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.

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.