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NOT YET RECRUITING

NCT07399106

Enhancing Child and Adolescent Mental Health Service Referrals 2

Sponsor: Greater Manchester Mental Health NHS Foundation Trust

View on ClinicalTrials.gov

Summary

Background Increasing numbers of children and young people are being referred to Child and Adolescent Mental Health Services (CAMHS). However, a quarter are 'rejected' for treatment. This can happen for simple reasons like: 1. confusion about what support CAMHS can and cannot provide 2. lack of information about available non-CAMHS support 3. the paperwork submitted to CAMHS is incomplete Being rejected by CAMHS is distressing for children and young people and families. The current process also costs the NHS because of wasted clinical time reviewing children and young people who do not need CAMHS' help. For GPs and school staff making referrals, rejection is frustrating especially if no other help is offered. In the previous NIHR-funded ENCAMHS 1; project, the project team spoke to many children and young people and families with experience of trying to get help from CAMHS. The project team asked the stakeholders about the problems they had and what solutions might help. Aims This project aims to develop a simple, clear way for children and young people to get the right support for their mental health problems when they need it. This project aims to solve the problems people told us about and to improve the quality of referrals made to CAMHS. Design \& Methods The project team shall: * work with all relevant groups including children and young people and families to build a better referral process * make an easy-to-use digital referral process for CAMHS * make everything built useful and easy to use for as many people as possible * provide GPs, school staff and parents with information about non-CAMHS support * learn how to embed the new referral system across NHS systems (e.g. NHS app) * test the new process across 5-8 different CAMHS e.g. in and outside cities * ask people who tested the new process if they liked it and found it useful * analyse information collected to see how people used it * work with the charity MQ to make sure what is built is used widely The project team shall talk to children and young people, families, GPs, school staff, CAMHS staff and policymakers and build the new referral process with the project team. The project team shall hold several workshops which will shape the new digital tools, and ensure the project team considers how to include the right non-digital supports. The project team shall test the new process across 5-8 CAMHS and use a mix of statistical and interview data to understand if the new referral process is valued, useful and easy to use. The project team's partner, MQ, will develop a plan to roll out the tool nationally and to support its use in the long term. Patient \& Public Involvement The project team shall build on established collaborations with young people, their parents/carers/families. The project teamwon a national award for public involvement in the ENCAMHS 1 project. The project team shall be advised throughout by the Young People's Advisory Group (YPAG) and by the Parents and Professionals Advisory group (PPAG). The YPAG and PPAG from the ENCAMHS 1 project have told the project team they would like to work with the project team again on this project. The project team shall also recruit new members. Dissemination The project team want this project to transform how children and young people get access to appropriate mental health support and to reduce some of the pressures on CAMHS. The project team shall share learning with national NHS bodies. The project team shall make the digital tools the project team builds widely available through the networks. The project team shall publish the academic findings and share widely through social media and mental health partner networks.

Official title: EN-CAMHS 2: Enhancing CAMHS Referrals

Key Details

Gender

All

Age Range

16 Years - Any

Study Type

OBSERVATIONAL

Enrollment

235

Start Date

2026-02-01

Completion Date

2026-11-30

Last Updated

2026-02-11

Healthy Volunteers

Yes

Conditions

No Conditions Improving Referrals Into NHS CAMHS

Interventions

OTHER

Work Package 1

Requirements Prioritisation We shall hold 2 x roundtable events (Manchester and London) to gather feedback and input from senior stakeholders (e.g. NHS England senior leaders; commissioners, CAMHS leaders). With our partner MQ, we shall conduct 6 stakeholder focus groups with CYP, families/carers and professionals including GPs, to collaboratively prioritise requirements (identified in EN-CAMHS 1) for the revised digital tool. We aim to recruit up to 10 stakeholders per group, therefore 60 participants in total. We shall use the MoSCoW prioritisation method \[29\] collaboratively as we have done in a number of other NIHR funded digital health projects. As part of this prioritisation process, each of the existing 11 interactive CAMHS referral forms created by individual CAMHS in England will be rated using the System Usability Scale \[30\] and using criteria from the EN-CAMHS 1 focus groups e.g. navigability, clarity of language, accessibility.

