Terms of Reference Clinical Psychologist

Transcription

1 Terms of Reference Clinical Psychologist 1. Background Montserrat is a UK Overseas Territory in the Eastern Caribbean with a population of 4,900 people. The on-going volcanic eruptions, which began in 1995, destroyed the capital city and the airport and rendered two-thirds of the island uninhabitable. A small community continued to keep Montserrat alive in the North. Families were torn apart as many left to live in the UK the US, Antigua and other Caribbean islands, resulting in a population decline of around 50% between 1995 and the present day. It is an island with a strong religious background and has a Christian Council that speaks on behalf of many of the churches that it represents. This population has necessarily been joined by other nationals from countries notably from Guyana, Jamaica, Haiti, Santa Domingo, Puerto Rico and other nations where persons have been seeking paid employment and a quieter life from strife in their own countries. The influx of persons from other cultures has brought challenges of language and other cultural issues. The last census, completed in 2012/13, revealed that 27% are non-nationals. The provision of social services on Montserrat is the responsibility of the Social Services Department (SSD), under the Ministry of Health and Social Services. Previously named the Community Services Department, the SSD now reflects the different orientation of the Department s work since the volcanic crisis some seventeen years ago. The focus over the past two years has been to introduce professional social work practice into the work of officers with all client groups. Recent events on the island related to child protection have highlighted the need for a Clinical Psychologist to provide psychological assessments and treatment for victims (both children and the family) and perpetrators of child abuse. Currently limited therapeutic support is provided by the Pupil Support Unit under the guidance of the Educational Psychologist and visiting Psychiatrist. Mental Health services on island are run by a mental health nurse practitioner and mental health nurse with the quarterly support of a visiting psychiatrist. The therapeutic interventions are largely medication based with some counseling support from the mental health nurses. There are no formal use of psychological therapies ie cognitive behaviour therapy known now to provide the first choice in depressive illness/anxiety. Services for drugs and alcohol misuse are incorporated into the mental health services to a limited extent.

2 Prisoners with mental illness are largely assessed and supported by the psychiatrist and therapy is maintained by the mental health nurse. The service would appear to be largely medication based. A forensic psychiatrist recently visited the island and rehabilitation plans for the prisoners assessed during her visit are currently being drafted. Elderly Care: There is limited psychological support for conditions such as Dementia. Strategic context: The recent Strategic Mental Health Plan (PAHO consultant Dr Abel) identifies the need to address current gaps in service provision. The gap analysis identifies among other requirements, the needs:- To increase awareness by health professionals of the psychosocial factors in and the maintenance of mental health disease processes. The need to further integrate mental health services into the general health services. The further need for counseling services. Regular in-service training of all staff in the management of common disorders. The development of Home based packages of care for family care and support. Expand the range of mental health services to children and adolescents. Expand mental health promotion programmes to schools including life skills training. To integrate the mental health information system into the general health information system. 2. Key objectives 1. To provide high quality clinical psychology services to the Montserrat population. 2. To provide support and advice to medical and Social Services teams in provision of age specific support, mental health services, and elderly care. 3. To train Social Services and Health staff, including mental health staff, prison staff, and carers involved with elderly and young people on the island; and identify distant support services in relevant areas to assist them long- term. 3. Expected outputs 1. High quality clinical psychology services provided in line with identified needs. Patient data will be regularly written up and placed in confidential files. Data to be updated and entered on EMIS when this information system is available. 2. Relevant skills transferred to staff and volunteers on island as appropriate and distant support services established in line with identified needs 3. Self- help groups established on island and running smoothly (for parenting, foster carers, alcohol/substance abuse etc

