Rejected referrals to child and adolescent mental health services: audit

Appendix Four: Teacher Survey

Q1. What type of school do you teach in?

Nursery school

Primary school

Secondary school

Q2. Have you ever made a referral to CAMHS that was rejected? (was not accepted by CAMHS)

Yes

No

Q3. How often do you make referrals to CAMHS?

Weekly

Monthly

Six monthly

Other (please specify)

Q4. Can you give a brief outline of the situation? (Including at what stage you became involved and your role in the referral process)

Q5. How long did it take to prepare and submit the referral?

Less than an hour

Half a day

A week

Other (please specify)

Q6. What information, if any, did you give to the parents / young person after making the referral?

Q7. Was an assessment undertaken by CAMHS?

Yes

No

Q8. What information were you given from CAMHS during/after the assessment?

Q9. What was your role, if any, in communicating with the young person / family?

Q10. Would you say that this experience was typical or not typical of CAMHS assessments?

Yes

No

Q11. How did you hear the referral had not been accepted by CAMHS?

GP/ doctor

Another health professional e.g. health visitor, pediatrician

Q12. What reasons were given for the referral not being accepted?

Not an appropriate referral

Not enough information was provided

Was not considered severe enough

Q13. What happened next?

Q14. What, if any, impact did the rejection have on the young person?

Q15. How do you feel about the CAMHS referral process?

Q16. What, if anything, do you think could be improved?

Q17. What do you think are the most important points for SAMH to take to the Scottish Government about the CAMHS referral process?

Q18. Is there anything else you would like to tell us about the referral process?

REJECTED REFERRALS

Topic Guide for Referrers

Introduction (10 mins)

• By moderator
  - Name, organisation, short intro to SAMH
  - Reminder that you are acting as a researcher today

• Explanation of purpose of session
  - To understand what happens when young people are referred to Child & Adolescent Mental Health Services but do not receive treatment / support from them
  - Collecting experiences of young people and their families for a report to Scottish Government.
  - Aiming to gather feedback on 350 cases where young people have been in this situation.
  - Our aim is to improve the experience of young people (and their families) who are referred to Child & Adolescent Mental Health Services
  - Important to understand the perspective of referrers (teachers & GPs)

• Introduction to the format of the session
  - 45-60 mins
  - Group discussion, rather than individual Q&A
  - Share experiences in confidence
  - No expectation of breaching patient-doctor confidentiality

• Explanation of research and group discussions
  - No right or wrong answers
  - Everyone’s views are important, please don’t be afraid to speak up

• Reassurance over confidentiality and MRS Code of Conduct
  - We will not disclose any of your details
  - We will anonymise all of our reports
  - We will only use the information you provide for the purpose of this research

• Explanation of recording – audio recording – to ensure we correctly capture the detail of what we are being told. This will be transcribed and analysed for use in our report.
• Individual introductions:
  - First name, school / GP practice, job role, length of time in job

Knowledge Of / Relationship with CAMHS (5 mins)

• How much do you know about Child & Adolescent Mental Health Services? How familiar are you with their services?
• How often do you tend to come into contact with them?

How often do you make referrals to CAMHS? When was the last time you made a referral?

Referrals (15 mins)

I’d like to spend most of the time we have talking about the referral process, and your role in it. It would be useful if you could think of the last referral you made, if you have made several recently.

• Can you give a brief outline of the situation?
• At what stage did you get involved?
• Who suggested a referral to CAMHS?
  - PROMPTS: young person, family member, GP, teacher, someone else
• Why was a referral to CAMHS suggested?
• What did you do next? What was your role?
• How long did it take to prepare and submit the referral?
• What information, if any, did you give to the parents / young person at this stage?
• What were your expectations of what would happen next?
• And what were the parent/young person’s expectations?
• Would you say that this experience was typical or not typical of making a referral?

Assessments (15 mins)

• Was an assessment undertaken by CAMHS?
  - How long was the wait for an assessment?
• What information, if any, were you given during this time?
  - Did you pass this on to the young person?
• Did the young person/ parents ask for any support during this time?
• Was any action required whilst waiting for the assessment, such as chasing CAMHS?
• What impact, if any, did the waiting time have on the young person?
  - PROBE: emotional, behavioural, impact on condition, impact on family life etc
• Did you have any involvement / role during the assessment process?
• What information were you given during / after assessment?
• What was your role, if any, in communicating with the young person / family?
• Would you say that this experience was typical or not typical of CAMHS assessments?

Rejections (15 mins)

• How did you hear that the referral had been rejected by CAMHS?
  - Is this typical?
• Did you understand the reasons given?
• What happened next?
• Are other services usually recommended? By CAMHS? By you?
  - IF YES: which services?
• How much involvement did you then have with the young person / their family?
• What impact did rejection have on the young person?
• Would you say that this experience was typical or not typical of a referral being rejected?
• Is the CAMHS similar to the process for making referrals to other health areas?

Sum Up (5 mins)

• Overall, how do you feel about the CAMHS referral process?
• What do you think could be improved?
• What do you think are the most important points for SAMH to take to the Scottish Government about the CAMHS referral process?
• Any final comments?

Thank & Close