Managing treatment closure in challenging circumstances in child mental health services
Child and youth mental health services are currently responding to high levels of need with finite resources. At the same time, data shows that not everyone improves or is better at the end of treatment and, for many, difficulties in their lives will be ongoing. Yet practitioners are not generally trained to manage endings when the person is not better and there is no guidance on this from NICE or from other bodies. The public are taught to expect specialist help will make the difference. In this context, ending mental health treatment can be challenging.
Our interest in this area arose out of conversations that were taking place across a broad range of cross-sector learning events, training and seminars - among them those arising from the i-THRIVE Community of Practice, CORC outcomes research, and ongoing PhD research hosted in the Evidence Based Practice Unit.
During 2017, the Anna Freud Learning Network was in dialogue with practitioners working in a range of settings, and with young people, to fully explore the factors that can make ending treatment a challenge, approaches that are helpful, and how we can improve things.
The practitioners involved in this work shared a rich variety of suggestions and approaches that help them to end treatment in difficult circumstances. Details of this are summarised in the report, and cover these areas:
- Beginning with the ending
- Planning for the ending
- Talking about the ending
- Supporting one another as professionals
- Helpful tips for practitioners
Please note that all treatment endings are different, and that many of these recommendations will make sense in some circumstances but not others.
In this report we review the challenges and suggest some ways forward.