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Wickersham A, Westbrook J, Colling C, Downs J, Govind R, Kornblum D, Lewis J, Smith P, Ford T. The patient journeys of children and adolescents with depression: a study of electronic health records. Eur Child Adolesc Psychiatry 2024; 33:1093-1101. [PMID: 37227528 PMCID: PMC11032266 DOI: 10.1007/s00787-023-02232-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/15/2023] [Indexed: 05/26/2023]
Abstract
In England, children and adolescents with depression can seek treatment from specialist mental health services. We know little about how they journey through these services, or whether healthcare providers collect sufficient data to accurately appraise this. We aimed to summarise the child and adolescent depression pathway for two healthcare providers. This cohort study used de-identified electronic health records extracted from Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) and South London and Maudsley NHS Foundation Trust (SLaM). We identified referrals between 2015 and 2019 during which the referred patient received their first depression diagnosis aged < 18 years. We described patient demographic and clinical characteristics, and features of the referral. In total, n = 296 (CPFT) and n = 2502 (SLaM) patients had a referral which met eligibility criteria. In both sites, patients were more frequently female (CPFT 79.3%; SLaM 69.3%) and White ethnicity (CPFT 88.9%; SLaM 57.9%) as compared to respective population estimates for the Trusts' catchment areas. Patients typically received their first depression diagnosis during adolescence (median ages 16 in CPFT and 15 in SLaM). The most common comorbidity was anxiety disorder. Referrals were usually routine, to community teams specialising in the child age group. Commonly mentioned interventions included antidepressant medication, cognitive behavioural therapy, and dialectical behaviour therapy. However, pathways varied within and between sites, and the quality and consistency of some data was poor. These findings provide an overview of service pathways experienced by children and adolescents with depression, but also highlight that pathways can vary according to individual need and healthcare provider. More systematic collection of some data, and standardisation in record systems used by different providers, would be beneficial.
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Affiliation(s)
- Alice Wickersham
- CAMHS Digital Lab, Department of Child and Adolescent Psychiatry, King's College London, London, UK.
| | | | - Craig Colling
- CAMHS Digital Lab, Department of Child and Adolescent Psychiatry, King's College London, London, UK
- South London and Maudsley Mental Health NHS Trust, London, UK
| | - Johnny Downs
- CAMHS Digital Lab, Department of Child and Adolescent Psychiatry, King's College London, London, UK
- South London and Maudsley Mental Health NHS Trust, London, UK
| | - Risha Govind
- South London and Maudsley Mental Health NHS Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Daisy Kornblum
- South London and Maudsley Mental Health NHS Trust, London, UK
| | - Jonathan Lewis
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Patrick Smith
- Department of Psychology, King's College London, London, UK
- South London and Maudsley Mental Health NHS Trust, London, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Blackshaw E, Sefi A, Mindel C, Maher H, De Ossorno Garcia S. Digital mental health outcome monitoring for a structured text-based youth counselling intervention: Demographic profile and outcome change. Psychol Psychother 2023; 96:644-661. [PMID: 36920075 DOI: 10.1111/papt.12461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 02/13/2023] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Digital mental health interventions comprise a potentially effective and accessible form of support for young people, particularly at times when traditional face-to-face service delivery is reduced, as in the COVID-19 pandemic. AIMS This study assessed the demographic profile of young people using a digital mental health support service and evaluated outcome change over the course of a structured online counselling intervention (synchronous text-chat sessions with a practitioner). MATERIALS AND METHODS The data were collected from 23,260 young people aged between 10 and 25 years engaging with the intervention between April 2019 and June 2021. RESULTS Young people accessing these services had high levels of mental health needs, particularly those identifying with non-binary gender identity. Service users were mostly female, with equitable rates of access for young people from racialised communities. Overall outcome change demonstrated small effect sizes according to the YP-CORE (0.19) and CORE-10 (0.38), which increased to a moderate level when young people remained engaged with a dedicated practitioner for at least seven sessions (0.38, 0.58). Regression analysis illustrated the effect of the number of sessions on outcome change, but this can be also influenced by other variables such as age and gender. DISCUSSION AND CONCLUSION Further research is required to explore ways to engage with young people using digital web-based services for a longer period and to collect and analyse single-session outcome data.
