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The role of the primary mental health worker (PMHW) is relatively new within child and adolescent mental health services (CAMHS). Different organisational structures have emerged and it is important to study the advantages and disadvantages associated with different PMHW practice models. The current study uses a large, representative sample of PMHWs and operationalises practice models according to the PMHWs' self‐reported location and team alignment thus identifying three models (namely CAMHS outreach, primary care based, and dedicated PMHW team). Comparisons between the models are made in relation to organisation and management, inter‐agency links, and job satisfaction with the aim of exploring the strengths and weaknesses of each model. The results suggest that each model meets the aims of the role and there is greater similarity than dissimilarity between models. However, it also indicates that attention should be paid to improving the working environments and training and development opportunities for all PMHWs irrespective of model, but with particular consideration given to improving the support available to PMHWs working in primary care based models.

It is estimated that approximately 10% of children and young people in Scotland have mental health problems (Scottish Government, 2008), resulting in a rapidly increasing need for child and adolescent mental health services (CAMHS). Primary mental health workers (PMHW) have been identified as one of the key professional groups within a multidisciplinary CAMHS team to progress the agenda of early intervention and identification of mental health problems among children and young people. One discrete aspect of the PMHW role is the facilitation and delivery of consultation services to a wide range of agencies. Consultation, in this context, is understood as a community activity for disseminating knowledge, creating understanding and facilitating non‐CAMH professionals to support children and young people with psychological difficulties (Scottish Executive, 2005). This paper discusses a smallscale study that aims to deconstruct the concept of consultation and explore the professional expertise and service requirements necessary for effective delivery. It concludes that complex and multifaceted skills are required if a consultation is to be meaningful and effective. Consequently, and despite competing discourse, there remains a strong debate for retaining the role of the PMHW, specifically for the delivery of early intervention and health promotion activities, such as consultation. The study took place in Scotland, but UK‐wide data is drawn on to provide a more comprehensive picture.

Primary mental health workers have been based in West Lothian schools since 2003 to act as links between the community and hospital‐based services. The research programme this paper describes aimed to examine how this model worked and its impact for children and their families.

This paper reports on interviews with secondary school staff, the link workers and comparative post‐holders. The research study was qualitative and the research question was “What is the perceived impact of Mental Health Link Workers in West Lothian schools?”.

The paper finds that Primary mental health workers felt that their main contribution was building capacity in the community to support children with mental health problems, and identified four strands to this: space, relationships, skills and containment. Two described direct access for children and their families as the main gain. Secondary school staff considered that the greatest impact was for children at the onset of mental illness, and their own knowledge and skills.

Primary mental health work in the community is fairly new in Scotland. This study suggested that it speeded up and improved access to services for children in need of mental health assessments and services. It was based on temporary contracts and short‐term funding. Sustainability within schools may only take place when the work becomes well resourced.

The paper is a detailed look at the views of Primary Mental Health Workers based in schools and school staff.

This paper provides initial findings from a pilot to introduce graduate mental health workers into primary care, child and adolescent mental health services (CAMHS) across three localities in the north west of England in the UK. The progress of the pilot was monitored by gathering information from students, managers, supervisors and mentors regularly throughout the 12 month period, during which the pilot cohort were being formally trained. The potential of the new role of primary care graduate mental health workers to address problems of volume and access to services, particularly how the role might contribute to developing nonspecialist primary care services, is considered.

This article aims to demonstrate a different approach to identify and assess adolescents experiencing mental health problems, within a school setting. Presently we rely on primary care professionals to identify mental health problems and adolescents are often reluctant to access such services. One of the benefits of utilising a mental health surveillance screening tool is to identify mental health problems in adolescents and to implement early intervention.

A cross‐sectional survey of school pupils from a secondary school was conducted, using the Paediatric Symptom Checklist for Youths (PSCY). The self‐administered questionnaire was completed and identified adolescents were then assessed by the Child and Adolescent Mental Health Services (CAMHS). Out of 247 pupils, 84 per cent of the adolescents completed the questionnaire.

From the screening tool, 25 per cent were identified for assessment. During their assessment 64 per cent of the young people were given self‐help guides and health promotion advice. The remaining 26 per cent of the adolescents were provided treatment sessions by CAMHS or by Children's Service Worker. Only 10 per cent of these adolescents had been previously seen within the CAMHS.

The PSCY is a useful tool for identifying and assessing adolescents with mental health problems. However, these results are the preliminary findings of a feasibility study. This subject area is a rich source for future research.

Findings from this project will influence wider mental health surveillance of our adolescent population.

This approach will also influence future service provision, for such a vulnerable population.

No comparative studies of this nature were found in the United Kingdom.

Pilot mental health link workers have been working in schools in West Lothian since 2002. This article reports initial findings from semi‐structured interviews with pupil support staff in 11 secondary schools receiving this service. School staff reported an improvement in referral systems for children at the early stages of mental illness, including quicker access to specialist services, and an improvement in their own knowledge and skills. These benefits were associated more strongly with frequency of contact with the mental health link workers than with the physical location of the worker within the school. Link workers with a social work background were more likely than those with a nursing background to be asked to deal with children presenting with behaviour problems.

The European Union‐supported Child and Adolescent Mental Health in an Enlarged Europe (CAMHEE) project aimed to provide an overview of the challenges, current practice and guidelines for developing effective mental health promotion and mental illness prevention policy and practice across Europe. As part of this work, an analysis was undertaken of the situation in England, making use of a bespoke data collection instrument and protocol.Our analysis suggests that there has been significant effort and investment in research, needs assessment, policy, human resource and service developments in CAMHS over the last 20 years, leading to a more detailed understanding and availability of services. Much of the emphasis has been on assessment and management of difficulties, however in recent years attention has begun to focus on mental health promotion. National standards and programmes such as Every Child Matters (Department for Education and Skills, 2004) have acted as catalysts for a number of national initiatives.

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.