Making sense of child and adolescent mental health

Aims and method A prospective audit of the 425 referrals made to a community child and adolescent menial health service over a three month period was undertaken. Standardised data were collected about the referrer, reason for referral, problem chronicity andcomplexity, serice response and first appointment attendance. Results. The service is currently seeing less than one in five of the children conservatively estimated to require specialist mental health services. The majority of thosereferred were appropriate, identifying multipie problems of longer than six months' duration presenting within a complex context. Clinical implications. The results have provided commissioning authorities with a clear specification of the current service. This can inform decisions about resource reallocation, prioritisation and future service development. Clinicians feel that the complexity of their work is now understood and various audit projects and initiatives have been established in order to explore alternative ways of responding to referrer demands.