Why Wait? The Effect of Wait-Times on Subsequent Help-Seeking Among Families Looking for Children’s Mental Health Services

Schraeder, Kyleigh; Reid, Graham J.

doi:10.1007/s10802-014-9928-z

Cited by 36 publications

(22 citation statements)

References 53 publications

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“…In line with previous studies, there was a high level of heterogeneity in waiting times. [13][14][15][16][17][18][19] We found shorter waiting times than reported in a recent child and adolescent mental health surveyin the present study, 16 737 (78%) young people waited less than 10 weeks, 3902 (18%) waited between 10 weeks and 6 months, and 780 (4%) waited more than 6 monthsalthough it should be noted that different methodologies including operationalisations of waiting times were used. 20 The hypothesis that young people with more severe problems would have shorter waiting times for mental health services than young people with less severe problems was supported.…”

Section: Main Findings and Comparison With Findings From Other Studiessupporting

confidence: 48%

“…There is a high level of heterogeneity in waiting times reported in previous studies. [13][14][15][16][17][18][19] A recent child and adolescent mental health survey in England found that 61% of those with a mental health problem accessed specialist services in less than 10 weeks, 18% in 10 weeks to 6 months, and 21% in more than 6 months. 20 Examining waiting times is complex given the number of environmental and individual characteristics related to mental health, help-seeking behaviour and service provision.…”

Section: Factors Linked To Waiting Timesmentioning

confidence: 99%

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

Edbrooke‐Childs

Deighton

2020

BJPsych open

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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.

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Section: Main Findings and Comparison With Findings From Other Studiessupporting

confidence: 48%

Section: Factors Linked To Waiting Timesmentioning

confidence: 99%

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

Edbrooke‐Childs

Deighton

2020

BJPsych open

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“…Long wait lists for access to psychiatrist consultation place constraints on specialists' time and ability to adequately perform metabolic monitoring; this necessitates fragmented physical care and places patients who are at risk for undetected cardiometabolic complications (Brown et al 2002;Cohn & Sernyak 2006;Pringsheim et al 2011a;Schraeder & Reid 2015). Long wait lists for access to psychiatrist consultation place constraints on specialists' time and ability to adequately perform metabolic monitoring; this necessitates fragmented physical care and places patients who are at risk for undetected cardiometabolic complications (Brown et al 2002;Cohn & Sernyak 2006;Pringsheim et al 2011a;Schraeder & Reid 2015).…”

Section: Challenges Associated With Meta-bolic Monitoringmentioning

confidence: 99%

“…Uptake of metabolic monitoring guidelines and the overall quality of care offered to children and adolescents using SGAs are influenced by how Canadian psychiatric services are currently being delivered. Long wait lists for access to psychiatrist consultation place constraints on specialists' time and ability to adequately perform metabolic monitoring; this necessitates fragmented physical care and places patients who are at risk for undetected cardiometabolic complications (Brown et al 2002;Cohn & Sernyak 2006;Pringsheim et al 2011a;Schraeder & Reid 2015). There are limited Canadian data on youth outpatient psychiatry service use and wait times (Canadian Association of Paediatric Health Centres & Youth Mental & Health Consortium Advisory 2010).…”

Section: Challenges Associated With Meta-bolic Monitoringmentioning

confidence: 99%

Enhancing metabolic monitoring for children and adolescents using second‐generation antipsychotics

