Purpose Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the current global pandemic. There is mixed evidence for the effectiveness of crisis teams in improving adult functioning, and none, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from child and adolescent mental health services (CAMHS) crisis teams in the UK. Therefore, the purpose of this paper is to use CAMHS Crisis Team data, from an NHS trust that supports 1.4 million people in the North East of England, to examine a young person's functioning following a crisis. Design/methodology/approach This service evaluation compared functioning, as measured by the Outcome Rating Scale (ORS), pre- and post-treatment for young people accessing the CAMHS Crisis Team between December 2018 and December 2019. Findings There were 109 participants included in the analysis. ORS scores were significantly higher at the end of treatment (t(108) = −4.2046, p < 0.001) with a small effect size (d = −0.36). Sixteen (15%) patients exhibited significant and reliable change (i.e. functioning improved). A further four (4%) patients exhibited no change (i.e. functioning did not deteriorate despite being in crisis). No patients significantly deteriorated in functioning after accessing the crisis service. Practical implications Despite a possibly overly conservative analysis, 15% of patients not only significantly improved functioning but were able to return to a “healthy” level of functioning after a mental health crisis following intervention from a CAMHS Crisis Team. Intervention(s) from a CAMHS Crisis Team are also stabilising as some young people’s functioning did not deteriorate following a mental health crisis. However, improvements also need to be made to increase the number of patients whose functioning did not significantly improve following intervention from a CAMHS Crisis Team. Originality/value This paper evaluates a young person’s functioning following a mental health crisis and intervention from a CAMHS Crisis Team in the North East of England.

The development of an operational currency and tariff system for forensic mental health services has been underway in the United Kingdom since 2011, in line with government targets. A successful approach to the currency and tariff agenda requires both a way of capturing patient's needs and resource requirements while providing a way of evidencing outcomes to support payment. The focus of the work to date has been to establish a methodology that quantifies patient's clinical and resource needs but has yet to explore outcome methodology. In 2015, Speak, Hay, and Muncer developed a 4-factor model of the Health of the Nation Outcome Scales, which was mandated for evaluating outcomes in adult and older person services. The focus of this article was to explore the Speak et al. ( 2015) 4-factor model of the HoNOS as an approach to evaluating outcomes in a forensic inpatient population. A national pilot study of 2,468 patients was used. Confirmatory factor analysis and exploratory factor analysis techniques were employed and indicated that the Speak et al. ( 2015) factor model did not provide an adequate fit to the forensic data. A new factor structure emerged that revealed potential domains for evaluation of outcome in forensic populations.

The Health of the nation outcome scales (HoNOS) [1] were designed to measure the health and social functioning of adults with severe mental health problems. They form part of the English mental health minimum data set and are recommended by the department of health and are part of the attempt to develop “payment by results” (PbR) for mental health [2]. They are also widely used in Australia, New Zealand and Canada [3, 4], and have also been used in Europe [5]. Although they are widely used there are still questions about their psychometric validity and their ability to predict anything useful.

Summary In this editorial we define ‘productivity’ and ‘efficiency’ in a mental health service context, outlining the key challenges to measuring these in practice. We attempt to bring clarity of thought to this often debated, but rarely researched area.