Case note review of community mental health services for children and young people in a UK rural location

Date01 April 2020
Publication Date01 April 2020
AuthorNicola Evans,Michelle Huws-Thomas
SubjectHealth & social care,Mental health,Mental health education
Case note review of community mental
health services for children and young
people in a UK rural location
Nicola Evans and Michelle Huws-Thomas
Purpose The aim of the review is to investigate the reasons for referral to this child and adolescent
mentalhealth (CAMH) service and determine whetherthese had been met by the service.
Design/methodology/approach This is a retrospective casenote analysis that was conducted of 66
referralsto CAMHS for children and young people serving a rural communityof 132,000. Case notes were
selected by the NHS CAMHS manager based on referrals during the pre-defined date set. Of the 66
referrals to CAMHS, 19 were not included in the analysisbecause they had not been accepted into the
service.Data were analysed on the remaining 47 caseswho were referred, accepted into the serviceand
had been offeredan assessmentby the service.
Findings General practitioners represented the most frequent health care practitioner to refer to
the service (n= 33, 70.2%). Self harm, suicidal intent, thoug hts or overdose represented the highest
percentage of referrals to the CAMHS service (38.3%); depression, low mood and sadness
represented the next highest figure (19%) and anxiety and depression (10.6%) broa dly speaking
68% of referrals related to low mood. Out of the 44 cases that were examined, 14/44 (32%) were
referred back to the GP and no specific intervention was provided. Interventions provided to five
cases were unspecified.
Research limitations/implications A number of opportunitiesfor developing the service that allowed
for a focus on the core businessof helping children and young people with low moodwere identified. One
of the limitations of thisretrospective review was the time frame selectedbecause it had been identified
as a particularlyhigh period for referral intothe service and may not have been representativeof the usual
Practical implications This informed a training strategyand resource allocation and a redefinition of
discreteroles within the service.
Originality/value This study highlighted the evidence about wherethe demand was on this service
and hence the requirement to focus on their core business. This evidence generated by the review
prompteda redirection of resources within theservice. Additional reflections anddiscussion informed the
developmentof a new training strategy and a redefinitionof discrete roles within theservice.
Keywords Suicide, Child and adolescent mental health, Service organisation, Low mood, Self-harm,
Paper type Case study
Introduction and background
Capacity for providing mental health services for children and young people (CYP) is
becoming more challenging with a national increase in the demand for specialist child and
adolescent mental health service (CAMHS) (NHS England, 2016). Even Childline noticed a
change in its reasons for accessing the service with one in three Childline counselling
sessions related to mental health and wellbeing, an 87 per cent increase in young people
reporting difficulties in accessing local support services and a 34 per cent increase in
dissatisfaction with mentalhealth support services where these had been accessed. Mental
Nicola Evans is based at
the School of Healthcare
Sciences, Cardiff
University, Cardiff, UK.
Michelle Huws-Thomas is
based at Primary Mental
Health Services, Cardiff
and Vale University Health
Board, Cardiff, UK.
Received 15 October 2019
Revised 2 March 2020
Accepted 2 March 2020
The authors would like to
acknowledge Donna Owen for
her assistance in data retrieval
and to the CAMHS service for
their helpfulness and
transparency during this
DOI 10.1108/JMHTEP-10-2019-0055 VOL. 15 NO. 3 2020, pp. 171-179, ©Emerald Publishing Limited, ISSN 1755-6228 jTHE JOURNAL OF MENTAL HEALTH TRAINING, EDUCATION AND PRACTICE jPAGE 171

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