Child And Adolescent Mental Health Services Research Articles

Transition from child and adolescent to adult mental health services: an evaluation

Background/Aims Evidence has highlighted dissatisfaction among patients with the process of transitioning from child and adolescent mental health services (CAMHS) to adult mental health services. This study aimed to evaluate compliance with and the impact of recommendations made at a mental health trust to improve the transition process after an audit carried out in 2015. Methods A nine-item audit tool was developed based on National Institute for Health and Care Excellence guidelines for transition from CAMHS to adult mental health services. Patient records were obtained from the trust's health informatics service and analysed for the calendar year of 2015, looking at compliance with the guidance. The results were used to implement recommendations to improve the transition process, then the audit was repeated for the calendar year of 2017. Data were analysed using descriptive statistics to compare the two periods and identify areas of improvement, or lack thereof. Results A total of 52 and 75 case records were audited in the 2015 and 2017 evaluations respectively. Some improvements were seen in some areas over the 2-year period, such as the introduction of a named transition worker and more joint working between child and adolescent and adult mental health services. However, several domains of practice still had low levels of compliance with recommendations in the 2017 audit, particularly items relating to information sharing and communication with patients and their caregivers. Conclusions Further work is needed to improve compliance with recommendations for transitional care in mental health services, particularly in terms of communication and involvement of the patient during this process. More research is needed into the barriers to effective transition and any strategies implemented to improve this process should be evaluated using robust methods. Successful strategies will likely require investment in staff recruitment and retention.

Pharmacological Treatment of Children and Adolescents Diagnosed with Attention-deficit/hyperactivity Disorder at Mental Health Services in Qatar: A Retrospective Study

Background: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. The consequences of ADHD could seriously impact the patient’s life, and thus parental training, behavioral therapies, and pharmacological interventions are the main therapeutic options applied. This study was conducted to explore the trends of prescribing pharmacological medications used in ADHD and identify the reasons for discontinuation of such medications. Methodology: A retrospective chart review for patients diagnosed with ADHD at Child and Adolescent Mental Health Services (CAMHS) in Qatar from January 2019 to December 2019 was carried out. Patients less than 18 years old, diagnosed with ADHD as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and were on pharmacological treatment for ADHD were suitable to be included. Patients who were not on anti-ADHD medications were excluded from the study. Results: Ninety-two patients were eligible to be included in the study. Autism Spectrum Disorder (ASD) was found to be the most coexisting condition in addition to ADHD in 16.3%. Methylphenidate was the most prescribed medication (68.5%), followed by atomoxetine (30.4%). None of the participants were found on modafinil, guanfacine, bupropion, or benzodiazepines, and none exceeded the maximum licensed dose of either methylphenidate or atomoxetine. Half (50%) of the sample on atomoxetine discontinued treatment compared to 14.2% in the methylphenidate group. Conclusion: The clinical practice of prescribing pharmacological options for ADHD was thoroughly in alignment with international guidelines. The effects of long-term use of these psychotropics in this particular group of patients on their neurobiological, behavioral, and physical health should be studied further.

General Practitioner referrals to Child and Adolescent Mental Health Services: Did they differ during Covid-19?

