What CAMHS interventions predict positive outcomes for which young people with a social worker: A mixed-methods study of clinical support and cost-effectiveness utilising linked operational data

Children and young people with social work involvement (CYPwSW) often experience an array of adversities and complex mental health needs. Yet little is known about factors affecting access to Child & Adolescent Mental Health Services (CAMHS) for CYPwSW, what interventions they find helpful, and in what ways they improve function. This project aims to address these questions by providing an account of profiles and trajectories of CYPwSW leading to and following from CAMHS treatment. We will explore what interventions and supports are provided to CYPwSW, which are linked to positive outcomes, and the lived experience of access to and involvement with these services. In addition, we will provide an economic analysis identifying the cost effectiveness of CAMHS provision for CYPwSW. To address these questions we will combine quantitative analysis of linked administrative health and education records, and co-produced qualitative analysis of case notes and semi-structured interviews. Data will be analysed from two large administrative datasets: Clinical Record Interactive Search (CRIS) at South London and Maudsley NHS Foundation Trust (SLaM) and Cambridgeshire and Peterborough NHS Foundation Trust (CPFT). We will utilise existing data linkages between each of these datasets and data held by the Office for National Statistics (ONS), Hospital Episode Statistics (HES) and the National Pupil database (NPD). Participants for the Delphi study will be recruited using professional networks in the UK. There are five interrelated work packages (WP): WP1: Examining accepted and rejected referrals - CRIS SLaM Using data from CRIS SLaM, we will examine sociodemographic and referral characteristics associated with accepted and rejected referrals in CAMHS and the longer term outcomes for these young people. WP2: Assessing interventions - CRIS SLaM A Delphi study will be conducted to create a typology of CAMHS interventions. Using CRIS SLaM, propensity score matching will compare CYPwSW to a group of CYP without a social worker. We will study the services provided to different CYPwSW, and explore the relationship between the interventions identified in the Delphi and outcomes for CYPwSW in terms of mental health, education, suicidality and self-harm, and wellbeing WP3: Replication of WP1 and WP2 – CRIS CPFT We will use data from CPFT to conduct a replication of WP1 and WP2. WP4: Economic analysis We will conduct an economic analysis to determine the economic impact and downstream public costs of the interventions and supports identified in WP2 and WP3. WP5: Coproduced qualitative studies With experts by experience, we will undertake co-produced research looking at clinical case notes in CRIS SLaM, and using the ‘consent for contact’ register to aid recruitment for an interview study. Academic outputs will include peer reviewed journal articles and a practice-focused report. We anticipate that the findings from this project will feed into updates to practice guidance. This study is jointly-funded by the NIHR HSDR Programme and What Works for Children's Social Care (WWCSC).