Factors influencing the outcomes of children utilising CAMHS
Thesis or dissertation
Peninsula College of Medicine and Dentistry
Childhood mental health problems are common (8-18% of the school age population), persistent, seemingly increasing, and can lead to a range of negative outcomes including adult mental illness, risk-taking behaviour, educational failure, and criminality (Costello, Egger & Angold, 2005). The effectiveness of child mental health care is therefore of great importance. This study examined the effectiveness of child and adolescent mental health services (CAMHS). This study explored the relationship of clinical outcome as reported by different informants and parental experience of the service and satisfaction, and the outcomes of children receiving evidence-based interventions for their disorder(s) were compared with children receiving interventions that lacked an evidence base, and the influence of case-complexity on both outcome and clinician workload was explored.. A sample of 302 children from two participating CAMHS was recruited. Parents completed the Development and Well-Being Assessment (DAWBA), and the Strengths and Difficulties Questionnaire (SDQ) at baseline, and the SDQ, and the Experience of Service Questionnaire (ESQ) every six months for two years. The practitioners completed questionnaires describing the child’s difficulties and used the Child Global Assessment Scale (CGAS) as an indication of the child’s level of functioning at baseline while the child attended the clinic. From the first follow up, practitioners completed a questionnaire about any interventions offered. This study found that there was little agreement between the parents and practitioners on the outcomes of the children in the sample, and that overall the outcomes of the children in this sample were poorer than would be expected if left untreated in the community. It was also found that evidence based practice did not appear to have an impact upon outcome, nor did workload. Case complexity did appear to have a negative impact upon outcome. This study suggests that perhaps baseline case complexity plays a larger role in determining the outcomes of children than the workload this creates or the interventions that are given. This study also found that parental satisfaction was not highly correlated with outcome, suggesting that satisfaction may not be a reliable indicator of the quality of a service.