The COVID pandemic has been associated with poorer mental health in youth. This study aimed to evaluate any change in General Practitioner (GP) referral pattern to Child and Adolescent Mental Health (CAMH) services during the first 10 months of Covid-19 and compare with a similar time frame in 2019. All accepted referrals to aCAMH Service in Dublin during the study time frame were reviewed. Referral letters were batch anonymised and clinical data extracted using a study specific proforma for analysis. Referral numbers between the two time periods did not statistically differ. Proportionally more females were referred during the pandemic, increasing to 56.9%, n = 99, compared to 43.1%, n = 75 in 2019 (p = 0.01). Referrals were more often designated by the clinician as urgent during the pandemic (61.3%, n = 98) than before (39%, n = 62, p < 0.001). Referrals outlining self-harm or suicidal ideation increased significantly, from 42.1% (n = 67) to 55.9% (n = 90) (p = 0.014). Referrals for externalising problems fell from 2019 rates; ADHD (21.4%, n = 34 vs 11.1%, n = 18; p = 0.013), ASD (26.4%, n = 42 vs 16.1%, n = 26; p = 0.038) and conduct problems (23.3%, n = 37 vs 7.4%, n = 12; p < 0.001). Although numbers for psychosis in 2019 were low (10.7%, n = 17), these also fell significantly in 2020 (2.5%, n = 4; p < 0.001). The finding of reduced referrals for ADHD and ASD has not previously been reported. With concerns regarding educational loss linked to online learning, it is crucial that these youth are not doubly disadvantaged by delayed referral and education decline.

Usability of the IDDEAS prototype in child and adolescent mental health services: A qualitative study for clinical decision support system development.

Child and adolescent mental health services (CAMHS) clinical decision support system (CDSS) provides clinicians with real-time support as they assess and treat patients. CDSS can integrate diverse clinical data for identifying child and adolescent mental health needs earlier and more comprehensively. Individualized Digital Decision Assist System (IDDEAS) has the potential to improve quality of care with enhanced efficiency and effectiveness. We examined IDDEAS usability and functionality in a prototype for attention deficit hyperactivity disorder (ADHD), using a user-centered design process and qualitative methods with child and adolescent psychiatrists and clinical psychologists. Participants were recruited from Norwegian CAMHS and were randomly assigned patient case vignettes for clinical evaluation, with and without IDDEAS. Semi-structured interviews were conducted as one part of testing the usability of the prototype following a five-question interview guide. All interviews were recorded, transcribed, and analyzed following qualitative content analysis. Participants were the first 20 individuals from the larger IDDEAS prototype usability study. Seven participants explicitly stated a need for integration with the patient electronic health record system. Three participants commended the step-by-step guidance as potentially helpful for novice clinicians. One participant did not like the aesthetics of the IDDEAS at this stage. All participants were pleased about the display of the patient information along with guidelines and suggested that wider guideline coverage will make IDDEAS much more useful. Overall, participants emphasized the importance of maintaining the clinician as the decision-maker in the clinical process, and the overall potential utility of IDDEAS within Norwegian CAMHS. Child and adolescent mental health services psychiatrists and psychologists expressed strong support for the IDDEAS clinical decision support system if better integrated in daily workflow. Further usability assessments and identification of additional IDDEAS requirements are necessary. A fully functioning, integrated version of IDDEAS has the potential to be an important support for clinicians in the early identification of risks for youth mental disorders and contribute to improved assessment and treatment of children and adolescents.

Is it 'just' trauma? Use of trauma-informed approaches and multi-agency consultation in mental healthcare of looked after children.

This article presents three case studies of patients that a child and adolescent mental health service (CAMHS) have supported and its purpose is to encourage discussion of two key learning points. The first of these is the utility of developmental trauma as an approach for children with mental health presentations. The second centres on the importance of multi-agency working when working with young people, principally those within the UK's local authority care system ('looked after children'), who have had traumatic experiences in order to enhance positive outcomes. We also want to encourage consideration of the implications of developmental trauma for current core CAMHS therapeutic models in an attempt to reach beyond the often held narrative that the trauma formulation implies there is 'just trauma, no mental illness'.

Adolescent schizophrenia: state of the art and proposals to improve transition management in Italy.

