Version 2: Investigating young people’s engagement with CAMHS
Research type
Research Study
Full title
Version 2: Investigating young people’s engagement with Child and Adolescent Mental Health Services (CAMHS).
IRAS ID
271196
Contact name
Rachel Harris
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde, Research and Development
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
NHS Greater Glasgow and Clyde (GGC) Child and Adolescent Mental Health Service (CAMHS) is a service for children and young people undergoing assessment and intervention for moderate to severe mental health difficulties. National and local data demonstrates that some young people struggle to attend their appointments in CAMHS and at other healthcare appointments (NHS Benchmarking Network, 2018). This means that a proportion of young people experiencing distress may remain unsupported, and those who have engaged with services may experience barriers to therapeutic intervention and wellness. Missing CAMHS appointments, or gradually disengaging, poses a clinical risk and can also indicate safeguarding issues for the young person and their family (Abdinasir, 2017). Appointments which are not formally cancelled or rescheduled can also contribute to service waiting times, and can be costly to the NHS (Campbell et al., 2015). The current literature suggests that structural, service and patient related factors can impact attendance at CAMHS and other healthcare appointments (Abdinasir, 2017; Campbell, Millard, McCartney & McCullough, 2015; Ellis, McQueenie, McConnachie, Wilson & Williamson, 2017; Minty & Anderson, 2004).
Much of the previous research around factors influencing appointment attendance has focused on the adult population, with a lack of research investigating this from a young person’s perspective (Worrall- Davies & Marino- Francis, 2008). To our knowledge, there are no published qualitative studies in Scotland which have investigated young people’s experiences of attending CAMHS appointments. This study intends to inform this gap in the literature by interviewing young people who attend CAMHS and CAMHS staff about young peoples' experiences of attending appointment at CAMHS. These interviews will be conducted by the research team either face to face, or over the telephone. We hope that this will help identify where CAMHS can focus efforts to improve engagement with young people.
Summary of Results
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Key Findings: How Therapists Influence Young People’s Engagement with CAMHS
This study looked at how therapists can help—or sometimes unintentionally hinder—young people from attending and staying engaged with Child and Adolescent Mental Health Services (CAMHS). It’s based on interviews with CAMHS clinicians and highlights what works well and what can be improved.
What Helps Young People Stay Engaged:
1. Clear Communication from the Start
o Young people and families are more likely to attend if they understand what CAMHS is, what to expect in sessions, and what won’t happen (e.g. no physical exams).
o Using simple language, visuals, and friendly explanations helps reduce anxiety and builds trust early on.
2. Working Together on Care Plans
o When therapists and young people plan care together, it helps build a sense of control and partnership.
o Setting goals that matter to the young person (not just the professionals) makes them more likely to keep coming back.
3. Flexibility Makes a Big Difference
o Offering appointments at times and places that suit the young person—like after school, at home, or even during a walk—can remove barriers to attendance.
o Some young people need more time and patience to feel comfortable, especially if they are anxious or neurodivergent.
4. Building a Strong Relationship
o The connection between the therapist and young person is seen as one of the most important reasons they keep attending.
o Feeling listened to, respected, and not judged helps young people feel safe and supported.
5. Making Homework Manageable
o Some young people find between-session tasks helpful, while others feel overwhelmed or guilty if they don’t complete them.
o Therapists who are understanding and flexible about homework can help young people stay engaged.
6. Involving Parents and Support Networks
o When parents or trusted adults are involved and supportive, young people are more likely to stick with therapy.
o It’s important not to overload families with too much information or responsibility.
7. Explaining Diagnoses Clearly
o Young people may not understand mental health terms like “ADHD” or “autism”.
o Therapists need to explain things in a way that makes sense to the young person, using everyday language and visuals when needed.
8. Avoiding Overwhelm in Assessments
o First appointments can feel intense or intrusive, especially when lots of personal questions are asked.
o Therapists can help by pacing the conversation, checking in regularly, and making the experience feel more relaxed.
9. Teamwork Among Clinicians
o When different professionals work together and coordinate appointments, it reduces stress for families.
o Considering the timing, if multiple appointments are required with different kinds of clinicians, and sharing information behind the scenes helps young people feel more supported and less confused.
Challenges Therapists Face:
· Limited time, set service guidance, and high workloads can make it hard for therapists to be as flexible or personalised as they’d like.
· When services are under pressure, young people may be matched with the next available therapist, rather than the one best suited to their needs.
· Long waiting times or inconsistent contact can damage trust and make it harder to keep young people engaged.
Overall Message:
Therapists play a crucial role in whether young people attend and stay involved in CAMHS. Building trust, being flexible, listening well, and working in partnership with young people and their families are key to making services more effective and welcoming.
REC name
West of Scotland REC 4
REC reference
19/WS/0135
Date of REC Opinion
13 Sep 2019
REC opinion
Favourable Opinion