• 14 February 2020
  • 9 min read

How to become a Child and Adolescent Mental Health Services Nurse (CAMHS)

  • Nathan Crimes
    Clinical Service Manager / Rheolwr Gwasanaeth Clinigol

Qualified Mental Health Nurses can choose to work in Child and Adolescent Mental Health Services. Nathan explains how to follow this career path and the deep reward of empowering young people.

Topics covered in this article

What is CAMHS?

How I came to work in CAMHS as a Mental Health Nurse?

What qualifications do you need to become a Child and Adolescent Mental Health Services Nurse?

What is the purpose of a CAMHS nursing role?

What are the challenges faced by RMNs working in CAMHS?

What career opportunities and different roles are there for Child and Adolescent Mental Health Nurses?

Why I enjoy working in Child and Adolescent Mental Health Services

What are the levels of pay / salary and benefits available to nurses working in CAMHS?

Are there private service providers of CAMHS that Mental Health Nurses can work for?

What kind of settings do Mental Health Nurses in CAMHS work in?

What does a typical day for an RMN working in Child and Adolescent Mental Health look like?

Who can refer to CAMHS?

About the treatment in Inpatient CAMHS

What is CAMHS?

CAMHS (CAMHS stands for Child and Adolescent Mental Health Services) are specialist services for children and young people.

The services offer a range of treatments to support young people who are experiencing problems with their emotions, behaviour or mental health.

CAMHS services are extremely busy and at times, challenging services, the rewards however, greatly outweigh the challenges.

How I came to work in CAMHS as a Mental Health Nurse

My own journey in to CAMHS nursing started shortly after qualifying as a Registered Mental Health Nurse (RMN).

I had previously worked for 13 years as a Clinical Support Worker (CSW) in a variety of mental health services for adults.

This provided me with a broad range of experience and knowledge working with adults though no experience of working with young people (YP).

Additionally, the misconception about nursing Children and Young People by experienced adult practitioners with whom I worked negatively influenced my own view of this group of individuals requiring care and treatment.

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It was during my student nurse journey that I was exposed to a number of new environments and ways of nursing, this is where CAMHS changed from being something that I feared and felt very reluctant to engage in, to becoming a real passion.

Observing how YP were at the centre of all decision making, quality collaborative working with children, young people and their families, compassion focused care from the top down and observing on a daily basis staff displaying genuine care and empathy really shaped my thinking and led me to a career working with children, young people and their families.

What qualifications do you need to become a Child and Adolescent Mental Health Services Nurse?

The journey to become a CAMHS nurse starts with the same 3 year nurse training programme as all qualified RMNs.

Registration requirements with the Nursing and Midwifery Council (NMC), the body that governs nursing within the UK remain the same as any practicing nurse – once qualified CAMHS nurses specialise in working with children and young people.

What is the purpose of a CAMHS nursing role?

The role of the nurse is to develop a meaningful therapeutic relationship based on trust, acceptance and understanding, CAMHS nurses provide specialist care while empowering the young person to identify effective means of managing their own thoughts and feelings.

CAMHS nurses work closely with families and carers providing psychoeducation, ensuring that they are equipped with the correct tools to appropriately support and manage their YP when they are experiencing difficulties.

What are the challenges faced by RMNs working in CAMHS?

CAMHS nurses will experience working with children and young people who present with issues such as...

Neuro developmental disorders:

• Attention Deficit Hyperactivity Disorder (ADHD)

• Autism Spectrum Disorders (ASD)

Mental health disorders:

• Violence and aggression

•  Depression

•  Eeating difficulties and disorders

•  Anxiety and phobias

•  Self-esteem problems

• Difficulties arising from trauma

• Obsessions and compulsions

• Relationship problems

• Sleep problems

•  Self-injury and suicidal thinking

Nationally there is a growing demand for access to CAMHS services, areas across the UK can struggle to meet the increased demand due to lack of resources, as a workforce.

If we were able to increase our ability to meet the demand in a timely manner, we would be able to treat Young People (YP) more effectively and improve long-term outcomes, preventing some YP from transition in to adult services and improving outcomes for those accessing the services.

The focus on Early Intervention and Prevention remains a key priority in CAMHS nursing.

Investment in training and resources are vital to ensure that nationally, we can meet the needs of the population.

What career opportunities and different roles are there for Child and Adolescent Mental Health Nurses?

CAMHS nurses can specialise in areas of treatment that have a strong evidence base for achieving long term positive outcomes, specialist therapeutic approaches that are widely utilised in CAMHS include:

Cognitive Behavioural Therapy

A therapy that supports a child or family to work on their difficulties by learning about the connections between thoughts, behaviours, physical body responses and the impact these can have on feelings.

Family Therapy

When one member of a family has a difficulty, it tends to impact on everyone in the family.

Often solving a problem or difficulty for a child or young person requires support from family members.

Family therapy is a therapy that helps families work together to improve relationships and to support each other in finding solutions to problems resulting from mental health difficulties.

Dialectical Behavioural Treatment (DBT)

DBT is a specific type of cognitive behavioural psychotherapy that utilises a cognitive behavioural therapy approach.

DBT emphasises the psychological aspects of treatment.

There are many other therapeutic approaches used to treat children and young people.

CAMHS practitioners are supported to learn and develop these approaches to ensure that the needs of the YP are met.

Why I enjoy working in Child and Adolescent Mental Health Services

CAMHS Child and Adolescent Mental Health Services (CAMHS) have received increased focus, investment and improvement over recent years.

The key focus has been to improve standards of care for children and young people who suffer with mental health problems.