In mental health care, transition refers to the pathway of a young person from a child and adolescent mental health service (CAMHS) to an adult mental health service (AMHS). In Italy, the age of transition from adolescents to adults' mental health services is at the age of 18. Difficulties in transitioning have shown to favor patients' and families' disengagement and discontinuity of care with pharmacological treatment dropouts. On the other hand, a smooth and effective transition may improve the management of the disease and increase the chances of improvement of young schizophrenic patients. This project of roundtables, including child neuropsychiatrists (CNPs) and adult psychiatrists (Psy) throughout Italy, was aimed at exploring the problems of transition in clinical practice and collecting the proposals to improve transition management. The need to fill some cultural and organizational aspects strongly emerged to improve the transition process of adolescents with schizophrenia to adults' mental health services. On the one hand, specific training programs for both Psy and CNPs on the transition process are hoped for. On the other hand, both Psy and CNPs have expressed a need for shared official protocols, direct handover between the services including a period of shared management, and building of territorial multidisciplinary teams. All these aspects imply having a national mental health policy dedicated to taking charge of young people with mental health disorders, and accompanying them across the border between children and adults' mental health services. Improving transitional care can facilitate not only recovery but also prevention of mental illness for young people. Allocation of resources should aim at matching the epidemiological burden and reducing the heterogeneity between Italian regions.

Receiving thank you letters in inpatient child and adolescent mental health services (CAMHS): A qualitative study of nurse's experiences.

Previous research has found that nurses in inpatient CAMHS can struggle to define their role and contribution to patient care. While gratitude has received increased attention in relation to subjective well-being in healthcare settings, the receipt of gratitude in the form of thank you letters is currently unexplored in the CAMHS context. To gain an understanding of how inpatient CAMHS nursing staff experience receiving expressions of gratitude from patients. Adopting an exploratory qualitative approach, two focus group interviews were conducted. Participants completed a brief online follow-up questionnaire. Data were examined using thematic analysis. Reflecting on expressions of gratitude improved understanding of professional identity, enhanced reflexivity, enhanced team cohesion and increased professional and personal confidence and motivation. Expressions of gratitude appear to offer meaningful sources of feedback for nurses and support a greater sense of personal accomplishment, professional role and the relational impact of care for patients. When nurses share and discuss expressions of gratitude with colleagues this brings benefits additional to the initial receipt. Nurses should be supported to engage in discussing and reflecting upon receiving thank you letters and other tokens of gratitude although care should be taken to support those who might experience unease or increased self-doubt.

Child and adolescent mental health services during the COVID-19 epidemic in Slovenia: Comparison with other European countries

Purpose: To evaluate the impact of the COVID-19 epidemic on child and adolescent mental health services (CHAMS) during the first and second epidemic wave.&#x0D; Methods: Members of the Slovenian Association for Child and Adolescent Psychiatry (n=66) were invited to participate in the study. The survey involved two semi-structured questionnaires on CHAMS and clinical and organizational issues with respect to the first and second COVID-19 waves. The findings were compared with similar studies conducted in other European countries.&#x0D; Results: Eighteen members fulfilled the first and seven the second questioner. Thirty-three percent of respondents reported that their CHAMS colleagues were assigned to the COVID-19 wards during the first and 43% in the second wave. The CHAMS were more affected by the public health measures for COVID-19 during the first wave. During the first wave, half of the respondents experienced worsening anxiety disorders, while an increase in all mental disorders was reported during the second wave.&#x0D; Conclusion: A concerning finding of this study was limited access to CHAMS as a result of public health measures, especially during the first wave. But the provision of services in Slovenia was not as severely limited as elsewhere in Europe. CHAMS in Slovenia were able to provide better employee safety measures in terms of COVID-19 infections compared to other European countries. CHAMS employees in Slovenia were more frequently transferred to COVID-19 wards compared to their European colleagues, despite the fact that they were faced with increasing numbers of children and adolescents with mental disorders.

Psychosis prediction 2.0: why child and adolescent mental health services should be a key focus for schizophrenia and bipolar disorder prevention research.

Existing approaches to psychosis prediction capture only a small minority of future cases. Recent research shows that specialist child and adolescent mental health services (CAMHS) offer a (previously unrecognised) high-risk and high-capacity approach for psychosis early identification, prediction and, ultimately, prevention.

