Impact of counselling provision in primary schools on child and adolescent mental health service referral rates: a longitudinal observational cohort study

被引:2
|
作者
Grant, Claire [1 ,2 ]
Blackburn, Ruth [3 ]
Harding, Duncan [1 ]
Golden, Sarah [4 ]
Toth, Katalin [4 ]
Scott, Stephen [1 ]
Ford, Tamsin [5 ]
Downs, Johnny [1 ,6 ]
机构
[1] Kings Coll London, Dept Child & Adolescent Psychiat, London, England
[2] UCL, Dept Epidemiol & Publ Hlth, London, England
[3] UCL, Inst Hlth Informat, London, England
[4] Place2Be, Dept Res & Evaluat, London, England
[5] Univ Cambridge, Dept Psychiat, Cambridge, England
[6] Natl Inst Hlth Res NIHR, Maudsley Biomed Res Ctr BRC, London, England
基金
英国医学研究理事会;
关键词
Mental health; counselling; school; longitudinal studies; screening; PSYCHOLOGICAL DISTRESS; HELP-SEEKING; EDUCATION; STUDENTS;
D O I
10.1111/camh.12519
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background In the United Kingdom, schools play an increasingly important role in supporting young peoples' mental health. While there is a growing evidence base to support the effectiveness of school-based interventions, less is known about how these provisions impact on local Child and Adolescent Mental Health Service (CAMHS) referral rates. There is a concern that an increase in school-based provision might lead to an increase in CAMHS referrals and overwhelm services. We aimed to examine the longitudinal association between Place2Be counselling provision in primary schools on CAMHS referral rates in South London. Method This was a retrospective cohort study using linked data from the National Pupil Database (NPD) and CAMHS referrals to the South London and Maudsley's NHS Foundation Trust (SLaM) identified through the Clinical Record Interactive Search (CRIS) tool. The cohort included a total of 285 state-maintained primary schools in four London boroughs for the academic years of 2007-2012. During the study period, 23 of these schools received school-based mental health provision from Place2Be. The primary outcome was the incident rate ratio (IRR) of school-level accepted CAMHS referrals in 2012/13 in schools with, or without, Place2Be provision. Results There was no significant association between elevated rates of CAMHS referral and Place2Be provision, even after comprehensive adjustment for school-level and pupil characteristics (IRR 0.91 (0.67-1.23)). School-level characteristics, including higher proportion of white-British pupils (IRR 1.009 (1.002-1.02)), medical staff ratio (IRR 6.49 (2.05-20.6)) and poorer Ofsted school inspection ratings (e.g. IRR 1.58 (1.06-2.34) for 'Requires Improvement' vs. 'Outstanding') were associated with increased CAMHS referral rates. Conclusions Place2Be provision did not result in increased specialist mental health referrals; however, other school-level characteristics did. Future research should investigate pupils' Place2Be clinical outcomes, as well the outcomes of individuals referred to CAMHS to better understand which needs are being met by which services.
引用
收藏
页码:212 / 220
页数:9
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