Abstract
Aims and methodIn 2006, staff in child and adolescent mental health services (CAMHS) in Lincolnshire, UK, felt that cases were becoming increasingly complex. The Pearce Case Complexity Scale (PCCS) and a staff opinions questionnaire were used to measure subjective and objective changes in case complexity in a relatively stable CAMHS service over a 10-year period from 1996 to 2006, with data examined between 2008 and 2010.ResultsClinicians reported an increase in case complexity over time. However, the PCCS did not show a significant change in the decade studied.Clinical implicationsStaff anxiety could be a determinant of judgements they make about case complexity in CAMHS.
Highlights
Clinical implications Staff anxiety could be a determinant of judgements they make about case complexity in child and adolescent mental health services (CAMHS)
Two-thirds (46/60, 77%) of clinicians returned completed questionnaires. They showed that 78% of staff thought that case complexity had increased during their professional lives in Lincolnshire; no one thought that cases had become less complex
When staff were asked about changes in each of the five factors contained in the Pearce Case Complexity Scale (PCCS), 68% thought that psychosocial problems had increased, 65% indicated that they thought that comorbidity of cases had increased and 59% thought more agencies were becoming involved over the years with the children they saw
Summary
Two-thirds (46/60, 77%) of clinicians returned completed questionnaires They showed that 78% of staff thought that case complexity had increased during their professional lives in Lincolnshire (95% CI 64 to 88%); no one thought that cases had become less complex. When staff were asked about changes in each of the five factors contained in the PCCS, 68% thought that psychosocial problems had increased, 65% indicated that they thought that comorbidity of cases had increased and 59% thought more agencies were becoming involved over the years with the children they saw. The degree of comorbidity and the extent of psychosocial factors showed a decrease in the mean PCCS scores between 1996 and 2006. Over 60% of staff judged the degree of comorbidity of cases and the extent of psychosocial factors to have increased, whereas the PCCS rating of these two factors was found to have decreased over time
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