Reflecting on professional self-disclosure and supportive relationships with foster carers during the COVID-19 pandemic

Professional self-disclosure can be defined as a clinician revealing personal information about themselves to the person they are caring for. This article provides reflections from clinicians working in child and adolescent mental health services (CAMHS) and their navigation of professional self-disclosure during the coronavirus disease 2019 pandemic. The reflections focus on the use of self-disclosure in supportive relationships with foster carers. Drawing on the authors’ practice experiences as clinicians in specialist CAMHS settings, the article considers changes in the way that self-disclosure was approached following the shift to remote care delivery during the pandemic. The authors suggest that remote working involves a potentially increased scope for inappropriate use of self-disclosure and outline the implications for mental health nurses working with foster carers.

The importance of clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their mental health services in Europe

BackgroundTo study clinicians' and parents' awareness of suicidal behaviour in adolescents reaching the upper age limit of their Child and Adolescent Mental Health Service (CAMHS) and its association with mental health indicators, transition recommendations and mental health service (MHS) use. Methods763 CAMHS users from eight European countries were assessed using multi-informant and standardised assessment tools at baseline and nine months follow-up. Separate ANCOVA's and pairwise comparisons were conducted to assess whether clinicians' and parents' awareness of young people's suicidal behaviour were associated with mental health indicators, clinician's recommendations to continue treatment and MHS use at nine months follow-up. Results53.5 % of clinicians and 56.9 % of parents were unaware of young people's self-reported suicidal behaviour at baseline. Compared to those whose clinicians/parents were aware, unawareness was associated with a 72–80 % lower proportion of being recommended to continue treatment. Self-reported mental health problems at baseline were comparable for young people whose clinicians and parents were aware and unaware of suicidal behaviour. Clinicians' and parents' unawareness were not associated with MHS use at follow-up. LimitationsAspects of suicidal behaviour, such as suicide ideation, -plans and -attempts, could not be distinguished. Few young people transitioned to Adult Mental Health Services (AMHS), therefore power to study factors associated with AMHS use was limited. ConclusionClinicians and parents are often unaware of suicidal behaviour, which decreases the likelihood of a recommendation to continue treatment, but does not seem to affect young people's MHS use or their mental health problems.

Working with trauma; finding new ports of entry1

ABSTRACT This paper describes how, in the wake of a spate of fatal knife crime in one London borough, the council, Clinical Commissioning Group (CCG) and Child and Adolescent Mental Health Service (CAMHS) got together to think about how to improve outcomes for their young people. Starting with schools and pupil referral units, the CAMHS and educational psychology service were commissioned to work with whole staff groups, from senior leadership to lunchtime monitors and playground staff, to embed trauma informed policy and practice. The aim was to spread understanding about complex developmental trauma; what it is, how it affects the behaviour and experience of children and families, and how to work with it. Given how widespread trauma is, the objective was also to think about what might need to change in the environment and ethos of the borough’s schools as a result. Following the project’s initial success, its scope and remit were expanded to support services on a policy level, while also working with their staff to think about the impact of trauma, and how best to support children and families who have been affected by it. As well as teaching about trauma, the project is primarily an experiential one. This paper explores the impact on staff who were involved in the project; what came out of it for them personally in terms of changes to their thinking and outlook, and what they saw as the changes for the children and families they worked with.

