Making sense of child and adolescent mental health services

1999 ◽  
Vol 23 (4) ◽  
pp. 217-221 ◽  
Author(s):  
Paul Stallard ◽  
Robert Potter
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Service Development ◽  
Resource Reallocation ◽  
Appointment Attendance ◽  
Making Sense ◽  
Adolescent Mental Health Service

Aims and methodA prospective audit of the 425 referrals made to a community child and adolescent mental health service over a three month period was undertaken. Standardised data were collected about the referrer, reason for referral problem chronicity and complexity, service response and first appointment attendance.ResultsThe service is currently seeing less than one in five of the children conservatively estimated to require specialist mental health services. The majority of those referred were appropriate, identifying multiple problems of longer than six months' duration presenting within a complex context.Clinical implicationsThe results have provided commissioning authorities with a clear specification of the current service. This can inform decisions about resource reallocation, prioritisation and future service development. Clinicians feel that the complexity of their work is now understood and various audit projects and initiatives have been established in order to explore alternative ways of responding to referrer demands.

Making sense of child and adolescent mental health services (CAMHS): An audit of the referral journey and the use of routine outcome measures (ROMS)

2021 ◽  
pp. 135910452199970
Author(s):  
Naomi Gibbons ◽  
Emma Harrison ◽  
Paul Stallard
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Outcome Measures ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Completion Rates ◽  
Making Sense ◽  
North East ◽  
Over Time

Background: There is increased emphasis on the national reporting of Routine Outcome Measures (ROMS) as a way of improving Child and Adolescent Mental Health Services (CAMHS). This data needs to be viewed in context so that reasons for outcome completion rates are understood and monitored over time. Method: We undertook an in-depth prospective audit of consecutive referrals accepted into the Bath and North East Somerset, Swindon and Wiltshire (BSW) CAMHS service from November 2017 to January 2018 ( n = 1074) and April to September 2019 ( n = 1172). Results: Across both audits 90% of those offered an appointment were seen with three quarters completing baseline ROMS. One in three were not seen again with around 30% still being open to the service at the end of each audit. Of those closed to the service, paired ROMS were obtained for 46% to 60% of cases. There were few changes in referral problems or complexity factors over time. Conclusion: Understanding the referral journey and the reasons for attrition will help to put nationally collected data in context and can inform and monitor service transformation over time.

scholarly journals Allocation of referrals within a child and adolescent mental health service

1998 ◽  
Vol 22 (8) ◽  
pp. 487-489 ◽  
Author(s):  
Sophie Roberts ◽  
Ian Partridge
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Response Rate ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Adolescent Mental Health Service ◽  
Multi Disciplinary Team

Long waiting lists are a common problem in child and adolescent mental health services. We describe how referrals to the service in York are considered and allocated by a multi-disciplinary team. The criteria for allocation to different professionals and specialist teams are described and data representing a snapshot of referrals and response rate over a three-month period presented, showing that most referrals are seen within two months. We postulate that consideration of referrals in this way is an effective and efficient way of running a service.

scholarly journals Providing 24-hour child and adolescent mental health services: demand and outcomes

2011 ◽  
Vol 35 (10) ◽  
pp. 374-379 ◽  
Author(s):  
Patricia Byrne ◽  
Lorna Power ◽  
Carole Boylan ◽  
Mohammed Iqbal ◽  
Margo Anglim ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Working Hours ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
High Risk Group ◽  
Service Development ◽  
Retrospective Case ◽  
Retrospective Case Study

Aims and methodThe provision of 24-hour specialist child and adolescent mental health services (CAMHS) is a key target for service commissioners. However, a lack of data exist on models of service delivery or levels of need for out-of-hours specialist CAMHS to guide service development. We aim to describe a model of 24-hour service provision and provide information on the demand for and outcome of assessments of a service in Dublin, Ireland, using a 6-year retrospective case study design.ResultsA total of 468 emergency presentations occurred during the study period; 80% presented with self-harm or suicidal ideation. Two-thirds presented outside of working hours. All presentations received a specialist CAMHS consultation. Over 50% required admission to a paediatric ward and 80% required onward referral to specialist CAMHS.Clinical implicationsThere is a need for a 24-hour specialist CAMHS and this allows increased rates of specialist assessment and onward referral for a high-risk group.

scholarly journals Establishing a specialist eating disorders team

1998 ◽  
Vol 22 (4) ◽  
pp. 214-216 ◽  
Author(s):  
Sophie Roberts ◽  
Toni Foxton ◽  
Ian Partridge ◽  
Greg Richardson
Keyword(s):  
Mental Health ◽  
Eating Disorders ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Adolescent Mental Health Service ◽  
Tier 3

Child and adolescent mental health services operate at four tiers. An eating disorders service is a tier 3 function and in the usual absence of specific funding has to operate from within current resources. The operation of an eating disorders team within a wider child and adolescent mental health service has significant advantages. The operation of such a team is explained and the advantages discussed.

Factors Associated with Dropout and Diagnosis in Child and Adolescent Mental Health Services

2009 ◽  
Vol 43 (5) ◽  
pp. 431-437 ◽  
Author(s):  
Emily Johnson ◽  
David Mellor ◽  
Peter Brann
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Factors Associated ◽  
Mental Health Settings ◽  
Adolescent Mental Health Service

Objective: Dropout from child and adolescent mental health services has ramifications for children, families and the services themselves. Understanding the factors that are associated with dropout for different diagnoses has the potential to assist with tailoring of services to reduce dropout. The aim of the current study was to identify such factors. Method: A file audit was conducted for all referrals to a child and adolescent mental health service over a 12 month period, yielding 520 subjects for analysis (264 male, 256 female, mean age = 12.6 years). Parent, child and service variables of interest were recorded as were diagnoses, which were categorized into 25 superordinate categories. Results: Almost 50% of subjects dropped out of treatment. Factors associated with dropout varied across diagnosis, and no factor was associated with dropout for all diagnoses. Conclusion: There are differences in the factors that were associated with dropout for different disorders. This is a useful finding in terms of understanding and preventing dropout in child and adolescent mental health settings, but more research is needed.

scholarly journals Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024230 ◽  
Author(s):  
Stephen Rocks ◽  
Melissa Stepney ◽  
Margaret Glogowska ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Resource Utilisation ◽  
South East England ◽  
The Impact

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

scholarly journals Child and adolescent mental health services liaison with Tier 1 services: a consultation exercise with school nurses

2000 ◽  
Vol 24 (12) ◽  
pp. 462-463 ◽  
Author(s):  
Greg Richardson ◽  
Ian Partridge
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Evidence Base ◽  
Audit Commission ◽  
Tier 1 ◽  
Tiered System ◽  
Consultation Intervention

Consultation with Tier 1 professionals is an integral part of comprehensive child and adolescent mental health services (CAMHS) (NHS Health Advisory Service, 1995; Audit Commission, 1999). Despite enthusiasm for consultative approaches and clearly described advantages (Steinberg, 1993), the evidence base for consultation work is thin. In schools, the consultation intervention has been found to be the least effective of four interventions (Kolvin et al, 1981). Consultation enables the development of an integrated tiered system, improves communication, provides a greater understanding of the roles of CAMHS by Tier 1 professionals and fosters more relevant referral patterns.

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