathway of young people from child and adolescent to adult services. Training of mental health psychiatrists on transition-related topics offers the opportunity to improve clinical practice and experiences of young people reaching the upper age limit of child and adolescent care.MethodsNational psychiatrist's organizations or experts from 21 European countries were surveyed 1/ to describe the status of transition in adult psychiatry (AP) and child and adolescent psychiatry (CAP) postgraduate training in Europe; 2/ to explore the amount of cross-training between both specialties. This survey was a part of the MILESTONE project aiming to study and improve the transition process of young people at the service boundary.ResultsTransition was a mandatory topic in the AP curriculum of 1/19 countries (5%) and in the CAP curriculum of 4/17 countries (24%). Most topics relevant for transition planning were addressed during AP training i...
Modified critical appraisal criteria for empirical studies (from Hawker et al., [28]). A validate... more Modified critical appraisal criteria for empirical studies (from Hawker et al., [28]). A validated critical appraisal tool for empirical studies. (DOCX 15Â kb)
Table S6. Child and adolescent psychiatry training in Europe - Available data detailed for each c... more Table S6. Child and adolescent psychiatry training in Europe - Available data detailed for each country (2). (XLS 39 kb)
Table S5. Child and adolescent psychiatry training in Europe - Available data detailed for each c... more Table S5. Child and adolescent psychiatry training in Europe - Available data detailed for each country (1). (XLS 41 kb)
Table S4. General and adult psychiatry training in Europe - Available data detailed for each coun... more Table S4. General and adult psychiatry training in Europe - Available data detailed for each country (2). (XLS 40 kb)
SPIRIT 2013 Checklist: recommended items to address in a clinical trial protocol and related docu... more SPIRIT 2013 Checklist: recommended items to address in a clinical trial protocol and related documents. (DOC 122 kb)
Mental Health Practice, 2001
Understanding and supporting troubled and troublesome girls and young women, 2005
Clinical Child Psychology and Psychiatry, 2011
The improved joint working between child and adolescent mental health services (CAMHS) and school... more The improved joint working between child and adolescent mental health services (CAMHS) and schools is a policy priority. Although there have been a range of school-based initiatives and studies on teachers' awareness of mental health issues, there has been limited evidence on the training needs of CAMHS practitioners. The aim of this study was to explore how much CAMHS staff know about educational issues and how confident they feel working collaboratively with education colleagues. Ninety-six staff from four specialist CAMHS completed a questionnaire with 40 items on perceptions of knowledge, practice and attitudes towards educational issues and services, and three case vignettes. Despite the fact that participants reported frequent contact with children with education-related needs and with education services, they also highlighted concerns about their level of training and skills in this regard. Perceptions of knowledge and attitudes significantly predicted response to case vignettes. Previous training and experience were associated with knowledge, but did not predict case vignettes scores. The results suggest that training of CAMHS staff should be integral to all services in helping improve their understanding of school and education systems, improve clinical skills in detecting education-related mental health problems, and develop strategies in increasing joint working.
Psychological Medicine, 2021
Background Poor transition planning contributes to discontinuity of care at the child–adult menta... more Background Poor transition planning contributes to discontinuity of care at the child–adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC). Methods A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and shari...
Social Policy & Administration, 2001
The introduction of market principles into public services in the s meant that British local ... more The introduction of market principles into public services in the s meant that British local authorities were required to develop complaints procedures. In the case of services for children and families, the Children Act required the appointment of an "independent person". This article describes the findings from a research study conducted in . A total of nineteen independent people from a range of London boroughs participated. It was found that young people themselves rarely use this system designed to protect their rights. As "sole traders" in adversarial situations between social services personnel and complainants, the independent people were constantly negotiating their position. Depending upon the issue, they are required to move skilfully between conciliation and formal investigation. The findings will be useful to local authorities using independent people, and to the independent people themselves who are largely unsupported in their roles.
BMC Pediatrics, 2020
Background Mental health disorders in the child and adolescent population are a pressing public h... more Background Mental health disorders in the child and adolescent population are a pressing public health concern. Despite the high prevalence of psychopathology in this vulnerable population, the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) has many obstacles such as deficiencies in planning, organisational readiness and policy gaps. All these factors contribute to an inadequate and suboptimal transition process. A suite of measures is required that would allow young people to be assessed in a structured and standardised way to determine the on-going need for care and to improve communication across clinicians at CAMHS and AMHS. This will have the potential to reduce the overall health economic burden and could also improve the quality of life for patients travelling across the transition boundary. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Health Care) project aims to address t...