Mental health in clinically referred children and young people before and during the Covid-19 pandemic

The Covid-19 pandemic and mitigation approaches, including lockdowns and school closures, are thought to have negatively impacted children and young people’s (CYP) mental health. However, the impact for clinically referred CYP is less clear. We investigated differences in the mental health of CYP referred to specialist Child and Adolescent Mental Health Services (CAMHS) before and since the onset of the pandemic. Using baseline data (self- and parent- completed Mood and Feelings Questionnaire and Strengths and Difficulties Questionnaire) from an ongoing RCT (STADIA; ISRCTN: 15748675) in England involving 5–17-year-olds with emotional difficulties recently referred to CAMHS (non-urgent referrals), with repeated cross-sectional comparisons of CYP (n = 1028) recruited during 5 different time periods: (1) Before schools were closed (Group 1 (pre-pandemic); n = 308; 27.08.2019–20.03.2020). (2) Early pandemic period until schools fully re-opened, which included the first national lockdown, its easing and the summer holidays (Group 2 (in-pandemic); n = 183; 21.03.2020–31.08.2020). (3) The following school-term—schools fully re-opened and remained open, including during the second national lockdown (Group 3 (in-pandemic); n = 204; 01.09.2020–18.12.2020). (4) Schools closed as part of the third national lockdown (Group 4 (in-pandemic); n = 101; 05.01.2021–07.03.2021). (5) Schools re-opened and remained open, until the school summer holidays (Group 5 (in-pandemic); n = 232; 08.03.2021–16.07.2021). Most CYP scored above cutoff for emotional problems and depression, with three-quarters meeting criteria for a probable disorder (‘caseness’). The groups did not differ on parent-rated mental health measures. However, self-rated emotional problems, depression, functional impairment and caseness appeared to be higher amongst participants recruited in the two periods following school re-openings. In particular, functional impairment and caseness were greater in Group 5 compared with Group 2. Although symptom severity or impairment did not change in the initial pandemic period, self-reported difficulties were greater during the periods after schools re-opened. This suggests possible greater stresses in the adjustment to re-starting school following recurrent lockdowns and school closures.

Variation in attitudes toward diagnosis and medication of ADHD: a survey among clinicians in the Norwegian child and adolescent mental health services

Prevalence and medication rates of ADHD vary geographically, both between and within countries. No absolute cutoff exists between ADHD and normal behavior, making clinician attitudes (leading to local practice cultures) a potential explanation for the observed variation in diagnosis and medication rates. The objective of this study was to describe variation in attitudes toward diagnosis and medication of ADHD among clinicians working in child and adolescent mental health services (CAMHS). We hypothesized that attitudes would vary along a spectrum from “restrictive” to “liberal”. We also explored whether differences in attitudes between clinicians were related to professional background and workplace (clinic). A survey in the form of a web-based questionnaire was developed. All CAMHS outpatient clinics in Norway were invited. Potential respondents were all clinicians involved in diagnosing and treating children and adolescents with ADHD. To investigate the existence of attitudes toward diagnosis and medication as latent constructs, we applied confirmatory factor analysis (CFA). We further examined how much of variance in attitudes could be ascribed to profession and clinics by estimating intraclass correlation coefficients. In total, 674 respondents representing 77 (88%) of the clinics participated. We confirmed variation in attitudes with average responses leaning toward the “restrictive” end of the spectrum. CFA supported “attitude toward diagnosis” and “attitude toward medication” as separate, and moderately correlated (r = 0.4) latent variables, representing a scale from restrictive to liberal. Professional background and workplace explained only a small part of variance in these attitudes.

Leaving child and adolescent mental health services in the MILESTONE cohort: a longitudinal cohort study on young people's mental health indicators, care pathways, and outcomes in Europe

