Adolescents with mental health problems are poorly served by mental health services, since responsibility for care often falls between child and adult services. Within the UK, there is no consensus on how service boundaries should be delineated. Some services use an age cut-off at some point between 16 and 18 years, whereas others consider child services to be appropriate only for those in full-time education. The Audit Commission (1999) reported that nationally 29% of health authorities commissioned child and adolescent mental health services for young people before their 16th birthday only, although adult services were not considered suitable for those under 17 years old. The report highlighted the poor development of adolescent services and their inadequate links with other agencies, including adult mental health services.

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There is growing interest in the provision of health services that are sensitive to the needs of diverse ethnic groups. This paper examines ethnic diversity of attenders at a Child and Adolescent Psychiatric Clinic and how these groups differ in terms of referral route, reason for referral, psychiatric diagnosis and school report of difficulties. Service access relative to the distribution of the local population is assessed. Modification of OPCS categories provides additional useful information. The findings are relevant for the planning and provision of child and adolescent psychiatric services in a highly diverse population.

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