OTHER

Work Package 2

Co-Design and Tool Implementation Onboard 5-8 CAMHS providers (with different characteristics and served populations) who are willing and can support an evaluation of the digitally-enhanced CAMHS tool in collaboration with our partners, NHS England. Workshops with 5-8 Trust staff from each provider. Co-design the tool with CAMHS stakeholders (2 x 1-hour workshops with 25 referrers). Ensure accessibility support (WCAG2.2 and assistive technology, translations of the tools etc) is extensive and supports needs identified by stakeholder consultation (Digital Accessibility Working Group n=10) and in collaboration with PPIE, YPAG and PPAG. This group will be formed from the project with characteristics derived from accessibility needs identified in the stakeholder codesign groups and from ENCAMHS 1. This group shall meet twice during the co-design process to review the tool and suggest accessibility enhancements. Every effort will be made to incorporate suggestions made by this group.

OTHER

Work Package 3

Evaluation of Implementation Evaluate implementation of the new digitally-enhanced referral process with 60 key referrers. Explore the potential, enablers and barriers of embedding a new CAMHS referral mechanism via semi-structured qualitative interviews with 25 referrers. Develop a blueprint and toolkit for CAMHS to implement the referral tool. Understand if and how the tool enhances the CAMHS referral process.

OTHER

Work Package 4

The charity MQ Mental Health Research was a key partner to EN-CAMHS 1. We plan to continue this successful partnership in EN-CAMHS 2. In this WP4, MQ will drive the sustainability of the EN-CAMHS tools. MQ are actively engaged in discussions with the Prudence Trust about longer-term sustainability support for the platform. MQ aim to collaborate to drive and support the tools' implementation, nationally if possible. This will require lobbying key national stakeholders (including senior policymakers, regional ICB leads, mental health professional bodies) to support implementation of the platform for the medium and longer terms, beyond the lifetime of this grant. MQ have secured funding from the Prudence Trust to support longer term sustainability for the referral tool and enhanced referral processes developed through this project.

Inclusion Criteria Participants recruited will: 1. Have capacity to consent. 2. Be 16 years or over. 3. Be a CAMHS stakeholder who has had experience with the CAMHS referral process: CAMHS Staff: we will include any staff who currently work in CAMHS services Collaborators: We will include collaborators who have direct experience of the current referral process for CAMHS Children and Young People (CYP): We will be recruiting CYP who have been referred to CAMHS regardless of whether they were accepted into the service or not. CYP will be aged 16-30, and will have experience of the CAMHS referral process in the past 5 years. Key referrers: We would ask that these individuals have had experience referring CYP to CAMHS, regardless of how many times. Parents/carers: we will ask parents/carers who have experience of their child or a child in their care having been referred to CAMHS, regardless of the outcome of the referral. CAMHS Commissioners: We will ask Commissioners who understand the current CAMHS referral processes locally or nationally, and who are involved in the funding process Mental Health Leads: We will invite people with a strategic overview of the CAMHS referral process locally or nationally to share their experiences of the referral process. 4. Be proficient in English (or a supported language of the translated referral process). Exclusion Criteria 1. People unable to speak and understand written English at a relatively high level. 2. People without good internet access to take part in the online focus groups. 3. People who have not had experience with the CAMHS referral process. 4. People who lack the capacity to consent. 5. Young people who are currently accessing CAMHS for support. Regarding any level of illness/disability: We feel it is up to the young person to make this decision during the consent process, and we could not make that decision for them. We will inform participants during the consent process (i.e. in the PIS and subsequent discussions) that there may be discussion which they could find upsetting, and we have a distress protocol in place for if anyone needs additional support, but that this should be considered when agreeing to take part in the study.

Locations (1)

University of Manchester

Manchester, United Kingdom

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Enhancing Child and Adolescent Mental Health Service Referrals 2

Summary

Key Details

Conditions

Interventions

Eligibility Criteria

Locations (1)