Digital opportunities to improve access to CAMHS and support young people's mental health going forwards
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Digital opportunities to improve access to
CAMHS and support young people’s mental
health going forwards
Dr. Johnny Downs
Clinical Senior Lecturer, NIHR Clinician Scientist
Department of Child and Adolescent Psychiatry, KCL
South London and Maudsley NHS Foundation Trust
Digital opportunities along the CAMHS pathway
YP, parents, Self/ CYP /
teachers, SW… family Review/triage Assessment Treatment Discharge
identifies need referral to
for CAMHS CAMHS
23.6%4 miss half
CYP/Family DNA of their
1.15 million closed CAMHS appointments
26%2
Rejected and returned to 19%3
referrals (Apr-Sept 2019)1 referrer
Referral to other services 92%1: no routine
Signposted to other sources measures to assess
change
1. NHS England and Improvement MHSDS data (2020)
2.Crenna-Jenning W & Hutchinson (2020) Access to Child and adolescent mental health services in 2019. Education Policy Institute. https://epi.org.uk/wp-
content/uploads/2020/01/Access-to-CAMHS-in-2019_EPI.pdf
3. Rocks S, Fazel M, Tsiachristas A Impact of transforming mental health services for young people in England on patient access, resource use and health: a
quasi-experimental study BMJ Open 2020;10:e034067
4. Morrati Rosa V, Parlatini V et al. Predictive factors for low attendance in community Child and Adolescent Mental Health Services using Electronic Health
Records (unpublished figures)
Digital opportunities along the CAMHS pathway
YP, parents, Self/ CYP /
teachers, SW… family Review/triage Assessment Treatment Discharge
identifies need referral to
for CAMHS CAMHS
23.6% miss half
CYP/Family DNA of their
1.15 million closed CAMHS appointments
26%
Rejected and returned to 19%
referrals (Apr-Sept 2019) referrer
Referral to other services 92%: no routine
Signposted to other sources measures to assess
improvement
Can digital approaches :
• Enhance the approachability and availability of evidence based CAMH provision?
• Enhance ability of YP, families, school staff.. to perceive need, reach support and
effectively engage?1
1Werlen, L.. (2020). Interventions to improve children's access to mental health care: A systematic review and meta-analysis. Epidemiology and Psychiatric Sciences, 29, E58.
doi:10.1017/S2045796019000544
Universal provision: where to start?
Funnel Plot showing incidence of A&E presentation with self-
Plot showing referral rates to Child and Adolescent Mental harm by secondary school as a function of the pupils enrolled
Health Services for each school by Key Stage 1 (infant
school) as a function of the pupils enrolled
Widnall E, Epstein et al. 2020 (unpublished data)
Downs et al. Arch Dis Child 2017;102:599-602
Understanding CYP needs via school survey
https://www.youtube.com/watch?v=
bY8hW9I479M
5
Addressing high demand and limited supply?
Signposting according to clinical needs
Digital Interventions
Kaplan-Meier curve illustrating the probability of SDQ-P within study period between
caregivers assigned to complete electronic compared to paper SDQ-P.
https://www.acamh.org/topic/dig
ital-interventions/
Impact on clinical service delivery : contacts with mental
health services
Patel R et al. (2021) BMJ Open [in press]
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