Referrals for suicidality to a UK child and adolescent mental health service: an evaluation of the policy and practice context of response to suicidal young people.

Abstract

Aims and method: We reviewed referrals mentioning suicidality to a Scottish CAMHS. The referrals were from January to June 2019 and 2022. We recorded the referral reason and outcome and compared these to the National CAMHS Service Specification (2020).

Results: Of 2,753 referrals, 560 (20.34%) mentioned suicidality. Of these, 82.4% were accepted. The majority of those rejected were from outside the region, already in the CAMHS, or provided insufficient information. The majority did not include any risk assessment (43.6%) or safety planning (67.7%). We identified lack of clarity in the National CAMHS Service Specification around the requirement for evidence of a serious mental illness and the meaning of "suicidal behaviours".

Clinical implications: We require clearer language concerning "rejected referrals", better communication between the CAMHS and referrers, improved pathways for referral re-direction, and support for referrers to assess risk and safety plan. We require clarity in national guidelines over where suicidal young people should be supported.