The effectiveness and quality of routine child and adolescent mental health care outreach clinics.
OBJECTIVE
Little evidence has been available about the functioning and outcomes of child mental health services operating at the primary care interface. This study investigated the effectiveness and quality of one particular model of outreach clinic.


METHODS
The study used a quasi-experimental design comparing outcomes of children attending the outreach clinics with a waiting list comparison. The intervention group (n=88) was assessed at referral, four months and twelve months later. The comparison group (n=99) completed measures at referral and four months.


METHODS
The main carers of participant children completed self-report measures of problem severity, impact, burden, parental stress and parent satisfaction. Clinicians provided clinical activity information.


RESULTS
There were significant reductions in children's problem severity, distress and impairment, particularly for behavioural difficulties. In contrast, the results showed no effect upon the outcomes of children's emotional problems or parental stress. High ratings of satisfaction were obtained for many aspects of care.


CONCLUSIONS
The children receiving care through this system of decentralised, outreach clinics derived clinical benefits that were maintained over time. The outreach clinics received strong consumer support suggesting the service offered a high level of acceptability to parents.
Day
Crispin
C
South London and Maudsley NHS Trust, London, UK. crispin.day@slam.nhs.uk
Davis
Hilton
H
D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D000554:Ambulatory Care Facilities; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000592:standards*; D003159:Community-Institutional Relations / Q000592:standards*; D017281:Cost of Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D010290:Parents / Q000523:psychology; D010549:Personal Satisfaction; D011320:Primary Health Care / Q000379:methods; D011787:Quality of Health Care / Q000592:standards*; D012944:Social Support; D006113:United Kingdom; D014850:Waiting Lists