The configuration of having separate mental health services by age, namely child and adolescent mental health services (CAMHS) and adult mental health services (AMHS), might be a barrier to continuity of care that adversely affects young people's mental health. However, no studies have investigated whether discontinuity of care in the transition period affects mental health. We aimed to discern the type of care young people receive after reaching the upper age limit of their CAMHS and examine differences in outcomes at 24-month follow-up between young people receiving different types of care. To assess mental health in young people from 39 CAMHS in eight European countries (Belgium, Croatia, France, Germany, Italy, Ireland, the Netherlands, and the UK), we did a longitudinal cohort study. Eligible young people were CAMHS users up to 1 year younger than the upper age limit of their CAMHS or up to 3 months older, if they were still in CAMHS. Information on mental health service use, mental health problems (ie, using the Health of the Nation Outcome Scale for Children and Adolescents, Youth Self-Report and Adult Self-Report, DSM-5, and ICD-10), and sociodemographic characteristics were collected using self-reported, parent-reported, and clinician-reported interviews and questionnaires. Mixed models were applied to assess relationships between baseline characteristics, mental health service use, and outcomes. The MILESTONE cohort included 763 young people. The participants were 60·0% female (n=458) and 40·0% male (n=305), 90·3% White (n=578), and had a mean age of 17·5 years (range 15·2-19·6 years). Over the 24-month follow-up period, 48 young people (6·3%) actively withdrew from the study. For young people, the higher their scores on the Health of the Nation Outcome Scale for Children and Adolescents (p=0·0009) and Youth Self-Report and Adult Self-Report (p=0·046), and who had a clinical classification of severe mental illness (p=0·0033), had suicidal thoughts or behaviours or self-harm (p=0·034), used psychotropic medication (p=0·0014), and had a self-reported or parent-reported need for continued treatment (p&lt;0·0001) at baseline, were more likely to transition to AMHS or stay in CAMHS than to have care end. Overall, over the 24-month follow-up period, the mental health of young people improved, but 24·4% of young people reported an increase in problems calculated using the reliable change index, of whom 5·3% had a clinically relevant increase in problems. At 24-month follow-up, no differences in change in mental health problems since baseline were found between young people who used different types of care (CAMHS, AMHS, or no care). Although approximately half of young people reaching the upper age limit of their CAMHS stop using mental health services, this was not associated with a deterioration in their mental health. Young people with the most severe mental health problems are more likely to receive continued care. If replicated, our findings suggest investments in improving transitional care for all CAMHS users might not be cost-effective in times of rising health-care costs, but might be better targeted at a subgroup of young people with increasing mental health problems who do not receive continued treatment. European Commission's 7th Framework Programme.

A MILESTONE study of youth service transitions in Europe

The transfer between services for children and adults falls at a particularly vulnerable time, coincides with multiple other transitions, and is reputedly “poorly planned, executed and experienced”.1–3 Suzanne E Gerritsen and colleagues’4 study challenges this orthodoxy. They recruited 763 young people from 39 Child and Adolescent Mental Health Services (CAMHS) across eight European countries, who were within 1 year younger than or less than 3 months older than the CAMHS maximum age.4 Young people, their parents, and clinicians completed interviews and questionnaires at 9, 15, and 24 months after the baseline assessment.

A randomised controlled trial to compare clinical and cost-effectiveness of an online parent-led treatment for child anxiety problems with usual care in the context of COVID-19 delivered in Child and Adolescent Mental Health Services in the UK (Co-CAT): a study protocol for a randomised controlled trial

BackgroundIn the context of COVID-19, NHS Child and Adolescent Mental Health Services (CAMHS) and other children’s mental health services have faced major challenges in providing psychological treatments that (i) work when delivered remotely and (ii) can be delivered efficiently to manage increases in referrals as social distancing measures have been relaxed. Anxiety problems are a common reason for referral to CAMHS, children with pre-existing anxiety problems are particularly vulnerable in the context of COVID-19, and there were concerns about increases in childhood anxiety as schools reopened. The proposed research will evaluate the clinical and cost-effectiveness of a brief online parent-led cognitive behavioural treatment (CBT) delivered by the OSI (Online Support and Intervention for child anxiety) platform with remote support from a CAMHS therapist compared to ‘COVID-19 treatment as usual’ (C-TAU) in CAMHS and other children’s mental health services throughout the COVID-19 pandemic.MethodsWe will conduct a two-arm, multi-site, randomised controlled non-inferiority trial to evaluate the clinical and cost-effectiveness of OSI with therapist support compared to CAMHS and other child mental health services ‘COVID-19 treatment as usual’ (C-TAU) during the COVID-19 outbreak and to explore parent and therapists’ experiences.DiscussionIf non-inferiority is shown, the research will provide (1) a solution for efficient psychological treatment for child anxiety disorders while social distancing (for the COVID-19 context and future pandemics); (2) an efficient means of treatment delivery as ‘normal service’ resumes to enable CAMHS to cope with the anticipated increase in referrals; and (3) a demonstration of rapid, high-quality evaluation and application of online interventions within NHS CAMHS to drive forward much-needed further digital innovation and evaluation in CAMHS settings. The primary beneficiaries will be children with anxiety disorders and their families, NHS CAMHS teams, and commissioners who will access a potentially effective, cost-effective, and efficient treatment for child anxiety problems.Trial registrationISRCTN ISRCTN12890382. Registered prospectively on 23 October 2020.