Coughlin

Goldie

Tregunno

et al. 2017

Int J Mental Health Nurs

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The prevalence of children and adolescents using second-generation antipsychotics (SGAs) has increased significantly in recent years. In this population, SGAs are used to treat mood and behavioural disorders although considered 'off-label' or not approved for these indications. Metabolic monitoring is the systematic physical health assessment of antipsychotic users utilized to detect cardiovascular and endocrine side effects and prevent adverse events such as weight gain, hyperglycaemia, hyperlipidemia, and arrhythmias. This practice ensures safe and efficacious SGA use among children and adolescents. Despite widely available, evidence-based metabolic monitoring guidelines, rates of monitoring continue to be suboptimal; this exposes children to the unnecessary risk of developing poor cardiovascular health and long-term disease. In this discursive paper, existing approaches to metabolic monitoring as well as challenges to implementing monitoring guidelines in practice are explored. The strengths and weaknesses of providing metabolic monitoring across outpatient psychiatry, primary care, and collaborative community settings are discussed. We suggest that there is no one-size-fits-all solution to improving metabolic monitoring care for children and adolescents using SGA in all settings. However, we advocate for a pragmatic global approach to enhance safety of children and adolescents taking SGAs through collaboration among healthcare disciplines with a focus on integrating nurses as champions of metabolic monitoring.

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“…age, gender and social deprivation). Yet, it is clear that waiting can lead to families of CYP seeking help from other sources (Schraeder & Reid, ), but we do not know whether these alternative sources are appropriate. Moreover, we do not know if those who wait without recourse to seeking help from other sources actually get support while waiting.…”

Section: Introductionmentioning

confidence: 99%

Patterns of referral and waiting times for specialist Child and Adolescent Mental Health Services

Smith

Kyle

Daniel

et al. 2017

Child Adoles Ment Health

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Background: During 12-month period (2012/13) around 21,480 children and young people (CYP) were referred to Child and Adolescent Mental Health Service (CAMHS) in Scotland (NHS Scotland, 2013, Child and Adolescent Mental Health Services waiting times in Scotland). At the end of September 2012, there were 3,602 CYP still waiting for 'start of treatment' or 'removal from the waiting list', 375 (10%) CYP had waited over 26 weeks and 1,204 (33%) CYP had waited over 18 weeks (NHS Scotland, 2013, Child and Adolescent Mental Health Services waiting times in Scotland). Referral source, referral reason and the sociodemographic characteristics of CYP are not routinely collected, and therefore, associations between these factors and wait times for 'start of treatment' or 'removal from the waiting list' (i.e. the referral outcome) are unknown. Method: In this exploratory study, a retrospective analysis of referral data was conducted in one CAMHS. Data for 476 referrals between 1st May 2013 and 31st May 2014 were initially analysed to define categories for each of the following key variables: referral source, referral reason and referral outcome. Data on CYP sociodemographic characteristics were extracted from referral records, including age, gender and postcode, from which Scottish Index of Multiple Deprivation quintile of residence was derived. Descriptive statistics were calculated for referral source, referral reason and CYP sociodemographic characteristics. Regression models were then built to determine predictors of a referral being rejected by CAMHS and waiting time for referrals accepted by CAMHS. Data were analysed in SPSS (Version 20). Results: Of the 476 referrals, 72% (n = 342) were accepted and 12% (n = 59) were rejected. Most referrals were made by general practitioners. Just under a third of referrals to CAMHS (31%) were for CYP with emotional and behavioural difficulties. The odds of being rejected by CAMHS were significantly higher if referred by teachers and for CYP with emotional and behavioural difficulties. Age and referral reason were significant independent predictors of waiting time after referral to CAMHS, with CYP referred for hyperactivity/inattention waiting significantly longer. Conclusions: Policymakers should consider ways to foster dialogue and collaboration between different groups of professionals making and accepting referrals to CAMHS in order to improve timely access to appropriate mental health support services for CYP. Research is urgently needed to investigate the experiences of CYP who are either rejected by CAMHS or wait lengthy periods of time before starting their treatment with CAMHS. Key Practitioner Message• Child and Adolescent Mental Health Services (CAMHS) are key supportive services for children and young people (CYP) with mental health difficulties.• Children and young people who are referred to this CAMHS by teachers were more likely to be rejected than those referred by medical professionals.• Children and young people with emotional and behavioural problems were more like...

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Why Wait? The Effect of Wait-Times on Subsequent Help-Seeking Among Families Looking for Children’s Mental Health Services

Cited by 36 publications

References 53 publications

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

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

Enhancing metabolic monitoring for children and adolescents using second‐generation antipsychotics

Patterns of referral and waiting times for specialist Child and Adolescent Mental Health Services

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