Enhancing CAMHS Referrals (EN-CAMHS)

More than 260,000 children in the UK were referred for help to Child and Adolescent Mental Health Services (CAMHS) in England in 2018/2019; and this number has risen steadily for the last five years. This number is expected to rise further following the difficulties Children and Young People (CYP) have faced through the pandemic. About one quarter of children referred to CAMHS by their GPs, schools or parents are rejected for treatment by the service because they are not deemed eligible for the service criteria, their service needs cannot be met by a local service but mostly because the correct referral process has not been followed.

This is clearly distressing for children and families who may wait a long time for an appointment at CAMHS and are turned away. The process is also costly to services because time is wasted reviewing referral documents and following up with referrers about children who should have been referred for alternative help.

Aims and Objectives

Our overarching aim is to find low-cost and widely reusable mechanisms to reduce inappropriate referrals. Our key objectives are to: 1) engage key stakeholders extensively to clarify the barriers they face in making appropriate referrals 2) analyse CAMHS referrals data to understand and identify problems 3) identify the specific requirements for viable and sustainable solutions 4) explore with key stakeholders how we can improve the referral process and provide signposting to alternative sources of help for CYP 5) identify how best the proposed solutions could be embedded into routine CAMHS referral pathways.

Methods

We shall consult extensively with key stakeholders across 12 focus groups to clarify the criteria for referrals to CAMHS and to understand the barriers to making appropriate referrals including referrals to other services more suited/better aligned to the CYP need. We shall analyse the CAMHS referral data to understand problems in the CAMHS referral pathways.

We shall aim to identify with stakeholders potential sustainable solutions to the current problems. We shall also examine the challenges to the adoption and sustainability of proposed solutions. PPI

We shall build on our established collaborations with YP and their parents/carers/families. Regular consultations with YP and other CAMHS stakeholders will ensure the study remains relevant and meaningful. Our work will be informed by our advisory groups comprising YP, parents/carers and relevant practitioners/professionals. Our PPI consultations have already indicated the need for improvements to the CAMHS referrals processes.

Impact and Dissemination

We shall identify the problems in CAMHS referrals processes working extensively with key CAMHS stakeholders across England, including young people and their families. Our confirmed collaborators, including our key referrers (GPs, schools), YP partners (CAMHS.Digital; Youth Mental Health Matters), parents/families partners (PLACE, CALM Connections), other third sector collaborators (e.g.

MQ Mental Health; Anna Freud Centre; McPinFoundation; 42nd Street), four NHS CAMHS providers, and national and regional strategic leads for CYP mental health will ensure our outputs are shared widely with key beneficiaries. Our extensive dissemination strategy, supported by our long list of mental health and YP collaborators, will ensure maximum impact and enable our outputs to be disseminated to all relevant CAMHS stakeholders.