Frameworks such as the Department of Health 2012 ‘Improving Children’s and Young People’s Health Outcomes; a system wide response have placed renewed emphasis on ensuring that young people and their families are at the centre of decision making around their care.

Proposals to engage parents, carers and pupils through partnership working have been considered where the focus would be to normalise mental health conditions, creating a shared common acceptance of all mental health conditions and developing an understanding that experiencing a mental health problem is part of life for us all.

Teaching young people and their families’ strategies to successfully manage their thoughts, feelings & risks brings an incredible sense of achievement for the individual, their family / carers, providing them with the correct strategies to manage any future issues that may arise.

As with all disciplines in nursing, CAMHS nurses are in a privileged position, working with individuals to improve long term outcomes.

The opportunity to work with someone at the start of their journey, providing evidence based treatment and witnessing recovery and improved outcomes is the most rewarding outcome for any nurse.

What are the levels of pay / salary and benefits available to nurses working in CAMHS?

NHS based CAMHS nurses will be subject to the Agenda for Change pay scales, a band 5 nurse salary starts at £24,214 the top of this band is £30,112.

This will become £24,907 and £30,615 respectively as of April 1st 2020.

As previously discussed, opportunities to develop professionally are encouraged and supported.

When nurses gain additional therapeutic qualifications they can expect to be paid at Band 6 / 7 dependent on the qualification, the maximum in these pay bands are £37,267 for Band 6 and £43,772 for B and 7 (these will become £37,890 and £44,503 in April 2020)

Are there private service providers of CAMHS that Mental Health Nurses can work for?

CAMHS services do not operate exclusively within the NHS, there are many private sector organisations that provide care, benefits to private sector working traditionally start with an improved starting salary.

They don’t, however, pay enhancements for weekend and night shifts.

Organisational policies in the private sector can differ, affecting terms and conditions of your working contract and associated benefits such as sick pay and annual leave entitlements.

What kind of settings do Mental Health Nurses in CAMHS work in?

CAMHS teams are accessible to YP both in the community and in a hospital based setting.

Community CAMHS teams provide a range therapeutic interventions to YP as do the inpatient settings.

YP are admitted to hospital when risks can’t be safely managed in the community or they require more detailed intensive assessments.

Whatever setting you work with the YP in, the approach to YP is paramount, the strength of relationship can dictate the success of the intervention.

CAMHS staff adapt means of communication to suit the individual and therapeutic sessions can also be tailored to meet an individual’s needs.

There are no hard and fast rules for communication, drawing on my own experience, I have always found having boundaries in addition to being fair and consistent is the best foundation for building a robust therapeutic relationship.

What does a typical day for an RMN working in Child and Adolescent Mental Health look like?

No two days are the same in CAMHS though inpatient settings do offer a little more routine.

A typical day would include 1-1 therapeutic sessions, meetings with members of the Multi-Disciplinary Team (MDT) such as psychologists, psychiatry, occupational therapist and art therapist to name but a few.

YP are expected to attend education which is provided in inpatient units.

A typical day in community CAMHS would include MDT reviews, family work, review of medication, assessment of a YP mental health and treatment using evidence based, recovery focused therapies.

Who can refer to CAMHS?

Generally speaking, the criteria for referral in to CAMHS services are very similar, however, there may be some variance across regions.

Referrals are accepted from any involved professionals such as social workers, health visitors, school professionals, doctors, and educational psychologists.

CAMHS teams use a triage system to appropriately assess and redirect referrals that do not meet the criteria for CAMHS services.

There has been a clear upward trend in referrals to CAMHS over the last 7 years, and numbers of referrals accepted have largely mirrored the increases in demand.

Although referrals have increased, the level of referrals marked as urgent has remained steady.

Therefore, the number of urgent referrals has risen at the same rate as the overall number of referrals being made.

The proportion of referrals that were re-referrals has also remained steady. 

Average waits from referral to second(treatment) appointments are now increasing.

32% of patients had an Referral To Treatment (RTT) of less than 4 weeks in 2018/19.

This indicates much variation in CAMHS access and a pathway that has long waiters in many areas, although over one third of children are seen within a month.

The overall length of the pathway in some areas is confirmed in that 21% of young people waited over 18 weeks to receive care.

About the treatment in Inpatient CAMHS

Within inpatient CAMHS, there is less change from year to year.

Bed occupancy in general admission beds has decreased to 69% and staffing measures 35 WTE  per 10 beds.

The average position is now 62 days which represents a sustained 16% reduction since2016/17.

Inpatient CAMHS beds are offered by around 60% of NHS Mental Health Trusts, along with a number of independent sector providers.

CAMHS beds are increasing gradually, one of the few mental health specialties to witness capacity growth in inpatient care (NHS Benchmarking Report 2019).

About the author

  • Nathan Crimes
    Clinical Service Manager / Rheolwr Gwasanaeth Clinigol

I am a regional Clinical Service Manager overseeing management of a CAMHS inpatient ward, community intensive support team and a regional eating disorder service for North Wales Adolescent Service. I have experience working as a specialist advisor for the CQC and a lead reviewer for the Royal College of Psychiatrists Quality Network for Inpatient CAMHS (QNIC).

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About the author

  • Nathan Crimes
    Clinical Service Manager / Rheolwr Gwasanaeth Clinigol

I am a regional Clinical Service Manager overseeing management of a CAMHS inpatient ward, community intensive support team and a regional eating disorder service for North Wales Adolescent Service. I have experience working as a specialist advisor for the CQC and a lead reviewer for the Royal College of Psychiatrists Quality Network for Inpatient CAMHS (QNIC).