Pathways to care of young people accessing a pilot specialist youth mental health service in Norfolk, United Kingdom.
Pathways to care (PtC) are a means of examining and understanding routes into mental health care. It is important to examine PtC in order to identify ways in which individuals access services, as well as highlighting barriers or delays to appropriate treatment. This study aimed to examine PtC experienced by young people accessing a pilot specialist youth mental health service (SYMHS) for those with non-psychotic, severe and complex mental health conditions in Norfolk, UK.



Data were collected on a subsample of referrals accepted into the pilot SYMHS (n = 94) over a 12-month period. Duration and number of PtC were assessed using a semi-structured interview augmented by health record examination. Measures of premorbid history, symptoms and functioning were also collected.



The mean length of PtC was 3.74 years, and a mean of 5.53 pathways was experienced before appropriate services were accessed. Individuals were most likely to first seek help from their general practitioner followed by an educational provider. There were no associations between PtC and current symptoms, although individuals with a premorbid history of mental health problems experienced shorter PtC. There was a trend suggesting that individuals with long pathways had poorer functioning compared with those with shorter pathways.



Pathways to care are variable in a group of young people presenting to mental health services. A majority of participants experienced 'long pathways', which may negatively impact on outcome. The results indicate the need to improve access to appropriate services by overcoming pathway barriers. Service implications are discussed.
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Brighton, UK.|Central Norfolk Youth Service, Brighton, UK.
Jo
J
Hodgekins
Central Norfolk Youth Service, Brighton, UK.
Timothy
T
Clarke
Central Norfolk Youth Service, Brighton, UK.
Hannah
H
Cole
Great Yarmouth and Waveney Youth Service, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Constantina
C
Markides
Great Yarmouth and Waveney Youth Service, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Uju
U
Ugochukwu
Great Yarmouth and Waveney Youth Service, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Peter
P
Cairns
Central Norfolk Youth Service, Brighton, UK.
Rebecca
R
Lower
School of Psychology, University of Sussex, Brighton, UK.
David
D
Fowler
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Brighton, UK.|Central Norfolk Youth Service, Brighton, UK.
Jon
J
Wilson
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D010865:Pilot Projects; D012017:Referral and Consultation; D013997:Time Factors; D006113:United Kingdom
adolescent; cross-sectional studies; delivery of health care; mental health; mental health services