How effective are changes to Child and Adolescent Mental Health Services (CAMHS) in the Oxfordshire and Buckinghamshire regions? What can we learn from them to improve CAMHS?

Camhs eval

Who?

Young people with mental health problems, their families and those running or commissioning the Child and Adolescent Mental Health Services (CAMHS) meant to help them.

What?

This research is looking at how two main changes in CAMHS services, working in schools and collaborating with third sector (charity) partners, are impacting these services and the young people seen by these services.

Aims:

We will use a variety of different, but complementary, research methods to:

1.     Provide a map of the changes in CAMHS services across Oxfordshire and Buckinghamshire; and

2.     Evaluate the new CAMHS models being rolled out by examining:

        a.     how well they were implemented;

        b.     their clinical effectiveness; and

        c.     their cost-effectiveness.

Why is this important?

This evaluation is important and timely for two main reasons.

Firstly, there is increasing dissatisfaction with the traditional ‘tiered’ CAMHS model – a system of steps that escalate in specialisation or treatment intensity and type depending on the needs of the young person.

Second, there has been significant investment in the transformation of CAMHS services, new models of services are emerging but little is known about their effectiveness. This includes new school-based mental health services and clinical collaboration with third sector partners. 

Although these changes have been welcomed by user groups, this does not negate the need to evaluate whether young people's outcomes have improved.

Methods

We will use direct interviews, observations and scrutiny of the electronic patient record, we will look to identify if any of the changes to CAMHS services lead to more efficient and effective services. We can make comparisons across services including traditional as well as ‘transformed’ services.  We call this a 'longitudinal, observational comparative study'. 

For the implementation of new services we will adopt a change management approach to describe current practice and determine different aspects relevant to transformation of services. We will observe the services, carry out semi-structured interviews of representative stakeholders including young people and their families.

We will also conduct an evaluation of clinical effectiveness and cost effectiveness by using the electronic health database, which in Oxford Health NHS Foundation Trust is one of the most comprehensive and complete in the country. 

How this could benefit patients/the public

It is essential to find out how the changes in CAMHS services might be improving the experiences and outcomes of young people in services and also their outcomes.

If, for example, the school InReach service in Oxfordshire – where a member of CAMHS staff goes for half a day each week to each secondary school – enables young people to be seen earlier in the course of their illness, or improves their engagement with services, this will be important information which could potentially be used to shape other services and help large numbers of children. 

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