Abstract
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). Our aim is to investigate reliable change and recovery rates for treatment as usual, provided by one community CAMHS over two time periods. 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. 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. 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.
Highlights
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)
Our findings indicate that reliable change and recovery on subscale rather than total scores may be a better indication of outcomes
In the UK, data are reported nationally and are derived from routine outcome measures (ROMs) completed for cases seen within child and adolescent mental health services (CAMHS) on at least two occasions.[2]
Summary
We prospectively audited accepted consecutive referrals from November 2017 to January 2018, and April to September 2019. We conducted in-depth prospective audits of new, consecutive referrals, accepted into Bath and North East Somerset, Swindon and Wiltshire community CAMHS during two separate time periods: November 2017 to January 2018 and April to September 2019. The time frames were pragmatically determined by the availability of psychology assistants to undertake the audits. This study is an audit of anonymised collective data, and as such, ethical approval was not required. Patients provided informed consent to complete outcome measures and for this to be analysed. The service has a local procedure where ROMS are completed at baseline, after three sessions and at discharge. The service has mandated the use of the following core outcome measures, to be completed when considered appropriate:
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