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Professional life in child and adolescent mental health services may be getting more complicated, but cases are not

  • Anne E. Thompson (a1), Amulya Nadkarni (a1), Saeed A. Nazir (a1), Walid Sorour (a2), Victoria Owen (a3) and Surendra Kumar Buggineni (a4)...
Abstract
Aims and method

In 2006, staff in child and adolescent mental health services (CAMHS) in Lincolnshire, UK, felt that cases were becoming increasingly complex. The Pearce Case Complexity Scale (PCCS) and a staff opinions questionnaire were used to measure subjective and objective changes in case complexity in a relatively stable CAMHS service over a 10-year period from 1996 to 2006, with data examined between 2008 and 2010.

Results

Clinicians reported an increase in case complexity over time. However, the PCCS did not show a significant change in the decade studied.

Clinical implications

Staff anxiety could be a determinant of judgements they make about case complexity in CAMHS.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Anne E. Thompson (anne.thompson@lpft.nhs.uk)
Footnotes
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Declaration of interest

None.

Footnotes
References
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2 Cottrell, D, Kraam, A. Growing up? A history of CAMHS (1987–2005). Child Adolesc Ment Health 2005; 10: 111–7.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Professional life in child and adolescent mental health services may be getting more complicated, but cases are not

  • Anne E. Thompson (a1), Amulya Nadkarni (a1), Saeed A. Nazir (a1), Walid Sorour (a2), Victoria Owen (a3) and Surendra Kumar Buggineni (a4)...
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eLetters

Measuring of environmental complexity by CAMHS

M Elena Garralda, Emeritus Professor
29 January 2014

Thompson et al in their recent paper "Professional life in child and adolescent mental health services may be getting more complicated, but cases are not" (1), considered the use ofthe Paddington Complexity Scale (2) to quantify the case complexity of their Child and Adolescent Mental Health Service (CAMHS) attenders, but discarded it largely because their study was based on CAMHS records which did not record systematically information on diagnoses or other items relevant to multi-axial formulations, such as physical health, and cognitive/developmental status of children and young people seen.

I would like to clarify that - to allow for the fact that CAMHS vary in the extent to which diagnostic and other detailed comprehensive information is obtained on cases seen by different professionals - the Paddington Complexity Scale has, in addition to a summative total score, two complexity sub-scores and scales: clinical (in itself sub-divided intopsychiatric, incorporating diagnostic, severity/duration, co-morbidity items, and physical/development, scoring information on physical health and intellectual disability) and environmental (with items on family status and attitudes to the use of the service, type of school and multi-agency involvement). These sub-scales, in particular adaptations of the environmental sub-scale, which is made up of items that will be known to most CAMHS workers, can and have been used on a stand alone basis, as a measure of psychosocial case complexity (3).

References:1. Thompson AE, Nadkarni A, Nazir SA, Sorour W, Owen V, and Buggineni SK.Professional life in child and adolescent mental health services may be getting more complicated, but cases are not.Psychiatric Bulletin 2013; 37: 326-330

2. Yates P, Garralda ME, Higginson I. Paddington Complexity Scale and Health of the Nation Outcome Scales for Children and Adolescents. British Journal of Psychiatry 1999; 174, 417-423

3. Audit Commission (1999). National report: Children in Mind - Child and Adolescent Mental Health Services http://archive.audit commission.gov.uk/auditcommission/subwebs/publications/studies/studyPDF/1350.pdf

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Conflict of interest: None declared

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