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Making sense of child and adolescent mental health services

Bath Mental Health Care Trust, Child and Family Therapy Service, Royal United Hospital, Combe Park, Bath BA1 3NG

^* Correspondence

Aims and method A prospective audit of the 425 referrals made to a community child and adolescent mental health service over a three month period was undertaken. Standardised data were collected about the referrer, reason for referral, problem chronicity and complexity, service response and first appointment attendance.

Results The service is currently seeing less than one in five of the children conservatively estimated to require specialist mental health services. The majority of those referred were appropriate, identifying multiple problems of longer than six months' duration presenting within a complex context.

Clinical implications The results have provided commissioning authorities with a clear specification of the current service. This can inform decisions about resource reallocation, prioritisation and future service development. Clinicians feel that the complexity of their work is now understood and various audit projects and initiatives have been established in order to explore alternative ways of responding to referrer demands.