Child and Adolescent Mental Health Services

British mental health services for children and adolescents

Child and Adolescent Mental Health Services (CAMHS) is the name for care provided by the NHS and other organisations in the United Kingdom for children, generally until school leaving age, who have difficulties with their emotional well being or are deemed to have persistent behavioural problems. CAMHS offer children, young people and their families access to support for mental health issues from third sector (charity) organisations, school based counselling, primary care as well as specialist mental health services. The exact services provided may vary, reflecting commissioning and providing arrangements agreed at local level.

Worldwide in 2021, one in seven 10 19 year olds have mental health problems, with approximately 14% of adolescents, experiencing depression, anxiety, and behavioural disorders. In 2020, it was reported that one in six 5 16 year olds in England had a probable mental health difficulty. One in five children and young people aged 8 25 in England had a probable mental disorder in 2023. The restrictions as a response to the COVID 19 pandemic negatively impacted on the mental health of children and young people.

In response to the criticisms of the four tier framework, there have been attempts to transform services using initiatives such as the Choice and Partnership Approach (CAPA), CYP IAPT (an analogue of the adult Improving Access to Psychological Therapies initiative for children and young people) and ‘THRIVE’. CAPA, developed in the early 2000s, was an initiative designed to improve service effectiveness and the management of service demand and capacity. CYP IAPT was a government supported initiative of the 2010s. Like its adult IAPT counterpart, CYP IAPT aimed to improve the availability of, and access to, evidence based psychological therapies. Unlike its adult counterpart, CYP IAPT did not involve the recruitment and development of new types of workers; instead, it championed the training of existing staff in evidence based therapies such as cognitive behavioural therapy, parenting and interpersonal therapy. THRIVE is a framework for creating coherent and resource efficient ‘communities’ of mental health that focuses on clarity around need rather than structures or interventions to meet such needs. THRIVE has been mooted as an alternative to the tiers model with the four tiers being replaced by five (increasingly complex) levels of need: thriving, getting advice, getting help, getting risk support, and getting more help.