‘Space to hide’: experiences of remote provision across child and adolescent mental health services (CAMHS)

BackgroundThe global COVID-19 pandemic necessitated rapid adoption of remote provision across child and adolescent mental health services (CAMHS). The study aimed to understand young people’s, parents’/carers’, and professionals’ experiences of remote provision across CAMHS in one NHS Trust in the North West of England to inform future recovery practice so that remote sessions can continue where they have been well received but re-thought or replaced where they have not.MethodsThe study sample comprised three groups: (i) young people, (ii) parents/carers, and (iii) clinical staff. Semi-structured interviews and focus groups were used to collect data. Data were analysed using thematic analysis.ResultsThree overarching themes were identified: ‘Remote therapeutic experiences’; ‘Spaces and places of therapy’; and ‘Future of CAMHS’. Although remote appointments increased flexibility within the service, the quality of the relational experience was altered, typically for the worse. Clinicians felt less able to examine vital forms of non-verbal communication, which were considered instrumental in assessing and engaging people experiencing difficulties, leaving some questioning their professionalism. Although some young people suggested that remote provision increased comfort levels, others felt their place of comfort and safety was invaded.ConclusionsReduced travel time for both clinicians and families may increase capacity, enabling the service to meet the increased demand if clinical effectiveness can be preserved. In considering future models of provision, assessing clinical need, patient and family preference, and access to space and hardware are all critical when deciding which modality to use for the best outcomes for each individual.

Finnish Population Study Yields New Way to Identify Youth at Risk for Serious Mental Illness

Finnish Population Study Yields New Way to Identify Youth at Risk for Serious Mental Illness

Implementation of Trauma-specific Interventions in a Child and Adolescent Mental Health Service

Exposure to childhood adversity is a prevalent and pressing issue due to its established links with poor physical and mental health outcomes across the lifespan. High rates of adversity have been found within young people attending mental health services, and the provision of trauma-informed care and trauma-specific therapies are therefore essential within these services. Trauma-focused cognitive behaviour therapy (TF-CBT) is an evidence-based intervention with established efficacy amongst traumatised children and youth. The primary objective of this study was to evaluate the effectiveness of trauma-specific therapy (TF-CBT) when implemented in a Child and Adolescent Mental Health Service (CAMHS). Given that most youth receive care in community settings, it is important to determine whether treatments tested under controlled conditions can apply in the real world of clinical practice. Specifically, this study aimed to quantify the number and type of adversities reported by clients receiving the intervention; investigate whether the intervention is associated with improvements in participants’ posttraumatic stress disorder (PTSD) symptoms, general mental health symptoms and functioning; and report contact with CAMHS at 3 months and 2 years post-treatment. Results showed that CAMHS clients were more likely to have experienced multiple traumatic events than single events, with 100% of clients experiencing suicidal thoughts. Treatment was associated with significant improvements in PTSD symptom severity and improvements in general mental health symptoms. Many clients received ongoing mental health support at the 3-month and 2-year follow-ups, reflecting the complex nature of their issues and the need for support to maintain gains achieved during treatment.