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Affiliation(s)
- Emily Blackshaw
- Department of Psychology, University of Roehampton, London, UK
- Impact and Evaluation, Coram, London, UK
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Thapa Bajgain K, Amarbayan M, Wittevrongel K, McCabe E, Naqvi SF, Tang K, Aghajafari F, Zwicker JD, Santana M. Patient-reported outcome measures used to improve youth mental health services: a systematic review. J Patient Rep Outcomes 2023; 7:14. [PMID: 36788182 PMCID: PMC9928989 DOI: 10.1186/s41687-023-00556-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are standardized and validated self-administered questionnaires that assess whether healthcare interventions and practices improve patients' health and quality of life. PROMs are commonly implemented in children and youth mental health services, as they increasingly emphasize patient-centered care. The objective of this study was to identify and describe the PROMs that are currently in use with children and youth living with mental health conditions (MHCs). METHODS Three databases (MEDLINE, EMBASE, and PsycINFO) were systematically searched that used PROMs with children and youth < 18 years of age living with at least one diagnosed MHC. All methods were noted according to Preferred Reporting Items for Systematic reviews and Meta-Analysis. Four independent reviewers extracted data, which included study characteristics (country, year), setting, the type of MHC under investigation, how the PROMs were used, type of respondent, number of items, domain descriptors, and the psychometric properties. RESULTS Of the 5004 articles returned by the electronic search, 34 full-texts were included in this review. This review identified both generic and disease-specific PROMs, and of the 28 measures identified, 13 were generic, two were generic preference-based, and 13 were disease-specific. CONCLUSION This review shows there is a diverse array of PROMs used in children and youth living with MHCs. Integrating PROMs into the routine clinical care of youth living with MHCs could improve the mental health of youth. Further research on how relevant these PROMs are children and youth with mental health conditions will help establish more uniformity in the use of PROMs for this population.
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Affiliation(s)
- Kalpana Thapa Bajgain
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Mungunzul Amarbayan
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, Calgary, AB Canada
| | - Krystle Wittevrongel
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, Calgary, AB Canada
| | - Erin McCabe
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Syeda Farwa Naqvi
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Karen Tang
- grid.22072.350000 0004 1936 7697Department of Medicine and Community Health Sciences, University of Calgary, Calgary, AB Canada
| | - Fariba Aghajafari
- grid.22072.350000 0004 1936 7697Department of Medicine and Community Health Sciences, University of Calgary, Calgary, AB Canada
| | - Jennifer D. Zwicker
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
| | - Maria Santana
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Canada.
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Morris AC, Ibrahim Z, Moghraby OS, Stringaris A, Grant IM, Zalewski L, McClellan S, Moriarty G, Simonoff E, Dobson RJB, Downs J. Moving from development to implementation of digital innovations within the NHS: myHealthE, a remote monitoring system for tracking patient outcomes in child and adolescent mental health services. Digit Health 2023; 9:20552076231211551. [PMID: 37954687 PMCID: PMC10638880 DOI: 10.1177/20552076231211551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 10/17/2023] [Indexed: 11/14/2023] Open
Abstract
Objective This paper aims to report our experience of developing, implementing, and evaluating myHealthE (MHE), a digital innovation for Child and Adolescents Mental Health Services (CAMHS), which automates the remote collection and reporting of Patient-Reported Outcome Measures (PROMs) into National Health Services (NHS) electronic healthcare records. Methods We describe the logistical and governance issues encountered in developing the MHE interface with patient-identifiable information, and the steps taken to overcome these development barriers. We describe the application's architecture and hosting environment to enable its operability within the NHS, as well as the capabilities needed within the technical team to bridge the gap between academic development and NHS operational teams. Results We present evidence on the feasibility and acceptability of this system within clinical services and the process of iterative development, highlighting additional functions that were incorporated to increase system utility. Conclusion This article provides a framework with which to plan, develop, and implement automated PROM collection from remote devices back to NHS infrastructure. The challenges and solutions described in this paper will be pertinent to other digital health innovation researchers aspiring to deploy interoperable systems within NHS clinical systems.