Children and Youth Services Review
Abstract Background Local government public sector children’s services working with vulnerable ch... more Abstract Background Local government public sector children’s services working with vulnerable children in England are faced with challenging cases involving potentially harmful digital/online risks. All services have a duty to safeguard. Educators and key professionals in children’s services such as in social care, mental health, youth justice, voluntary sector advice centres or policing may be involved. Yet little is known about how these services identify, assess, refer and respond to such cases. Aim This study aims to explore how local services working with children and young people, including social care, health and the police, address cases with digital components among children and adolescents and how equipped they are to do so. Methods Using semi-structured interviews, this study interviewed 14 participants within 10 services such as mental health, social care, youth justice, teenage pregnancy prevention, voluntary sector online youth counselling, school nursing and children’s education inspection and safeguarding services. Interviews were transcribed and thematically analysed. Results A narrowly focused awareness of online risk was noticed among all participants, reflecting an emphasis on a singular target (e.g. Child Sexual Exploitation - CSE). This led frontline staff to omit exploration of wider online risks or antecedents of grooming. The outcome therefore was a lack of data on harms other than CSE or sharing of explicit images, and limited knowledge of a wider range of fast changing risks to children, which could inform prevention. Assessment tools seemed generic and focus heavily on CSE or social media; some omitted online risk unless safeguarding issues were raised. Furthermore, multi-agency collaboration was hampered by simplistic or no referral mechanisms for evidence involving online risks. Finally, it was also apparent that there is a lack of structured and mandatory training programmes around online risk and children and young people’s digital lives. Conclusion Online risks need careful consideration within children’s services’ cases and to be more systematically embedded within practice. The findings are crucial in guiding services towards modernising their methods, advancing their training and assessment tools to enhance multi-agency collaboration in cases involving vulnerable children.
Frontiers in Psychiatry, 2022
BackgroundIn mental health, transition refers to the pathway of young people from child and adole... more BackgroundIn mental health, transition refers to the pathway of young people from child and adolescent to adult services. Training of mental health psychiatrists on transition-related topics offers the opportunity to improve clinical practice and experiences of young people reaching the upper age limit of child and adolescent care.MethodsNational psychiatrist's organizations or experts from 21 European countries were surveyed 1/ to describe the status of transition in adult psychiatry (AP) and child and adolescent psychiatry (CAP) postgraduate training in Europe; 2/ to explore the amount of cross-training between both specialties. This survey was a part of the MILESTONE project aiming to study and improve the transition process of young people at the service boundary.ResultsTransition was a mandatory topic in the AP curriculum of 1/19 countries (5%) and in the CAP curriculum of 4/17 countries (24%). Most topics relevant for transition planning were addressed during AP training i...
Modified critical appraisal criteria for empirical studies (from Hawker et al., [28]). A validate... more Modified critical appraisal criteria for empirical studies (from Hawker et al., [28]). A validated critical appraisal tool for empirical studies. (DOCX 15Â kb)
Table S6. Child and adolescent psychiatry training in Europe - Available data detailed for each c... more Table S6. Child and adolescent psychiatry training in Europe - Available data detailed for each country (2). (XLS 39 kb)
Table S5. Child and adolescent psychiatry training in Europe - Available data detailed for each c... more Table S5. Child and adolescent psychiatry training in Europe - Available data detailed for each country (1). (XLS 41 kb)
Table S4. General and adult psychiatry training in Europe - Available data detailed for each coun... more Table S4. General and adult psychiatry training in Europe - Available data detailed for each country (2). (XLS 40 kb)
Children and Youth Services Review
Abstract Background Local government public sector children’s services working with vulnerable ch... more Abstract Background Local government public sector children’s services working with vulnerable children in England are faced with challenging cases involving potentially harmful digital/online risks. All services have a duty to safeguard. Educators and key professionals in children’s services such as in social care, mental health, youth justice, voluntary sector advice centres or policing may be involved. Yet little is known about how these services identify, assess, refer and respond to such cases. Aim This study aims to explore how local services working with children and young people, including social care, health and the police, address cases with digital components among children and adolescents and how equipped they are to do so. Methods Using semi-structured interviews, this study interviewed 14 participants within 10 services such as mental health, social care, youth justice, teenage pregnancy prevention, voluntary sector online youth counselling, school nursing and children’s education inspection and safeguarding services. Interviews were transcribed and thematically analysed. Results A narrowly focused awareness of online risk was noticed among all participants, reflecting an emphasis on a singular target (e.g. Child Sexual Exploitation - CSE). This led frontline staff to omit exploration of wider online risks or antecedents of grooming. The outcome therefore was a lack of data on harms other than CSE or sharing of explicit images, and limited knowledge of a wider range of fast changing risks to children, which could inform prevention. Assessment tools seemed generic and focus heavily on CSE or social media; some omitted online risk unless safeguarding issues were raised. Furthermore, multi-agency collaboration was hampered by simplistic or no referral mechanisms for evidence involving online risks. Finally, it was also apparent that there is a lack of structured and mandatory training programmes around online risk and children and young people’s digital lives. Conclusion Online risks need careful consideration within children’s services’ cases and to be more systematically embedded within practice. The findings are crucial in guiding services towards modernising their methods, advancing their training and assessment tools to enhance multi-agency collaboration in cases involving vulnerable children.
