Paediatric mental health liaison services in England: findings from a national survey

BACKGROUND: Paediatric Mental Health Liaison (PMHL) in England is poorly understood with limited data on services previously collected. AIM: To describe the characteristics of PMHL services in England and create a service model typology. METHOD: Data were collected using a cross-sectional online survey adapted from the questionnaire used by the existing adult-care-focussed Liaison Psychiatry Surveys of England (LPSE). The survey was distributed via email through professional networks and social media. Survey data were supplemented with direct correspondence with survey respondents. Responses were coded numerically and analysed descriptively using SPSS. Free-text responses were analysed using NVivo. RESULTS: Results were obtained from 28 services serving 47 hospitals. Three service models were identified; Type 1 services providing psychological care for children and young people (CYP) with long-term conditions (LTCs); Type 2 services providing care for CYP in crisis, and Type 3 services providing care for both groups. Few services provided 24/7 crisis care for all under-18s; many respondents reported this was provided by community child and adolescent mental health (CAMH) teams. Type 1 services were often constrained by condition-specific funding. Type 1 and Type 2 services lacked multidisciplinary staffing compared to Type 3 services. CONCLUSIONS: This is the first survey of English PMHL service provision. Findings are exploratory, as they are based on a partial and non-representative sample of services. However, they suggest significant variation by hospital including a lack of dedicated 24/7 crisis care for all under-18s, and inequitable access to psychological support. Further research is required to replicate findings with a larger dataset, and to explore differences in service models. However, this preliminary data suggests that adequate PMHL provision would benefit from clearer national standards. Commissioning should ensure adequate funding and equity with adult provision. Terminology disagreements represent a research barrier.