Problem severity and waiting times for young people accessing mental health services

Abstract

Background Access to timely care is a quality standard underpinning many international healthcare models, and long waiting times for child and adolescent mental health services are often reported as a barrier to help-seeking. Aims The aim of this study was to examine whether young people with more severe problems have shorter waiting times for mental health services. Method Multilevel multinomial regression analysis controlling for service-area deprivation, age, gender, ethnicity, referral source and contextual factors was conducted on N = 21 419 episodes of care (mean age 12.37 years (s.d. = 3.71), 11 712 (55%) female) using data from child and adolescent mental health services. Results There was high variation in waiting times, which ranged from 0 days to 1629 days (mean 50.65 days (s.d. = 78.03), median 32 days). Compared with young people with less severe problems young people with severe problems, self-harm, psychosis or eating disorders were less likely to experience longer waiting times. Moreover, referrals from sources other than primary care were generally less likely to have longer waiting times than referrals from primary care sources, especially referral from accident and emergency services. Conclusions The findings suggest that young people with more severe problems had shorter waiting times. Intermediary information and resources for support before access to services is needed to prevent escalation of problems and to support individuals and families while waiting for care. Interventions to reduce waiting times should be considered without compromising on the quality and experience of care that young people and families deserve when seeking help.

Facilitating factors and barriers in help-seeking behaviour in adolescents and young adults with depressive symptoms: A qualitative study

“…Furthermore, in our sample waiting time appeared to be a problem. This is in accordance with previous research [ 62 , 63 ] and indicates that the number of young adults in need of treatment exceeds the available treatment resources. This problem needs particular attention from policy makers and governments, and suggests that rearrangement of treatment resources for youngsters might be necessary.…”

“…the GP or school contact person) to help assess their symptoms and the need for treatment. Previous research has found promising effects from education and awareness programmes on mental health literacy, help-seeking behaviour or intention to seek help and stigma reduction [59][60][61][62][63], using different methods including psycho-education and (video) presentations with former patients.…”

Exploring the Potential of a School-Based Online Health and Wellbeing Screening Tool: Young People’s Perspectives

“…Importantly, however, many more young people are suggested to experience adverse symptoms and effects of mental health conditions without meeting the threshold for clinical diagnosis [ 9 ]. More recent crises, most notably the COVID-19 pandemic, have intersected with ongoing system-wide challenges (e.g., deficits in specialist young people’s mental health provision [ 10 ]), and exacerbated health and wellbeing issues for many young people [ 11 , 12 , 13 ].…”

The role of mental health symptomology and quality of life in predicting referrals to special child and adolescent mental health services

“…Furthermore, of those young people and families who are referred to CAMHS, one in four were not accepted into treatment [2]. Demand outstrips supply to such an extent that some CAMHS services set their acceptance thresholds based on imminent risk to self or others, leaving many young people with treatable mental health conditions unable to access CAMHS or facing extra-ordinary waiting times [3].…”