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Affiliation(s)
- Anna C Morris
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Zina Ibrahim
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Omer S Moghraby
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Argyris Stringaris
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Emotion & Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Ian M Grant
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR South London and Maudsley Biomedical Research Centre, London, UK
| | - Lukasz Zalewski
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR South London and Maudsley Biomedical Research Centre, London, UK
| | | | - Garry Moriarty
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Emily Simonoff
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR South London and Maudsley Biomedical Research Centre, London, UK
| | - Richard JB Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR South London and Maudsley Biomedical Research Centre, London, UK
- Health Data Research UK London, University College London, London, UK
- Institute of Health Informatics, University College London, London, UK
- NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Johnny Downs
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR South London and Maudsley Biomedical Research Centre, London, UK
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The effective delivery of digital CBT: a service evaluation exploring the outcomes of young people who completed video conferencing therapy in 2020. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Despite its impressive evidence base, there is a widening access gap to receiving cognitive behavioural therapy (CBT). Video conferencing therapy (VCT) offers an effective solution for logistical barriers to treatment, which has been salient throughout the Coronavirus pandemic. However, research concerning the delivery of CBT via VCT for children and young people (CYP) is in its infancy, and clinical outcome data are limited. The aim of this service evaluation was to explore the effectiveness of a VCT CBT intervention for CYP referred from Child and Adolescent Mental Health Services (CAMHS) in the UK. A total of 989 records of CYP who had completed CBT via VCT in 2020 with Healios, a digital mental health company commissioned by the National Health Service (NHS), were examined to determine changes in anxiety, depression and progress towards personalised goals. Routine outcome measures (ROMs) were completed at baseline and endpoint, as well as session by session. Feedback was collected from CYP and their families at the end of treatment. There was a significant reduction in symptoms of anxiety and depression and significant progress towards goals, with pre- to post-effect sizes (Cohen’s d) demonstrating medium to large effects (d=.45 to d=−1.39). Reliable improvement ranged from 31 to 80%, clinical improvement ranged from 33 to 50%, and 25% clinically and reliably improved on at least one measure; 92% reported that they would recommend Healios. This service evaluation demonstrates that Healios’ CBT delivered via VCT is effective for CYP receiving it as part of routine mental health care.
Key learning aims
(1)
To consider whether CBT can be effectively delivered in routine care via VCT.
(2)
To explore whether CBT delivered in routine care via VCT is acceptable to children, young people and their families.
(3)
To reflect on the benefits of VCT and the collection of a variety of ROMs via digital platforms.
