Adolescent Forensic PsychiatrySpecial Interest Group (AFPSIG)

MINUTES

AFPSIG Meeting

Meeting Room 2, Hilton Hotel, Newcastle
4.30-5.30pm, Wed 1st February 2012

1.Attendance: N. Hindley, A. Blower, O. White, M. Deshpande, G. Bell, E. Staufenberg, L. Sivaprasad, E. Delmage, R. Church, D. Witharana, M. Ali, V. Moore, F. Yarwood, J. Anderson, P. Monks, C. Lengua.

Apologies: P. Misch, A. Kraam.

2. Minutes from last meeting in Cambridge on22nd September 2011 were approved.

3. Update from Executive Committee:

Aileen Blower, representative for Scottish services, was welcomed to the executive committee.

Member / Year of joining / Position
Nick Hindley / 2011 (E)
2002 (C) / Chair
Community and Prisons
Richard Church / 2009 (E)
2007 (C) / Finance Officer
Web Content Editor
Peter Misch / 2002 (C) / Honorary Secretary
Heidi Hales / 2009 (C) / Academic
Paul Monks / 2010 (C) / Independent Sector
Ernest Gralton / 2002 (C) / Forensic Developmental Disability
Ollie White / 2007 (C) / Higher Specialist Training
Aileen Blower / 2011 (C) / Scottish Services
CesarLengua / 2010 (C) / Forensic Faculty Liaison
AbdullahKraam / 2010 (C) / Child & Adolescent Faculty Liaison

4.Update on dual training(Ollie White)

Only three dual trainees in child and adolescent and forensic psychiatry reaching the end of their training in the UK. There are no legal or RCPsych barriers to dual training, in fact the new Dean of the RCPsych (Wendy Burn) is supportive – but it appears that some Deaneries are reluctant to facilitate dual training.The only dual training scheme in the UK (Oxford) will be advertising in July 2012 for the 5-year scheme.

Dual training is also relevent to other subspecialties such as LD; the benefits of collaboration with the LD Faculty were discussed.

Nick Hindley and Ollie White will discuss further action on the subject of dual training.

5.Adolescent Secure and PICU in Scotland (Aileen Blower)

Aileen Blower raised concern around the lack of access to secure / PICU beds for adolescents in Scotland. The local NCG unit is the Roycroft in Newcastle, where several young people have been placed. However, there is a legal obstacle for remand prisoners, who are not permitted to cross the border. In contrast, young people who are bailed can be admitted under a civil section.

Due to a lack of secure mental health provision for young people in Scotland, and the barriers to transfer across the border, young people needing treatment are therefore admitted to adult wards or simply remain in prison, both of which are unacceptable.

The meeting discussed possible routes to rectify this problem, including lobbying the Scottish government (already attempted without success) for amendment to the law. It was noted that the UNCRC and Children’s Commissioners might provide a route to influence government policy and bring about the change in this area.

6.Minimum age of criminal responsibility (MACR) and proposed possible defence of developmental immaturity (Nick Hindley and Enys Delmage)

The Centre for Social Justice published a report on youth justice that suggests a MACR of 12. In view of miscarriages of justice, it is proposed that the defence of developmental immaturity should be reviewed, alongside concepts such as “capacity to commit crime”, as distinct from mental illness. The AFPSIG will be consulted to develop a statement on MACR.

7. Update on mapping of Forensic CAMH services (Nick Hindley)

A mapping exercise of forensic CAMHS provision is underway in collaboration with Caroline Twitchett from the Department of Health, with the aim of establishing what is currently being provided where. The project also aims to explore how a coherent care pathway might be developed.

8.Payment by Results for CAMHS (Richard Church)

A recent proposal from the Department of Health defines clusters in CAMHS by severity of illness/intensity of need, alongside a dimension of complexity. This has gained much initial support across CAMHS, and may be very well suited to forensic CAMHS. Members should look out for a consultation document on the AFPSIG website.

9. It was noted that regarding MHA assessments, s12 doctors and AMHPs should be CAMHS clinicians.

10.C. Lengua, P. Monks and A. Okoye have planned to discuss secure inpatient provision at the interface of independent and NHS units, and to exchange ideas about service provision and quality. There is a degree of uncertainty around how nationally commissioned units will proceed, but it was acknowledged that current commissioning introduces discontinuities. It was proposed that the AFPSIG could have more of a role in promoting communication across secure inpatient services.

11. R. Church’s role as Finance Officer is due to conclude in June 2013 – AFPSIG members were encouraged to consider being nominated for this role.

12. Upcoming meetings/new resources:

  • EFCAP Conference 2012 (European Forensic Child and Adolescent Psychiatry, Psychology and other involved Professions) 7-9th March 2012, Berlin. For more info see
  • The Forensic CAMHS Network( – a multidisciplinary network supported by the AFPSIG. Date for your diary: conference planned for 2nd May 2012 in Manchester
  • ebrainJNC.comNeuropsychiatry Module e-learning resource (Ekkehart Staufenberg)

RC

Feb 2012