Dr Tina Irani, Scottish
Specialist Registrar, Forensic CAMHS,
West of Scotland
The only health board that has an
established Community Adolescent Forensic Mental Health Service in
Scotland is NHS Greater Glasgow and Clyde and it only available to
patients within the Greater Glasgow area.
The Adolescent Forensic Team consist
- Senior Clinical Specialist (Interim
- Consultant Child & Adolescent
- Forensic Nurse Therapist
- Nurse Therapist
- Social Worker
- Assistant Clinical Psychologist
- Trainee Forensic Psychologist
- Consultant Clinical/Forensic
- 2x Secretary
80% of referrals come from Social Work.
Remaining (20%) of referrals come from inpatient units, other
health professionals, the secure estate and others.
Services the team offer include Forensic
and Clinical interventions.Forensic Interventions include
specialist risk assessments, formulations of risk and evidence
based individual, behavioural and prevention programmes to
programmed manualised approaches for risk reduction. Clinical
interventions involve comprehensive mental health care and
treatment. This includes medication and psychological approaches.
The team also offer in-reach services to inpatients and secure
settings. They also offer consultancy and advice to all stages of
services both health and social work who are working with high risk
FCAMHS services in
There are pockets of individuals but none
that offer a stage 4 comprehensive multidisciplinary integrated
service. There are no secure Inpatient services in Scotland for
children and young people. The national commissioning group accepts
referrals for admission.
When enquiring about FCAMHS services around
the country I got strong response from my trainee colleagues both
in Forensic Psychiatry and CAMHS. There is a keen interest in the
subject and disappointment in the lack of training opportunities.
Some of the quotes are as follows:
- “I am interested in FCAMHS and would like
to know more about the scope for training in Scotland”.
- “do think that a bit more FCAMHS training
in the generic CAMHS training would be good given the lack of
FCAMHS in everywhere but Glasgow”. Glasgow
- “I would be very interested in FCAMHS
training. I thought it was one of the greatest MMC failures that
this opportunity had been removed”. Glasgow
Adolescent Forensic Psychiatry
training in Scotland
The Forensic CAMHS training in available in
the West of Scotland training scheme. It’s a five year training
programme, the first two years in CAMHS the next two in Forensics,
with the final year in Forensic CAMHS. The core CAMHS training
involved one year of generic community CAMHS and one year at the
regional adolescent inpatient unit.
Other Specialist CAMHS training available
is at the national child in- patient unit, paediatric liaison,
Scottish Centre for Autism, Learning Disability CAMHS, Looked after
and Accommodated Child and Adolescent Mental Health Services, and
The core Forensic training involved one
year at the regional medium secure unit, 6 months of Community
Forensics and 6 months of Learning Disability Forensics.
Other Forensic experience available: High
Secure placement at the state hospital, low secure placement,
Female offenders, prison Psychiatry (Adult males, young offenders,
and female offenders) and working with sex offenders. The final
year of training involves 3 months in a FCAMHS in-patient unit in
England, 6 months with the community FCAMHS Team in Glasgow and 3
months to cover any special interest including being attached to
the mental welfare commission.
I would like to say thanks to the Community
Forensic CAMHS team, Dr Aileen Blower and all my SpR/ ST colleagues
within Forensic Psychiatry and CAMHS in Scotland for helping me
collate this information.