Review Article: The acceptability and effectiveness of standardised diagnostic assessment approaches in children and young people's mental health services - an updated systematic review.

Background: Standardised diagnostic assessment (SDA) tools are designed to comprehensively evaluate various mental health disorders and support accurate diagnoses. While evidence for their routine use in child and adolescent mental health services (CAMHS) remains limited, increasing service demands underscore the need for efficient clinical assessments. This updated review examines the acceptability and clinical utility of SDA tools in CAMHS.

Method: A systematic review of 464 studies published between January 2013 and February 2025 was conducted (PROSPERO: CRD42024494051). Ten studies met the inclusion criteria, comprising eight cross-sectional studies and two randomised controlled trials.

Results: SDA tools reviewed included Development and Wellbeing Assessment (DAWBA), Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS). DAWBA improved referral decision accuracy, while both DAWBA and MINI-KID had acceptable agreements with expert consensus diagnoses. MINI-KID and KSADS were able to identify more cases than routine clinical assessments. However, DAWBA did not show effectiveness in changing diagnostic practice. Clinicians were favourable of SDA tools' psychometric properties but less favourable of diagnostic labels and feasibility in practice. Psychiatrists and psychologists were more likely than other healthcare professionals to use these tools in practice.

Conclusions: This review highlights that while SDA tools may aid referral decisions, evidence supporting their overall effectiveness in CAMHS is lacking. Clinician concerns pose barriers to routine use, requiring further research before implementation.