An evaluation of comorbid substance misuse in Lewisham CAMHS: prevalence, characteristics and support provision.

A quarter of young people in Lewisham’s child and adolescent mental health services may be using drugs or alcohol in ways that harm their treatment, but clinicians often miss the signs. This matters because substance misuse can derail recovery from depression, anxiety, or psychosis, yet CAMHS teams lack routine screening tools and clear referral pathways for it. Without knowing how widespread the problem is or what these young people actually need, services cannot adapt. The project will audit clinical records and interview staff and families to map the true prevalence of substance use and the specific challenges—such as housing instability, family conflict, or school exclusion—that accompany it. If successful, the findings could reshape how CAMHS triages new referrals, prompting automatic substance-use checks and tailored support packages. That would mean fewer young people falling through the gap between mental health and addiction services. On a system level, the work could inform commissioning decisions across London CAMHS, potentially reducing emergency admissions and long-term harm by catching substance problems early, when intervention is most effective.