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Mulligan A, Sresthaporn N, Mulroy S, Rudd T, Coffey A, Joyce M, Gadancheva V, Glancy C. Development, preliminary validation and reliability of the colourful 'My Feelings Form' self-report for young children. Child Adolesc Ment Health 2022; 28:299-306. [PMID: 35614029 DOI: 10.1111/camh.12566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Patient-reported outcome measures place the patient at the centre of his/her care. There are calls to introduce child-reported outcome measures to mental health services. We aimed to (a) develop an age-appropriate patient-reported outcome measure for children's mental health, and (b) validate this in a primary school and Child and Adolescent Mental Health Service (CAMHS). METHODS A list of items to measure children's mental health was proposed (Draft 1) and revised to 14 items following focus group and user consultation (Draft 2). A colourful, cartoon and emoji version was created in consultation with children (Draft 3); a professional cartoon artist created the final 'My Feelings Form' (MFF), with usability feedback (Draft 4). The MFF was tested by 317 children aged 4-13 years from one mixed-gender primary school at two time points in 1 day, and 25 children aged 4-13 years from CAMHS. Results were analysed using test-retest reliability and exploratory factor analysis; a receiver operator characteristic curve was constructed. RESULTS The CAMHS group scored significantly higher than the school group for the mean total score (23.5 ± 11.3 vs. 16.1 ± 6.2) and for 10 items. Test-retest reliability was acceptable (correlation = 0.74, p < .001). Exploratory factor analysis using 10 informative items identified two factors - emotional factor (Cronbach's alpha = 0.74) and function factor (Cronbach's alpha = 0.59). The revised 10-item form has a Cronbach's alpha of 0.77; a cut-off of 12 has a sensitivity of 80% and specificity of 60%, indicating that it correctly identified 80% of those who were attending CAMHS and gave 60% of the schoolchildren a negative result. CONCLUSIONS The colourful MFF was co-produced with children, and preliminary data suggest that it is a useful patient-reported outcome measure for children's mental health.
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Affiliation(s)
- Aisling Mulligan
- Department of Child and Adolescent Psychiatry, School of Medicine, University College Dublin, Dublin, Ireland.,Dublin North City and County Child and Adolescent Mental Health Service, Dublin, Ireland
| | | | - Sinead Mulroy
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Tara Rudd
- Dublin North City and County Child and Adolescent Mental Health Service, Dublin, Ireland
| | - Anne Coffey
- Department of Psychotherapy, University College Dublin, Dublin, Ireland
| | - Maria Joyce
- Department of Psychotherapy, University College Dublin, Dublin, Ireland
| | - Veselina Gadancheva
- Dublin North City and County Child and Adolescent Mental Health Service, Dublin, Ireland
| | - Caoimhe Glancy
- School of Medicine, University College Dublin, Dublin, Ireland
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Anderson JK, Newlove-Delgado T, Ford TJ. Annual Research Review: A systematic review of mental health services for emerging adults - moulding a precipice into a smooth passage. J Child Psychol Psychiatry 2022; 63:447-462. [PMID: 34939668 DOI: 10.1111/jcpp.13561] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The transition between child and adult services should aim to support young people into the next stage of their life in a way that optimises their function. Yet financial, organisational and procedural barriers to continuity of care often hamper smooth transition between child and adult services. AIM AND METHOD We reviewed studies of transition from child to adult mental health services, focusing on: (a) rates of referrals and referral acceptance; (b) barriers and facilitators of successful transition; (c) continuity of care during and post-transition and (d) service users' experience of transition. Studies were identified through systematic searches of electronic databases: PsycINFO, Medline, Embase and Child Development and Adolescent Studies. FINDINGS Forty-seven papers describing 43 unique studies met inclusion criteria. Service provision is influenced by previous history and funding processes, and the presence or absence of strong primary care, specialist centres of excellence and coordination between specialist and primary care. Provision varies between and within countries, particularly whether services are restricted to 'core' mental health or broader needs. Unsupportive organisational culture, fragmentation of resources, skills and knowledge base undermine the collaborative working essential to optimise transition. Stigma and young people's concerns about peers' evaluation often prompt disengagement and discontinuation of care during transition, leading to worsening of symptoms and later, to service re-entry. Qualitative studies reveal that young people and families find the transition process frustrating and difficult, mainly because of lack of advanced planning and inadequate preparation. CONCLUSIONS Despite increasing research interest over the last decade, transition remains 'poorly planned, executed and experienced'. Closer collaboration between child and adult services is needed to improve the quality of provision for this vulnerable group at this sensitive period of development.
