RQIA Independent Review of Child and Adolescent Mental Health ...

5.3 Theme 3: Access and Availability
This theme is based on Bamford recommendations aimed at addressing the range and scope of services which are required to
help prevent mental health problems. This would include services aimed at early intervention and considers whether there is an
appropriate level of support for children and young people accessing CAMHS. An analysis of the information provided by trusts
was systematically captured by the independent review team in order to evaluate the Did not Attend (DNA) and Could not Attend
(CNA) ie. missed appointments. In addition, the DHSSPS "Card Before You Leave" scheme has been included in this section, as
it applied to children and young people who self-harm or have emotional problems accessing services via accident and emergency
departments. The rationale of "Card Before You Leave" is to ensure all young people and adults who have self-harmed have
contact with a professional in the days following discharge from hospital or the accident and emergency department.
Criterion 1.3.1- CAMHS should provide cover up to the young person's 18th birthday. At all times they should be located
in developmentally appropriate settings.
Bamford suggests that the upper age limit for access to services has led to difficulties for some young people accessing a
comprehensive service. Historically, not all areas provided CAMHS up to 18th birthday. For example, the Western Trust has only
provided this service since 1 January 2010. This resulted in inequality of access to CAMHS for some young people between 16
and 18.
Two of the trusts' CAMH services indicated that a referral to adult mental health services is appropriate if a young person in their
17th year requires ongoing expertise and long-term intervention. The rationale is that their needs can be best met if provided by
adult mental health services.
All trusts have now achieved this recommendation.
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