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The aim of the review is to investigate the reasons for referral to this child and adolescent mental health (CAMH) service and determine whether these had been met by the service.

This is a retrospective case note analysis that was conducted of 66 referrals to CAMHS for children and young people serving a rural community of 132,000. Case notes were selected by the NHS CAMHS manager based on referrals during the pre-defined date set. Of the 66 referrals to CAMHS, 19 were not included in the analysis because they had not been accepted into the service. Data were analysed on the remaining 47 cases who were referred, accepted into the service and had been offered an assessment by the service.

General practitioners represented the most frequent health care practitioner to refer to the service (n = 33, 70.2%). Self harm, suicidal intent, thoughts or overdose represented the highest percentage of referrals to the CAMHS service (38.3%); depression, low mood and sadness represented the next highest figure (19%) and anxiety and depression (10.6%) broadly speaking 68% of referrals related to low mood. Out of the 44 cases that were examined, 14/44 (32%) were referred back to the GP and no specific intervention was provided. Interventions provided to five cases were unspecified.

A number of opportunities for developing the service that allowed for a focus on the core business of helping children and young people with low mood were identified. One of the limitations of this retrospective review was the time frame selected because it had been identified as a particularly high period for referral into the service and may not have been representative of the usual trend.

This informed a training strategy and resource allocation and a redefinition of discrete roles within the service.

This study highlighted the evidence about where the demand was on this service and hence the requirement to focus on their core business. This evidence generated by the review prompted a redirection of resources within the service. Additional reflections and discussion informed the development of a new training strategy and a redefinition of discrete roles within the service.