RESUMEN

Consumer-directed, personal recovery-oriented mental health services are now the focus of mental health policies around the globe. However, there has been minimal debate about how the approach applies to young people. This study sought to address this gap through a Delphi approach, using three rounds of surveys, to gain a convergence of opinion from Australian Child and Adolescent Mental Health Service (CAMHS) practitioners regarding the relevance of personal recovery for children and adolescents. The findings suggest that concepts of personal recovery are appropriate for a young population. However, parents and carers are integral to the mental health recovery journeys of young people, either directly as guardian/decision-maker and/or indirectly through the impact of caring for a young person with mental health problems. Further exploration of the relevance and application of personal recovery in the context of young people is warranted, particularly from the perspectives of adolescents, younger children and carers of young people with mental health problems.

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RESUMEN

BACKGROUND: The Choice and Partnership Approach (CAPA) model has been implemented widely into Child and Adolescent Mental Health Services (CAMHS) in the United Kingdom and similar health systems in Australia and New Zealand. This study investigated whether the implementation of the CAPA model was related to changes in client clinical outcomes and response times within a regional Australian CAMHS. METHOD: Multiple measures of time, clinical diagnosis, contact and outcomes were collected at intake and discharge for 33 clients prior to and 77 following the implementation of CAPA. RESULTS: A two-tailed t-test showed that the significantly reduced waiting time was associated with the timing of CAPA implementation. The Health of the Nation Outcome Scales for Children and Adolescents information subscale showed a significant post-CAPA implementation improvement. A chi-square test for independence showed that the CAPA model group had significantly more initial clinical appointments. CONCLUSIONS: After the implementation of CAPA, the flow of young people through the service improved, with children and adolescents being seen in a more timely manner. The findings highlighted that the greater client throughput did not negatively impact upon clinical outcomes. Further prospective research with the completion of multi-informant outcome measures is recommended.

RESUMEN

OBJECTIVE: This study outlines the service issues and adjustments associated with the implementation of Choice and Partnership Approach (CAPA) into a rural Child and Adolescent Mental Health Service (CAMHS). METHOD: A mixed-methods approach examined the impacts of the CAPA implementation. A qualitative review of the minutes from team and implementation group meetings illustrated themes according to 11 key CAPA components. Quantitative internal audit data illustrated waiting list times. RESULTS: Findings showed that inclusive language has replaced the traditional, pathology-driven psychiatric discourse, though this has been met with mixed response from CAMHS clinicians, service users and referrers. Data also showed that a waiting list for clinician allocation has been eliminated, and the waiting time between the referral date and the first face-to-face contact has decreased from 63.9 days to 10.7 days. CONCLUSION: A modified CAPA Choice appointment system has allowed quick access without a waiting list, in line with government guidelines. A full-booking system and focussed, goal-oriented interventions has led to lower caseloads and optimum use of CAMHS clinician skillsets.

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