How well do children in the North East of England function after a crisis: a service evaluation

Abstract

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.

How well do children in the North East of England function after a mental health crisis during the COVID-19 pandemic: A service evaluation

“…This is the second service evaluation, to the authors' knowledge, that empirically examines the functioning of young people following intervention from a CAMHS Crisis Team in the UK. It supports the baseline data provided from the first service evaluation (Staite et al, 2021) in highlighting how intervention(s) from a CAMHS Crisis Team can contribute to a young person's functioning, enabling the majority of young people to return to a 'healthy' level of functioning following a mental health crisisdespite being in a global pandemic. However, improvements still need to be made to reduce the 20% of patients whose functioning did not significantly improve following treatment from a CAMHS Crisis Team.…”

“…We conducted a service evaluation comparing treatment outcomes over time, replicating the methodology in Staite et al’s (2021) original service evaluation. There was no randomisation to treatment group, as this was also a service evaluation of routine practice.…”

“…Some patients will also be discharged to other CAMHS services (e.g. generic CAMHS, Eating Disorder team, Autism Spectrum Disorder team, Learning Disability CAMHS, Early Intervention in Psychosis team, Liaison and Diversion team or Street Triage team) ( Staite et al, 2021 ).…”

“…Evaluation was completed before and after treatment for patients discharged from the CAMHS Crisis Team between December 2019 and December 2020. Full ORS information is available from Staite et al's (2021) (Staite et al, 2021).…”

“…The first service evaluation to do this in the UK was published this year and examined data from 2018/2019. Staite et al (2021) found a 16.2% increase in the mean ORS score (which measures a young person’s functioning) after intervention and 15% of young people exhibited both reliable change and clinically significant change ( Staite et al, 2021 ). The service evaluation also reported that 97 (89%) patients were co-worked by another Child and Adolescent Mental Health Services (CAMHS) team and there were 29 (26%) multiple referrals within 2018/2019.…”