Evaluation of an early intervention Tier 2 child and adolescent mental health service

Abstract

While the recommendation issued by the Health Advisory Service in 1995 is for a tiered child and adolescent mental health service, there is little published evidence about the outcomes of such services. Our objective was to evaluate an innovative community-based child and adolescent mental health service in South and East Leeds using before and after measures. The client group of the service was children and families with emotional and behavioural problems and/or parenting difficulties. Standardised assessment of families and young people was followed by brief intervention (solution-focused therapy) to the child and family. Descriptive demographic and referral pathway details were recorded, as were baseline and postintervention Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) scores. South Leeds generated almost four times as many referrals in the 9 months after the Tier 2 Child and Adolescent Mental Health Service (CAMHS) was set up. Clinically and statistically significant decreases in symptom scores were found for families completing work with the Tier 2 workers. Families referred on to Tier 3 had complex but not more severe problems. The new service encountered previously unmet need among troubled young people in the community, whilst freeing specialist Tier 3 staff to concentrate on complex, chronic problems.