title: Overcoming barriers in referral from schools to mental health services.
abstract: OBJECTIVE
  This survey of primary, secondary and area schools investigated their referrer satisfaction with six Child and Adolescent Mental Health Service (CAMHS) teams, spread over two metropolitan and four rural centres, and servicing six corresponding metropolitan and rural education districts. The survey aimed to identify barriers to referral from schools to CAMHS and to generate domains for quality improvement across the six local areas.
  
  
  METHODS
  School principals and counsellors completed the online Southern Schools Satisfaction Survey, which sought qualitative comment about aspects of the community mental health service in their area.
  
  
  RESULTS
  The response rate (65%) was reasonably good for a large online survey, with 149 schools participating (171 respondents: 113 principals and 58 counsellors). The majority of the respondents were satisfied with the service from CAMHS (24% were 'very satisfied', 47% 'mostly satisfied' 23% 'mildly dissatisfied' and 6% 'very dissatisfied'). The main barriers and sources of dissatisfaction that schools identified were CAMHS waiting lists, service availability and lack of flexibility. Practices from the team with the highest percentage of satisfied school respondents formed a constructive basis for service-wide quality improvement. These changes focused on flexibility in emergency responses, communication with schools and process of care with students.
  
  
  CONCLUSIONS
  Surveying referrer satisfaction can be useful for quality improvement within regional mental health services through the identification of good practice which can be transferred across teams.
authors.affiliation: Child and Adolescent Mental Health Services, Flinders Medical Centre, Adelaide, SA, Australia. stephen.allison@flinders.edu.au
authors.forename: Stephen
authors.initials: S
authors.lastname: Allison
authors.forename: Leigh
authors.initials: L
authors.lastname: Roeger
authors.forename: Dorothy
authors.initials: D
authors.lastname: Abbot
mesh_terms: D000293:Adolescent; D001291:Attitude of Health Personnel; D002648:Child; D003156:Community Mental Health Services; D003625:Data Collection; D006297:Health Services Accessibility; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011787:Quality of Health Care; D012017:Referral and Consultation; D012424:Rural Population; D012572:School Health Services; D013021:South Australia; D014505:Urban Population