Introduction to this Emerging Minds funded project by the Lead Researcher, Dr Charlotte Hall, University of Nottingham:
The overarching aim of this project is to improve timely access to evidence-based interventions.
Children and young people often feel ‘abandoned’ on waiting lists, with some waiting over a year to start treatment. Offering waiting-list interventions may help support families during this difficult time, however, to date we don’t know how often or what type of waiting list interventions may be being offered.
The “WAIT” project has three main aims:
Understand the waiting times for mental health treatment for children and young people by disorder and across regions;
Identify the waiting-list interventions e.g. self-help resources) currently offered by disorder post-referral;
Evaluate the evidence base for the efficacy of current interventions offered.
Addressing these points will identify which interventions may benefit from wider scale adoption and which may benefit from future research to establish clinical and cost-effectiveness.
Establishing an evidence-base for waiting-list interventions that are implemented in routine care would enable children and young people to access timely support and may prevent further deterioration experienced on waitlists. Accessing waiting-list interventions may also result in service-efficiencies, resulting in earlier symptom improvement/improved quality of life, requiring fewer sessions of the designated treatment reducing the burden on healthcare systems.
After the project’s conclusion, Dr Charlotte Hall explained the key messages which the research found.
Individuals referred for psychosis, suicide/self-harm, in-crisis, and eating disorders were usually assessed more promptly than those referred for neurodevelopmental disorders.
The overall number of referrals were comparable across years reflecting only a 1% increase from 2019/20 to 2020/21.
Trusts do not routinely record information about waiting times by reason for referral. Recording information would help Trusts to be better able to provide appropriate support services for families on waiting lists.
The variation across Trusts is vast both in terms of waiting times and support offered for CYP on waiting lists which does not seem to be related to region. Trusts may benefit from information sharing to identify good practice within CAMHS services.
Limited Trusts currently offer WLIs (although this was restricted by poor response rates). Further research on WLIs currently being offered would be useful.
Trusts that do provide WLIs and currently evaluate them report that early intervention strategies have the potential to improve timely access to support for children, young people, and their families and improve outcomes for families.
There is a lack of research on the WLIs identified as being currently used, however, many of these WLIs are founded from concepts which do have a good evidence base (e.g. psychoeducation).
Further research on the efficacy, cost-effectiveness and service efficiencies of support services which could be used as WLIs is necessary. However, this should be completed within CAMHS services where implementation can be evaluated, this may benefit from real world evaluation rather than RCT to ensure timely implementation.
Therapist-supported online remote behavioural intervention for tics in children and adolescents in England (ORBIT): a multicentre, parallel group, single-blind, randomised controlled trial
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