Frontiers in Psychiatry, 2022
BackgroundIn mental health, transition refers to the pathway of young people from child and adole... more BackgroundIn mental health, transition refers to the pathway of young people from child and adolescent to adult services. Training of mental health psychiatrists on transition-related topics offers the opportunity to improve clinical practice and experiences of young people reaching the upper age limit of child and adolescent care.MethodsNational psychiatrist's organizations or experts from 21 European countries were surveyed 1/ to describe the status of transition in adult psychiatry (AP) and child and adolescent psychiatry (CAP) postgraduate training in Europe; 2/ to explore the amount of cross-training between both specialties. This survey was a part of the MILESTONE project aiming to study and improve the transition process of young people at the service boundary.ResultsTransition was a mandatory topic in the AP curriculum of 1/19 countries (5%) and in the CAP curriculum of 4/17 countries (24%). Most topics relevant for transition planning were addressed during AP training i...
Modified critical appraisal criteria for empirical studies (from Hawker et al., [28]). A validate... more Modified critical appraisal criteria for empirical studies (from Hawker et al., [28]). A validated critical appraisal tool for empirical studies. (DOCX 15Â kb)
Table S6. Child and adolescent psychiatry training in Europe - Available data detailed for each c... more Table S6. Child and adolescent psychiatry training in Europe - Available data detailed for each country (2). (XLS 39 kb)
Table S5. Child and adolescent psychiatry training in Europe - Available data detailed for each c... more Table S5. Child and adolescent psychiatry training in Europe - Available data detailed for each country (1). (XLS 41 kb)
Table S4. General and adult psychiatry training in Europe - Available data detailed for each coun... more Table S4. General and adult psychiatry training in Europe - Available data detailed for each country (2). (XLS 40 kb)
SPIRIT 2013 Checklist: recommended items to address in a clinical trial protocol and related docu... more SPIRIT 2013 Checklist: recommended items to address in a clinical trial protocol and related documents. (DOC 122 kb)
Mental Health Practice, 2001
Understanding and supporting troubled and troublesome girls and young women, 2005
Clinical Child Psychology and Psychiatry, 2011
The improved joint working between child and adolescent mental health services (CAMHS) and school... more The improved joint working between child and adolescent mental health services (CAMHS) and schools is a policy priority. Although there have been a range of school-based initiatives and studies on teachers' awareness of mental health issues, there has been limited evidence on the training needs of CAMHS practitioners. The aim of this study was to explore how much CAMHS staff know about educational issues and how confident they feel working collaboratively with education colleagues. Ninety-six staff from four specialist CAMHS completed a questionnaire with 40 items on perceptions of knowledge, practice and attitudes towards educational issues and services, and three case vignettes. Despite the fact that participants reported frequent contact with children with education-related needs and with education services, they also highlighted concerns about their level of training and skills in this regard. Perceptions of knowledge and attitudes significantly predicted response to case vignettes. Previous training and experience were associated with knowledge, but did not predict case vignettes scores. The results suggest that training of CAMHS staff should be integral to all services in helping improve their understanding of school and education systems, improve clinical skills in detecting education-related mental health problems, and develop strategies in increasing joint working.