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Child and Adolescent Mental Health Needs Assessment and Service Implications in an Inner City Area

South London and Maudsley NHS Trust/Guy’s, King’s & St Thomas’ School of Medicine, London, UK

Crispin Day

South London and Maudsley NHS Trust/Guy’s, King’s & St Thomas’ School of Medicine, London, UK

Antony Cox

Guy’s, King’s & St Thomas’ School of Medicine, London, UK

Lucy Cutler

Ray Williams Institute of Paediatric Endocrinology, Parramatta, Australia

A random sample of 253 parents and young people were interviewed to elicit: (i) the number, type and severity of psychosocial problems in children/young people; and (ii) the number and type of risk factors for mental health in a very deprived inner city locality. The results suggest high levels of need for mental health services, with, for example, 37% of children having three or more problems, and over 51% having three or more risk factors. From subjective case-by-case analysis, preliminary criteria were derived for judging the level of required service response and the numbers likely to present appropriate to the various tiers of service. Of the 25% of the sample expressing a need for help, 6% were judged to be manageable by community staff (e.g. health visitors) with support from child mental health specialists, 4% by specially trained community staff (e.g. parent advisers), 8% by solo child and adolescent mental health specialists and 7% by generic or specialist child mental health teams.

Key Words: child and adolescent mental health • needs assessment • tier criteria • tiered system

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