Predictors of amounts of child and adolescent mental health service use.

The aim of this study was to build evidence about how to tailor services to meet the individual needs of young people by identifying predictors of amounts of child and adolescent mental health service use. We conducted a secondary analysis of a large administrative dataset from services in England was conducted using the Mental Health Services Data Set (years 2016-17 and 2017-18). The final sample included N = 27,362 episodes of care (periods of service use consisting of at least two attended care contacts and less than 180 days between care contacts) from 39 services. There were 50-10,855 episodes per service. The descriptive statistics for episodes of care were: Mage = 13 years, SDage = 4.71, range = 0-25 years; 13,785 or 50% male. Overall, there were high levels of heterogeneity in number of care contacts within episodes of care: M = 11.12, SD = 28.28, range = 2-1529. Certain characteristics predicted differential patterns of service use. For example, young people with substance use (beta = 6.29, 95% CI = 5.06-7.53) or eating disorders (beta = 4.30, 95% CI = 3.29-5.30) were particularly more likely to have higher levels of service use. To build on this, evidence is needed about predictors of child and adolescent mental health treatment outcome and whether the same characteristics predict levels of improvement as well as levels of service use.

Children and young people's mental health outcome measures in paediatrics.

Paediatricians are increasingly likely to encounter children and young people with mental health difficulties, either as primary presentations or as comorbidities linked with chronic illnesses. However, paediatricians may have limited training or experience regarding the tools available to identify mental health needs and how to use these tools. The current paper aims to provide a go-to guide for paediatricians when considering the use of mental health and well-being outcome measures, including how to select, administer and interpret measures effectively. It also provides practical guidance on the most common mental health outcome measures used in children and young people's mental health services across the UK and elsewhere, which paediatricians are likely to encounter in their practice. Paediatricians may also find these measures useful in their own practice to screen for potential mental health difficulties, monitor the impact of chronic health conditions on a young person's mental health and well-being, or to provide evidence when referring young people to mental health services.

Predictors of child and adolescent mental health treatment outcome.

BACKGROUND: To examine the predictors of treatment outcome or improvement in mental health difficulties for young people accessing child and adolescent mental health services. METHODS: We conducted a secondary analysis of routinely collected data from services in England using the Mental Health Services Data Set. We conducted multilevel regressions on N = 5907 episodes from 14 services (Mage = 13.76 years, SDage = 2.45, range = 8-25 years; 3540 or 59.93% female) with complete information on mental health difficulties at baseline. We conduct similar analyses on N = 1805 episodes from 10 services (Mage = 13.59 years, SDage = 2.33, range = 8-24 years; 1120 or 62.05% female) also with complete information on mental health difficulties at follow up. RESULTS: Girls had higher levels of mental health difficulties at baseline than boys (ß = 0.28, 95% CI = 0.24-0.32). Young people with higher levels of mental health difficulties at baseline also had higher levels of deterioration in mental health difficulties at follow up (ß = 0.72, 95% CI = 0.67-0.76), and girls had higher levels of deterioration in mental health difficulties at follow up than boys (ß = 0.09, 95% CI = 0.03-0.16). Young people with social anxiety, panic disorder, low mood, or self-harm had higher levels of mental health difficulties at baseline and of deterioration in mental health difficulties at follow up compared to young people without these presenting problems. CONCLUSIONS: Services seeing higher proportions of young people with higher levels of mental health difficulties at baseline, social anxiety, panic disorder, low mood, or self-harm may be expected to show lower levels of improvement in mental health difficulties at follow up.

A Mixed-Methods Realist Evaluation of the Implementation and Impact of Community Forensic CAMHS to Manage Risk for Young People With Forensic and Mental Health Needs: Study Protocol.

Introduction: Young people in contact with forensic child and adolescent mental health services present with more complex needs than young people in the general population. Recent policy has led to the implementation of new workstreams and programmes to improve service provision for this cohort. This paper aims to present the protocol for a national study examining the impact and implementation of Community Forensic Child and Adolescent Mental Health Services (F:CAMHS). Methods and analysis: The study will use a mixed-methods Realist Evaluation design. Quantitative service activity and feedback data will be collected from all 13 sites, as well as questionnaires from staff. Non-participant observations and qualitative interviews will be conducted with staff, young people and parents/guardians from four focus study sites. An economic evaluation will examine whether Community F:CAMHS provides good value for money. The results will be triangulated to gain an in-depth understanding of young people's, parents/guardians' and staff experiences of the service. Ethics and dissemination: Ethical approval was granted by the Health Research Association and UCL Ethics. The results will be disseminated via project reports, feedback to sites, peer-reviewed journal publications and conference presentations.

Realist Process Evaluation of the implementation and impact of an organisational cultural transformation programme in the Children and Young People's Secure Estate (CYPSE) in England: study protocol.

INTRODUCTION: Young people in contact with the youth justice system are more likely to present with complex ongoing needs than young people in the general population. To address this, the Framework for Integrated Care (SECURE STAIRS) is being implemented in the Children and Young People's Secure Estate: a 'whole systems' approach to support secure settings to develop trauma-informed and relationally based environments, supporting staff to provide consistent, therapeutic care. This paper aims to present the protocol for a national cohort study examining the impact and implementation of this cultural transformation programme. METHODS AND ANALYSIS: A mixed-methods realist evaluation will be conducted. Data collection will take place between August 2018 and December 2020. Eighteen sites will collect routine service activity data and questionnaires completed by young people, parents/guardians and staff. Semi-structured interviews and non-participant observations will be conducted across five qualitative focus sites with young people and staff. An economic evaluation will examine value for money. The results will be triangulated at the analysis stage to gain an in-depth understanding of experiences. ETHICS AND DISSEMINATION: Ethical approval was granted by the Health Research Authority, Her Majesty's Prison and Probation Service and UCL Ethics Committee. Findings will be disseminated via project reports, site feedback, peer-reviewed journal publications and conference presentations.