Allocation of referrals within a child and adolescent mental health service

Abstract

Long waiting listsare a common problem in child and adolescent mental health services. We describe how referrals to the service in York are considered and allocated by a multi-disciplinary team. The criteria tor allocation to different professionals and specialist teams are described and data representing a snapshot of referrals and response rate over a three-month period presented, showing that most referrals are seen within two months. We postulate that consideration of referrals in this way is an effective and efficient way of running a service.

Triage: a waiting list initiative in a child mental health service

“…Jones & Bhadrinath (1998) found that general practitioners' (GPs') main concern regarding prioritisation of child mental health problems was the time taken for non-urgent referrals to be seen. Several initiatives to decrease waiting time to first appointment and improve attendance at child mental health clinics have been described recently (Munjal et al, 1994;Wenning & King, 1995;Geekie, 1995;Potter & Darwish, 1996;Roberts & Partridge, 1998). We report on our novel initiative to reduce our waiting time to first appointment.…”

“…Multiple factors are involved in nonattendance for first appointments, including a lower level of maternal education, older age of the referred child, parental belief that intervention may worsen the problem and unrealistic expectations for a rapid treatment response (Ewalt et al, 1972). A long waiting time has also been found to increase the rate of non-attendance (Subotski & Berelowitz, 1990). Jones & Bhadrinath (1998) found that general practitioners' (GPs') main concern regarding prioritisation of child mental health problems was the time taken for non-urgent referrals to be seen.…”

Assessing the Risks Presented by Parents

“…Where the referral takes place in the context of court proceedings a letter of instruction from the appropriate legal agencies will be expected. Once the written referral has been received it will be processed through the allocations meeting (Roberts & Partridge, 1998) to the Risk Assessment Team within the Lime Trees CAMHS.…”

Evaluating family therapy in a child and adolescent mental health service

“…However, with limited resources and with in creasing demands upon the service as a whole such a provision must be effectively allocated (Roberts & Partridge, 1998) to ensure clinical relevance. To ensure such relevance and effec tiveness as a child and adolescent mental health service (CAMHS) treatment modality it is neces sary to address the following issues.…”

“…A previous service review showed a non-attendance rate of over 40% with the consequences of under-used clinical time as well as increased waiting times for appointments. At that time 40% of referrals to family therapy had to wait over 12 weeks for their initial appointment (Roberts & Partridge, 1998).…”