Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan;27(1):5-14.
Epub 2018 Jan 1.

Improving Access to Child and Adolescent Mental Health Care: The Choice and Partnership Approach

Sharon Clark  1 , Debbie Emberly  1 , Kathleen Pajer  2 , Emily Delong  1 , Susan McWilliam  1 , Alexa Bagnell  1 , Sabina Abidi  1 , Barbara Casey  2 , William Gardner  3
Affiliations

Improving Access to Child and Adolescent Mental Health Care: The Choice and Partnership Approach

Sharon Clark et al. J Can Acad Child Adolesc Psychiatry. 2018 Jan.

Abstract
in English, French

Objective: The Choice and Partnership Approach (CAPA) is designed to improve access and quality of pediatric mental health care. We tested whether CAPA improved access in an academic pediatric hospital.

Method: We used de-identified administrative data to compare access pre- (2011) and post-CAPA (2013).

Results: Wait time to first appointment in 2011 was 225.3 days (95% CI = [211.0, 239.6], N = 364), compared to 93.0 days (95% CI = [89.2, 96.8], N = 838) in 2013 (p<.001). Mean wait time between the first and second appointments was 59.2 days (95% CI = [46.5, 71.9], N = 86) in 2011, compared to 95.9 days (95% CI = [90.3, 101.5], N = 487) in 2013 (p < .001). However, overall mean wait time from referral to second appointment decreased from 271.2 days (95% CI = [236.5, 305.9], N = 86) in 2011 to 168.9 days (95% CI = [161.6, 176.2], N = 487) in 2013 (p < .001). Provider productivity increased from 32.6 to 57.0 first appointments/FTE/year. Depending on the question, 65 to 95% of parents and children gave positive answers about CAPA.

Conclusions: CAPA implementation was associated with more patients served, decreased waiting time to first appointment, and higher productivity.

Objectif: L’approche choix et partenaires (CAPA) est destinée à améliorer l’accès et la qualité des soins de santé mentale pédiatriques. Nous avons vérifié si CAPA améliorait l’accès dans un hôpital pédiatrique universitaire.

Méthode: Nous avons utilisé des données administratives dépersonnalisées pour comparer l’accès avant 2011 et après-CAPA (2013).

Résultats: Le temps d’attente pour un premier rendez-vous en 2011 était de 225,3 jours (IC à 95% = [211,0, 239,6], N = 364), comparé à 93,0 jours (IC à 95% = [89,2, 96,8], N = 838) en 2013 (p < 0,001). Le temps d’attente moyen entre le premier et le deuxième rendez-vous était de 59,2 jours (IC à 95% = [46,5, 71,9], N = 86) en 2011, comparé à 95,9 jours (IC à 95% = [90,3, 101,5], N = 487) en 2013 (p < 0,001). Cependant, le temps d’attente moyen global de l’aiguillage au deuxième rendez-vous est passé de 271,2 jours (IC à 95% = [236,5, 305,9], N = 86) en 2011 à 168,9 jours (IC à 95% = [161,6, 176,2], N = 487) en 2013 (p < 0,001). La productivité des prestataires a augmenté de 32,6 à 57,0 premiers rendezvous/ETP/année. Dépendamment de la question, 65 à 95% des parents et des enfants ont donné des réponses positives à l’endroit de CAPA.

Conclusions: La mise en oeuvre de CAPA était associée à plus de parents servis, à un temps d’attente réduit pour le premier rendez-vous, et à une plus grande productivité.

Keywords: access; child and adolescent mental health; patient engagement; services; wait times.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The CAPA Model Note. Dashed lines reflect that in Partnership, Specific Partnership work may be pulled in as needed.
Figure 2
Figure 2
Definitions of Wait Times
Figure 3
Figure 3
Patient flow pre- and post-CAPA
Figure 4
Figure 4
Changes in Wait Times Pre- and Post-CAPA
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Brown A, Ford T, Deighton J, Wolpert M. Satisfaction in child and adolescent mental health services: Translating users’ feedback into measurement. Administration and Policy in Mental Health. 2014;41:434–446. - PubMed
    1. Busner J, Targum SD. The Clinical Global Impressions Scale. Psychiatry (Edgmont) 2007;4(7):28–37. - PMC - PubMed
    1. CAMHS Network. CAPA: The Choice and Partnership Approach. CAMHS Network; 2013. Retrieved from http://www.camhsnetwork.co.uk/index.htm.
    1. Coghill D. Getting the basics right in mental health assessments of children and young people. Journal of Child Psychology and Psychiatry and Allied Disciplines. 2012;53(8):815–817. https://doi.org/10.1111/j.1469-7610.2012.02591.x. - DOI - PubMed
    1. Davidson S. The state of child and youth mental health in Canada: Past problems and future fantasies. Healthcare Quarterly (Toronto, Ont) 2010;14(Spec No 2):8–13. - PubMed

LinkOut - more resources