In England, the demand for, and access to Child and Adolescent Mental Health Services (CAMHS) have led to endemic and intractable problems: long waiting lists, non-attendance and complaints of inaccessibility from both users and referrers. The dilemma facing CAMHS is how best to respond to rising demand without compromising the quality of specialist secondary care services. As a pilot, we developed an alternative model of service delivery that provided a brief (2+1) consultation. We also created a manual as a guide to this process. This was evaluated with 50 families, who were seen within four weeks of their returned questionnaire. Strengths and Difficulties Questionnaire (SDQ) scores showed that 72% of families improved and 95% of parents were satisfied with the service they received. This approach is brief and empowering, and is sufficient to produce change. Implications for services using this approach would include: (i) informing referrers of the alternative model, (ii) training requirements, (iii) increasing the number of mental health workers so that secondary care services are able to function effectively, and (iv) allowing more specialist services to deal with the more severely disturbed cases.
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