Lynne Neagle AM: Okay. Thank you. We've got some questions now on specialist CAMHS—if I can just ask about the impact of the specialist CAMHS framework, and how effective you feel that has been in promoting a consistent delivery of care for young people.
Carol Shillabeer: Thanks very much for that. Without wanting to go back too far in history, I remember coming into this area back in 2014 as I was asked to establish a CAMHS network. My observation was there wasn't really a strong and well-connected clinical community in this area. When we spin forward five years, I can confidently say that there is a strong and well-connected clinical community around specialist CAMHS. The programme has helped; the emphasis and the focus of the programme has helped to bring people together with that more common endeavour to understand, actually, there is a good case for consistency in the main, with local variation. There has been a case for much greater learning between organisations. If I just give you an example—you'll know that the community intensive service teams were put in place in 2015-ish. Some areas have them, but a lot of areas didn't. We do have inconsistency in that, but the consistent part is there is a service now right the way across Wales for more intensive support to children and young people and their families in their own homes, which helps to prevent admissions and then, where there are admissions, helps to support people to be at home. They're all called slightly different things. So, I might have referred in my papers to CITT, CATT, COT and CITE. So, they've all got slightly different names and they've got slightly different opening hours. The key thrust of this is that there is a backbone, if you like, of a consistent approach with that local variation. We have to check. So, things like frameworks for improvement—there is a coming together of the clinicians and the professionals to agree what that framework for improvement is. That then gets implemented, with some local variation. So, I think the process of moving in that way has been extremely helpful. There will be some variation. We want some variation, to some extent, as places try new things and evaluate new things. So, if I just refer to the previous question that I had, and I talked about hot clinics and different ways of reaching out; that's been tried in one area, been evaluated—let's see the spread of that. So, you'll know my view on internet counselling, for example; I feel that is quite a strong offer for children—not necessarily in the specialist end. If that works in one area, why aren't we rolling that out to other areas? So, I think the framework for improvement has provided a vehicle for those clinicians and professionals to come together. It's in a stronger place—a much stronger place—than it was five years ago.
Lynne Neagle AM: Okay, thank you. You've referred to there being some inconsistencies in terms of crisis care, but are you able to assure the committee that all young people are now getting at least a consistent service, especially in terms of interventions in the instances of young people self-harming. Wherever you live in Wales, is that help there for you now?
Carol Shillabeer: Well, in your work to produce the 'Mind over matter' report, I clearly listened to the views from the police and the recommendations in relation to the police. We've taken that as a further piece of work under the specialist CAMHS umbrella, to truly understand what the experiences of the police are and what some of the root issues may be in relation to that. For example, is it that because the CIT, CAT, COT, CITE—the community intensive service—closes at 10 o'clock in a certain area, that actually it's after that that the network of support isn't as strong, and, if that is the case, what are we going to do about that? There's certainly potential in working more regionally or even working between adults' and children's in terms of the crisis resolution services that work beyond those hours. So, we are taking an extra look at this, because I could not be 100 per cent confident that, throughout the 24-hour period, we've got this fully settled. I continue to hear some stories from the police that they are picking up young people and feeling that they've not got that solid place to go, and we're following those through.