Editorial: The future of crisis mental health services for children and young people

The future of mental health services for children and young people are at a turning point. There is increasing recognition that there is huge unmet need. In the UK only approximately 25% of children and young people with a mental health disorder receive treatment, but demand to access care is increasing. At the same time evidence is building on what treatments are effective. This has not been matched by equivalent research evidence on what service configurations are most effective. In their systematic review of the impact of pediatric mental health care provided in outpatient, primary care, community and school settings on emergency department use', Kirkland etal (2018) found only limited evidence to suggest that the provision of services in the community impact on the use of emergency departments. The absence of robust RCT evidence should not prevent us from improving the outcomes and experience of children and young people facing a mental health crisis. Much is known about the value of early intervention and effective community interventions. Action should be taken now to prioritise the use of scarce resources where they are needed most to reduce unnecessary and sometimes unhelpful attendances at emergency departments and avoid potentially harmful mental health admissions.