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Title: The outcome of tier 2 Child and Adolescent Mental Health Service (CAMHS) intervention : predictors of subsequent access to CAMHS tier 3 in the short and long-term
Author: Rowland, Ann Louise
ISNI:       0000 0004 2739 0547
Awarding Body: University of Essex
Current Institution: University of Essex
Date of Award: 2011
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Child and Adolescent Mental Health Services (CAMHS) are provided according to a four tiered model (Health Advisory Service, 1995), based on the assumption that increasing levels of problem severity, complexity and persistence should be managed across the tiers. There is little research to underpin these assumptions and while some studies have indicated factors associated with CAMHS access and usage, there is a paucity of evidence to suggest which children can be managed at each tier of service. If severity, complexity and persistence do differ across the tiers, measures could be used at assessment that would indicate which children should access tier 2 or tier 3. This would aid the effective use of resources. A retrospective longitudinal study followed-up 378 children after assessment in CAMHS tier 2 to determine whether parental and clinician ratings of severity, complexity, duration and type of difficulties reported at assessment, differed between children who accessed tier 2 only or subsequently accessed tier 3 within 1 or 1-5 years. Parents completed the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997), while the researcher completed the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA; Gowers et al., 1999) and the Paddington Complexity Scale (Yates et al., 1999) retrospectively from case-notes. Findings indicated that children with more severe, complex, persistent and externalising difficulties were more likely to access tier 3 in both the short and the long-term. Multinomial regression indicated that the strongest predictors of tier 3 access within l-year was HoNOSCA total scores, while SDQ total and SDQ conduct scores predicted access within 1-5 years. A model is proposed to use information from the SDQ and HoNOSCA, at assessment, to allocate children to tier 2 or 3 CAMHS. The limitations of the study, national implications and suggestions for future research are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available