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Affiliation(s)
| | | | - Tamsin J Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Eilander MMA, van Mil MMA, Koetsier LW, Seidell JC, Halberstadt J. Preferences on how to measure and discuss health related quality of life within integrated care for children with obesity. J Patient Rep Outcomes 2021; 5:106. [PMID: 34648095 PMCID: PMC8517052 DOI: 10.1186/s41687-021-00381-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/26/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Childhood obesity can affect physical as well as psychosocial wellbeing. Therefore, childhood obesity care aims to improve all dimensions of health related quality of life (HRQoL). HRQoL can be measured with the generic questionnaire PedsQL4.0 and the weight-specific IWQOL-Kids. In the Netherlands, HRQoL assessment is conducted by the coordinating professional (CP). The aim of this qualitative study was to examine how and when to implement the measurement and discussion of HRQoL using the PedsQL4.0 and IWQOL-Kids within the integrated care for children with obesity in the Netherlands. Semi-structured interviews were conducted with fourteen CPs, in which the following was discussed: a) familiarity and attributions with regard to the assessment of HRQoL; b) wishes and needs with regard to the usage of the questionnaires; c) its practical incorporation. RESULTS Interviews revealed that most CPs gained insight into the HRQoL by talking with families. One CP used the PedsQL4.0, the remaining CPs were unfamiliar with the two questionnaires. Even though some barriers, for instance a lack of time, might hinder the implementation of the PedsQL4.0 and IWQOL-Kids, all participants think the usage of either one or both questionnaires would have additional value to the support and care for children with obesity. There was no consensus about the questionnaire of preference. CONCLUSIONS When the right preconditions are met, HRQoL questionnaires have the potential to support CPs in improving the care for children with obesity, tailored to each individual child.
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Affiliation(s)
- Minke M A Eilander
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Marieke M A van Mil
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leandra W Koetsier
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jutka Halberstadt
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Gibbons N, Harrison E, Stallard P. Assessing recovery in treatment as usual provided by community child and adolescent mental health services. BJPsych Open 2021; 7:e87. [PMID: 33888176 PMCID: PMC8086392 DOI: 10.1192/bjo.2021.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite the importance of routinely assessing the outcomes of everyday practice, few studies have reported outcome metrics for child and adolescent mental health services (CAMHS). AIMS Our aim is to investigate reliable change and recovery rates for treatment as usual, provided by one community CAMHS over two time periods. METHOD We prospectively audited accepted consecutive referrals from November 2017 to January 2018, and April to September 2019. Cases with paired outcomes were identified, and reliable change and recovery rates were calculated. RESULTS Baseline outcome data were obtained for 672 (78.2%) and 744 (77.5%) young people in 2018 and 2019, respectively. Of eligible participants, 174 (59.2%) and 155 (45.7%) completed at least one follow-up outcome measure in 2018 and 2019, respectively. Pre- and post-test scores on the Revised Child Anxiety and Depression Scale (RCADS) and Strengths and Difficulties Questionnaire (SDQ) showed a reduction in symptoms. Total RCADS scores showed 21-25% of participants reliably improved, with 44-49% showing reliable improvement on one or more subscale. On the SDQ, 11 (15.5%) and 19 (25.3%) participants reported reliable improvement on at least one subscale in 2018 and 2019, respectively. Reliable recovery rates ranged from 48 to 51% for youth-completed and 40 to 42% for parent-completed RCADS. CONCLUSIONS Half of young people receiving treatment as usual from CAMHS reliably improved on at least one routine outcome measure subscale, improvement rates comparable with adult psychological therapies services. Our findings indicate that reliable change and recovery on subscale rather than total scores may be a better indication of outcomes.
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Affiliation(s)
- Naomi Gibbons
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Melksham Community Hospital, UK
| | - Emma Harrison
- Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Melksham Community Hospital, UK
| | - Paul Stallard
- Child and Adolescent Mental Health Group, Department for Health, University of Bath, UK; and Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, UK
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