Kirwan CAMHS, Australia

Kirwan

Service description

Kirwan is the largest city north of the state capital Brisbane. Total population 169,000. We have regular outreach clinics in Ingham 14,000 & Palm Island, which is an indigenous community, 3,000. 9 Full time Equivalent allied health clinical positions 2 Full time indigenous mental health workers 1 Full time speech pathologist 2.8 Full Time Equivalent consultant psychiatrists (increasing to 3.4 FTE) 2 specific outreach clinics (one is 2-3 days weekly & the other 1 day 2x per month) & in general provide support to some other smaller services in surrounding areas.

Kirwan CAMHS receives approximately 645 referrals per year, accepting around 490.

CAPA experience

Kirwan CAMHS decided to start CAPA in Feb 06. The planning took a month! We had two whole team planning days and a staff training day, including on Motivational Interviewing and Brief Solution Focused Therapy. Our plan was to take written referrals from other clinical services and from GPs (and self-referrals from adolescents); do a daily quick triage of these and if clearly inappropriate we inform the referrer immediately (not many of these); send a letter to the client asking them to call us (except hard to engage clients such as indigenous families in which case our indigenous mental health worker approaches them directly); when the client calls admin, we offer a Choice Appointment. We have Choice appointments three mornings a week, up to three clinicians per morning.

Impact

We do have “priority appointments” available to see clients within 48 hours of referral, but haven’t had to use these since introducing CAPA. Around 50% of Choice clients go on to Partnership. The clients are booked in for Partnership immediately - usually there is no more than a couple of weeks wait for this - or referred on to one of our Specific clinics (ADHD, ASD), or referred to one of the psychiatrists if all they need is a medication review. Zero waiting list. Zero (almost) DNA rate for first appointments.

Were collecting client satisfaction data so hopefully well be able to report back on that later in the year.

What do we like?

Team leader intimately involved in daily review of referrals, planning of Choice appointments and weekly review of flow-through and caseloads. Happy clinicians (people enjoy doing Choice appointments!)

What helped us?

Admin staff who understand the system and can use IT effectively to support it.

Any problems and advice?

There are still some issues around how to fit the Specific clinics (ASD, ADHD, family therapy) into the system without adding too many steps. Were also wondering what will happen when our referrers realise we don’t have a waiting list any more -- there might be a sudden increase in referrals from people who had given up on us before. Were looking at an efficient booking system for doctors time.

And finally

We’re about 2 months into CAPA and so far it has been a resounding success.

CAPA 11 components

This is the rating scale of the 11 components of CAPA: a green light is fully implemented, amber is partial and red is not implemented.

Team photo
No. Component Score
1 Leadership 2
2 Language 2
3 Handle Demand 2
4 Choice Framework 2
5 Full Booking 2
6 Selecting by Skill 2
7 Extended Skills 1
8 Job Plans 1
9 Goal Setting 1
10 Peer Group Supervision 1
11 Team Away Days 1

Kirwan had no red lights and an overall implementation score of 77% = nearly full.