PRIVATE, PRO BONO AND VIRTUAL CHILD & ADULT PSYCHIATRY CONSULTATIONS
 
We accept self-referrals as well as referrals from private, charity and governmental organisations such as Health, Education and Social Care.  It is helpful to receive referrals from General Practice or Paediatrics alongside self-referrals of children.  Details of our referrals process and relevant documents to complete are available at Contact Us for referrers and self-referrers.
 
All referrals are reviewed to ascertain whether we are the appropriate service to effectively meet needs.  Most adult referrals relate to assessment and therapeutic intervention.  Examples of referrals for children and adults can be found on the Home Page. 

Pro bono or reduced fee consultations or services can be arranged; these are usually requested by GPs, social workers or medical directors.  Pro Bono applications are available at Contact Us.
 
Seeing a Psychiatrist offers helpful information regarding what to expect. 
 
Virtual consultations (internet video teleconference, email or telephone) are available for follow up consultation and if clinically appropriate.  

NHS SERVICE PROVISION AND SERVICE DEVELOPMENT
    
We provide short term or long term services within the NHS (National Health Service) in the UK. Our role usually includes assessment and treatment, consultation, management, supervision, training and service development.  Our contracts are mostly longstanding and open ended.  Please see further details on Service Contracts at Contact Us.
  
We are usually (more than 75% of the time) asked to provide input during a period of significant crisis within a team or Trust, often when no resolution has been found or no consultant has accepted a vacant post due to ongoing challenges and risks within the system.
 
We work within the team, as a regular consultant offering regular consultant services; our aim is to provide clarity regarding systemic challenges, concerns and risks, as well as recommendations relating to possible steps forward, which we usually implement whilst working within the team. Significant emphasis is placed on identifying and maintaining existing strengths within a team throughout the process.
 
We usually remain in the placement until the risks or challenges have been resolved, along with the morale of the team.   
 
Working within a team as a regular consultant, whilst aiming to assist with a larger systemic crisis or crises, is often helpful, as it provides permanent team members with an opportunity to openly and confidentially discuss concerns or work experiences with an external and 'safe' person (not permanent in post) with 'new eyes', that now shares the same work environment and clinical risk, and can witness and experience the concerns and risks for themselves.  Permanent staff members sometimes do not want to be the 'named person' in a report relating to another member of staff or the team and often value the opportunity to evidence the challenges to an external person.  This process facilitates assessment of chronic and high risk challenges within complex systems and usually provides significant clarity relating to steps forward to resolve challenges.  Most team members are usually comfortable to put their names in reports and provide written statements themselves as the process continues. 
    
During our placements, we compile a report which includes statistics (number of patients in teams, number misdiagnosed, number started on medication, number of side-effects, complications, comorbidities etc) along with observed challenges, risks (systemic risk assessment), strengths of the team and recommendations for steps forward.
 
These projects or placements usually last 3 to 24 months.  We have had sustained positive outcomes in all placements and we have often been asked to return to satellite teams.   We have thus far accepted more than 15 requests for NHS roles/projects.  We credit our success to the team members for their dedication to the best interest of the children and their willingness and enthusiasm to work collaboratively with us to achieve common goals.  We have often been asked to return to teams and have always received a warm welcome, which is much appreciated. 
  
Our interest within the NHS relates to service development.  It is very important to us to work towards developing and maintaining services (or assisting others to achieve this goal) where professionals work well together, collaboratively within the team and with other services, and this can be achieved if service goals and priorities are agreed upon and shared (the well-being and safety of the child first). 
 
We sometimes accept NHS projects to reduce waiting lists.  Our consultation time is never shortened due to long waiting lists; instead we offer weekend or after hour clinics.  Our appointment slots for new cases (new to us) are 1-2 hours.  It is our opinion that thorough initial assessments will significantly benefit children and families (by reducing the risk of inaccurate diagnoses, less helpful recommendations and treatment plans, and so reducing morbidity and mortality), as well as NHS Trusts, through a high team morale (most professionals enjoy good work and evidence of children making progress) and cost saving (inaccurate diagnoses can lead to months or sometimes years of follow up appointments, therapeutic intervention and prescribing without progress, which can directly affect children's emotional, social and cognitive development and cause other complications).  
 
Our availability to engage in NHS projects vary depending on international service development, provision and outreach projects, and professionals available in the UK.  
  
For details of previous NHS service projects and outcomes or for more information on our services or to request CVs, please Contact Us directly.
 
We sometimes offer pro bono presentations on previous NHS projects for the purpose of learning and morale building.  
  
