Professor Kathryn Abel, an MQ researcher, and her team are trying to understand the difficulties in making referrals to CAMHS services and if there are any alternate solutions. Here, Kathryn and her team explain more.
The number of children referred to Children and Adolescent Mental health Services (CAMHS) in England and Wales has steadily risen over the last five years.
In 2018/19, over a quarter of a million children were referred. In the last year alone, this figure has increased by 35%, and in June 2021 340,694 children were in contact with CAMHS, which is 51% higher than before COVID.
Prior to the pandemic, approximately 1 in 5 referrals was deemed inappropriate or unsuitable for CAMHS; many were not signposted to alternative services or provided with advice about the next steps. This can be incredibly upsetting for children/young people and their families. Imagine the difficulty and distress for parents who have been struggling to help their children and thought that their local CAMHS would be the answer. When they are not accepted into the service, parents and families may feel helpless, unsupported and unsure about what to do next.
However, expansion of CAMHS’ capacity may not be the best solution. Both the services and the referral processes need to be configured so that referrers, children/young people and their families can readily navigate available services aligned to the problem that needs help. This means a precise mapping of local resources and clear guidance about the criteria and ways to access them. This is likely to be very important if children are to access help in a more timely way to prevent worsening symptoms and crisis; and if they are to access the resources and support most appropriate to their needs. A broad range of non-CAMHS, possibly non-NHS provisions, may be more suited to the young person’s needs and potentially accessible quicker in the local area than CAMHS.
Many children have been referred inappropriately to CAMHS because referrers (GP’s, Schools or parents) may be unaware of better alternatives for the young person.
For example, a young person experiencing anxiety due to the pandemic or feeling lonely because of school closure or social distancing measures may not require specialist mental health care.
These feelings may be healthy reactions to a very distressing situation rather than a mental health issue. These children may benefit more from support and normalisation in the acute phases of distress, along with a range of non-medical coping strategies for these young people and the families in which they live. In this instance, a referral to CAMHS is unlikely to help the child and would clog up already overburdened systems. Instead, peer support, family coping strategies and local advice services would be more readily accessible to young people and their families; and might be more appropriate.
Reform of the referral process and raising awareness of the different options available is no small feat. But this is the focus of a project sponsored by Greater Manchester Mental Health NHS Foundation Trust (GMMH).
Principal Investigator, Professor Kathryn Abel from the Centre for Women’s Mental Health, University of Manchester and Director of the GM. Digital Research Unit at GMMH is leading the programme.
“We aim to understand what the difficulties are in making referrals to CAMHS services. We want to improve the quality of referrals to CAMHS so that only children and young people who CAMHS can help are referred. A key objective is to talk widely with young people and families, with people working in CAMHS and mental health leads, to fully understand the problems and develop solutions with them to meet their needs and make things better for young people and services. We also aim to work with GPs, teachers and parents to find ways to develop and share information about alternative local resources for children who CAMHS cannot support.”
The programme is working with CAMHS staff, agencies and service users, including GP’s, Schools and other stakeholders. Initially, eight focus groups will map out the current referral processes and identify areas for improvement. The overall aim of the programme is to speed up access to the proper support for everyone.
If you have experience with the CAMHS referral process, Kathryn and her team want to hear from you. Have you or your children been referred to CAMHS, either successfully or unsuccessfully? Have you referred someone in need to the service? Whether your experience has been positive or negative, easy, or frustrating, this team want to hear from you.
You can contact them here: [email protected]; [email protected]; [email protected].
