Risk rates and profiles at intake in child and adolescent mental health services: A cohort and latent class analyses of 21,688 young people in South London
Barry Coughlan,
Matt Woolgar,
Rick Hood,
Dustin Hutchinson,
Ella Denford,
Amy Hillier,
Keith Clements,
Teresa Geraghty,
Ava Berry,
Paul Bywaters,
Andy Bilson,
Jack Smith,
Taliah Drayak,
David Graham,
Francesca Crozier‐Roche,
Robbie Duschinsky
Affiliations
Barry Coughlan
Department of Public Health and Primary Care University of Cambridge Cambridge UK
Matt Woolgar
Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
Rick Hood
Department of Social Work and Social Care Kingston University London UK
Dustin Hutchinson
National Children's Bureau London UK
Ella Denford
School of Sport, Exercise and Health Sciences Loughborough Univeristy Loughborough UK
Amy Hillier
Department of Psychology Univerity of Bath Bath UK
Keith Clements
National Children's Bureau London UK
Teresa Geraghty
National Children's Bureau London UK
Ava Berry
National Children's Bureau London UK
Paul Bywaters
School of Human and Health Sciences University of Huddersfield Huddersfield UK
Andy Bilson
Department of Public Health and Primary Care University of Cambridge Cambridge UK
Jack Smith
Department of Public Health and Primary Care University of Cambridge Cambridge UK
Taliah Drayak
Department of Public Health and Primary Care University of Cambridge Cambridge UK
David Graham
Department of Public Health and Primary Care University of Cambridge Cambridge UK
Francesca Crozier‐Roche
Department of Public Health and Primary Care University of Cambridge Cambridge UK
Robbie Duschinsky
Department of Public Health and Primary Care University of Cambridge Cambridge UK
Abstract Background Children and young people (CYP) seen by child and adolescent mental health services (CAMHS) often experience safeguarding issues. Yet little is known about the volume and nature of these risks, including how different adversities or risks relate to one another. This exploratory study aims to bridge this gap, examining rates at entry to services and profiles of risk using a latent class analysis. Methods Data were extracted for CYP who received at least one risk assessment at CAMHs in South London between January 2007 and December 2017. In total, there were 21,688 risk assessments. Latent class analysis was used to identify profiles of risk from the risk assessments. Results Concerns about parent mental health (n = 5274; 24%), emotional abuse (n = 4487; 21%), violence towards others (n = 4210; 19%), destructive behaviour (n = 4005; 18%), and not attending school (n = 3762; 17%) were the most commonly identified risks. Six distinct profiles of risk were identified from the latent class analyses: (1) maltreatment and externalising behaviours, (2) maltreatment but low risk to self and others, (3) antisocial behaviour, (4) inadequate caregiver supervision and risk to self and others, (5) risk to self but not others, and (6) mental health needs but low risk. Conclusions These findings provide fresh insights into adverse experiences and risks identified by CAMHS. For professionals, the profiles identified in this study might provide insights into profiles of identified risks, in contrast to traditional cumulative approaches to risk. For researchers, these profiles may be fertile ground for hypothesis‐driven work on the association between adversity and later outcomes.