SERVICE DEVELOPMENT IN DEVELOPING COUNTRIES
 
Some countries have very little specialist children's mental health services.   Governmental initiatives often include improving care for children and we have been contacted by Health Ministries or medical directors to provide ideas or to help with specific targets and plans.

Options to assist with service development may include working with local paediatricians, GPs and adult psychiatrists to identify ways to assist with or facilitate care.  Our services may include direct clinical care and on site service development, usually from our directors, or consultation from the UK.  We aim to be flexible, according to the needs of the local communities.  Projects usually take at least 1 year to develop.  We usually aim to be available to return to existing projects once or twice a year, usually for 2-6 weeks at a time.  More information on Service Contracts are available at Contact Us. 
 
Service Development in different cultural contexts is of significant interest to us, as it directly affects quality of patient care and outcome for children and families.  It is our aim to develop services that are accessible, user-friendly, creative, flexible, evidence based and committed to common goals (the well-being and safety of the child first), alongside local professionals and staff, working collaboratively with local governmental, private and charity Health and Children's organisations.
 
Our work in locations with different cultural contexts, especially where limited specialist services are available, offers us unique opportunities to learn from local professionals and services who often meet children's needs in creative and effective ways.  

One example - no ambulance services existed in an area of 500 000 high risk and high need individuals, the Police took the initiative to offer a free 'hospital service', which not only provided the community with medical access, but the opportunity for the Police to gain trust, become allies with the community and learn more about need and risk.  There is much to learn from every experience.  Most professionals will agree that the most important lesson that we often learn from our colleagues working in areas of high need relates to attitude; nothing is taken for granted, everyone helps and takes every role that can safely be taken, and celebration and gratitude for the little things take centre stage. 
  
Please Contact Us for further information, to request CVs, discuss previous services or discuss service needs and service development options.
   
INTERNATIONAL SERVICE DEVELOPMENT AND SERVICE PROVISION
 
We believe it is very important to spend time working in countries with different cultures, ranging from Ireland, Canada and New Zealand, to smaller countries and islands scattered across the oceans.  Our Service Contracts are usually longstanding and open ended.  Please see Contact Us for further information on our contracts.  

Our directors aim to be available to offer Consultant Child and Adolescent Psychiatry services outside of the UK, where there is a particular need within specialist mental health services or for specialist mental health services.  Initial placement duration is usually between 1-6 months.
 
We aim to be available on a regular basis (once or twice a year for a period of 4-6 weeks) to return to previous roles if required.  Teams often find it helpful to have regular and reliable cover available if permanent staff members go on sick leave, study leave, maternity leave or sabbaticals. Teams, like us, often find it valuable to share knowledge, views and experiences with professionals working in different countries with different cultures, legislation, policies, procedures and practices.

We have completed assignments where we have worked through interpreters in clinically high risk settings.  One example - we provided more or less 100 mental health and risk assessments, including review of physical health, for unaccompanied minors in a period of 2 months. 

Working in different cultural contexts in developed and developing countries facilitates communication in the international psychiatric community and provides doctors and other mental health professionals with the opportunity to learn from each other whilst working together, encouraging education, development and growth as a professional; a unique understanding relating to culture, mental health and service development.   
 
Please Contact Us if you are interested to discuss services or to request CVs. 
 
INTERNATIONAL OUTREACH SERVICES
 
Mental Health Bus International Projects is the international outreach division of CINAPS Ltd.       We offer specialist mental health services to vulnerable, usually hard to reach children, young people and families in high risk and high need settings in developing countries and underprivileged communities in the UK and other developed countries.  Mental Health Bus International Projects is a pro bono service.  
    
Please see www.mentalhealthbus.co.uk for more information, to join us or to support our work.  
 
CHARITABLE WORK
 
We have been fortunate to have had the opportunity to work alongside communities and professionals in deprived areas in developed and developing countries.  These experiences have inspired us and continue to inspire us.  We offer a presentation with several photographs of the challenges and benefits relating to this work, but most importantly, the determination and spirit of generosity of the inspiring communities and our creative international colleagues.  Through this presentation you will see that we learn most from the children and that we gain much more than we can ever give in return.  
 
We have presented this work to several NHS CAMHS (Child and Adolescent Mental Health Service) teams on request and can, for no charge, present it to individuals or organisations who may be interested in knowing more, doing similar work, joining us on a next project or learning how other cultures manage mental health and service related difficulties.  
 
These stories will inspire and bring hope to children, young people and adults from all walks of life.
  
Please see Voluntary Work for more information.
 
PROFESSIONAL RESOURCES, TRAINING AND DEVELOPMENT