Can clinical complexity or early response differentiate outcomes in child and adolescent mental health?

Abstract

Background

This study examined relationships between clinical complexity, early response, and outcomes in a Child and Adolescent Mental Health Service (CAMHS) using the Paddington Complexity Scale (PCS) and Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). Associations with treatment dose were also explored.

Methods

Data from consumers aged 4–17 years discharged from a metropolitan CAMHS over 5 years were analysed. Baseline PCS scores measured clinical complexity. Early response was defined as a reduction in HoNOSCA total score at 3 months post-intake. A three-way mixed ANOVA tested effects of complexity, early response, and time (assessment vs discharge) on HoNOSCA outcomes and on treatment dose (total contact hours).

Results

Neither complexity nor early response influenced treatment dose or contact hours. Early response was significantly related to better treatment outcome at discharge. Complexity was not related to treatment outcome.

Conclusions

Early response was more useful in predicting long-term outcomes in CAMHS than clinical complexity. Further research should consider the impact of systematically attending to early response, as well as potential moderating factors, alternative complexity measures, and the generalisability of these findings.

Keywords

treatment outcome complexity early response child and adolescent mental health

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