3 4. Updated library with key mental health related literature and list of relevant online resources to be made available in the new hospital library 5. A Work Plan to be prepared and regularly updated. 6. Quarterly update reports submitted to the Chief Medical Officer and Director of Social Services 7. End of contract report submitted with recommendations and agreed action plan prior to departure. 4. Recipient Ministry of Health and Social Services, Montserrat Government Headquarters, Brades. 5. Scope & Deliverables 5.1 Clinical Care and Service Provision A General Mental Health 1. Assess and provide short- and long term psychological interventions for a range of people including children, school students, young people, prisoners and adults experiencing psychological problems in the community or in residential care (through referral or self referral). Clinical areas that the psychologist could be involved in include: o Substance abuse (inc alcohol, cannabis) o Psycho-somatic illness o Rehabilitation programmes for convicted sex offenders o Depression o Anxiety o Age related mental health problems 2. Following assessment construct and guide the maintenance of psychological intervention plans in collaboration with other agencies/medical staff, which may include the establishment and support to self help and patients groups as well as relevant distant support. 3. Convene inter-agency/inter-departmental meetings to finalise and agree follow-up plans, including psychological aspects of care plans B Persons in Custody 4. Asses and give psychological support to people in custody. 5. Keep proper records of all activities and contacts and personally update patient files. C Children with disabilities 6. Engage in multi-disciplinary discussions to continue the development of a Multiagency early intervention service for children with developmental delays/disabilities. Provide ongoing support for the developing multi-agency Disabled Children Service within Social Services.

4 D Children Adolescents and Safeguarding 7. Involvement in Child and Adolescent Mental Health services and assist in the development of a Safeguarding Children Board to monitor and assess safeguarding responses on the island. E Professional 8. Cooperate in clinical audits as required. F Health Promotion 9. Assist with mental health promotion with the Health Promotion Co-ordinator through various media to raise awareness and assist with identification of common mental health problems in the community and how these can be addressed by the general public. G Management 10. Assist in the implementation of the new mental health strategy. 11. Discuss care plans as needed with the Social Services Senior Social Workers (Child Care and Adult Care) by Educational psychologist and psychiatrist during visits to the island and assist Social Services and Community Nursing teams with development of action plans to address agreed recommendations. 5.2 Training and Professional Development Duties 1. Provide guidance and assist in the supervision of the activities of the Community Mental Health Nurses, including conducting biannual performance reviews. 2. Conduct a training audit amongst health and social services staff and identify priority training needs in consultation with CMO, psychiatrist, and Social Services Director and mental health staff. 3. Provide short courses to a range of agencies/professionals and volunteers in the workplace on common behavioural/psychological interventions for children, young people and adults. Courses should include an introduction to sustainable cognitive behavioural techniques that can be applied by others. 4. Identify simple assessment tools for screening of mental health problems and train Review available guidelines/protocols and identify priority needs in consultation with CMO, Social Services Director, Mental health team, Pupil Support Unit. Develop specific guidelines/protocols to support school, social work and nursing staff covering sustainable psychological interventions on key mental health/ behavioural issues. Advise nursing/medical/ Social Services / Education staff in its use. 5. Review literature on Mental Health in Medical and Nursing Libraries and advice on new text books/journals to be procured and useful online resources. Note These Terms of Reference are intended only as a guide to the duties involved and may be modified to meet changing needs. The post holder will be expected to be flexible in his/her role and

5 responsibilities to enable the Island s health and Social Services teams to work together more effectively. 6 Reporting The Psychologist will directly report to the Chief Medical Officer/ (on professional issues) and Director of Social Services (on Child Protection / Adolescent, Elderly issues). The jobholder will be expected to prepare a Work Plan outlining key roles/tasks and expected outputs in close consultation with the psychiatrist social services and nursing staff which will be submitted to the Chief Medical Officer and Social Services Director (Dept of Health and Social Services for approval). The Work Plan will include a time frame for key training sessions planned and development of protocols/procedures as per identified needs. Quarterly progress reports against the Work Plan will need to be submitted. The Work Plan will be reviewed and updated on a quarterly basis as/if required. 7 Contracting The jobholder will be contracted by the Human Resource Management Unit, Government of Montserrat. 8 Time frame The position is for two years. On the job training of relevant staff and identification of ongoing distant support services will be a key task of the job holder. 9 Qualifications A Broadly Qualified Clinical Psychologist. 10 Skills/Experience required Essential to have experience in working with children who have been abused and their families. Background in cognitive therapy Ability to employ brief therapy Knowledge of computer based therapies Experience in working with people with mental health issues. A broad range of clinical psychological experiences especially with children and young people who are disabled, people with mental illness, Elderly people.