Monitoring Change in Families Receiving Primary Mental Health Specialist Services: A Pragmatic Evaluation Within an Existing Service for the Under-Fives.

Background:   Specialist CAMHS-based services for pre-school age children are being introduced in the UK using different models of care. The clinical value of these new services requires assessment.

Method:   Over 20 months a Primary Mental Health Specialist (Under 5s) service operating in South West UK was evaluated on a variety of themes including effectiveness. Recruited clients completed questionnaires on their own well-being (on two occasions) and their child's behaviour (on three occasions) over the intervention period.

Results:   Of the 67 carers assessed at or shortly after recruitment using the General Health Questionnaire, 55.2% were at high risk of having a clinically significant affective mental condition. Despite a trend towards improvement, neither the GHQ-12 total score nor the proportion meeting the clinical criterion was statistically significantly reduced. The main index of child behaviour and emotional state demonstrated a statistically significant reduction in the number of disturbance-indicating behaviours over the service intervention period. The largest changes occurred between recruitment and the 4 visit. Selection bias cannot be excluded.

Conclusions:   Significant changes determined over a relatively short period of intervention is consistent with an effect of service, but direct attribution demands care as no control groups were included.