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Copying letters to families: attitudes and experiences of child and adolescent psychiatrists

Child and Adolescent Mental Health Service, Delancey Hospital, Cheltenham

Clare Short, Specialist Registrar

Riverside Adolescent Unit, Blackberry Hill Hospital, Bristol

Helen Stephens, Specialist Registrar

East Bristol Child and Adolescent Mental Health Service, Buckingham Gardens, Downend, Bristol, email: helenstephens{at}doctors.org.uk

Declaration of interest

None.

AIMS AND METHOD

A national survey of consultants in child and adolescent psychiatry was conducted to explore their attitudes to copying correspondence to patients and their families and the impact of recent national guidelines on practice.

RESULTS

Of the 290 respondents, 261 (90%) agreed in principle with copying letters to patients but only two-thirds (n=186) were routinely doing so. Nearly half (n=139, 48%) had changed their practice as a consequence of the guidelines. The majority (n=160, 55%) felt that the guidelines lacked clarity with regard to the complexities of child psychiatry and a third (n=93, 32%) had experienced difficulties when copying letters to patients.

CLINICAL IMPLICATIONS

This survey highlights some of the benefits and risks involved in child and adolescent psychiatry when letters are routinely shared with families. Increased openness and transparency can enhance the therapeutic relationship; however, given the complexities and sensitivities implicit in child psychiatry, there is a risk of jeopardising engagement and alienating the family.