Overcoming barriers in referral from schools to mental health services

Objectives: This survey of primary, secondary and area schools investigated their referrer satisfaction with six Child and Adolescent Mental Health Service (CAMHS) teams, spread over two metropolitan and four rural centres, and servicing six corresponding metropolitan and rural education districts. The survey aimed to identify barriers to referral from schools to CAMHS and to generate domains for quality improvement across the six local areas. Method: School principals and counsellors completed the online Southern Schools Satisfaction Survey, which sought qualitative comment about aspects of the community mental health service in their area. Results: The response rate (65016) was reasonably good for a large online survey, with 149 schools participating (171 respondents: 113 principals and 58 counsellors). The majority of the respondents were satisfled with the service from CAMHS (24% were 'very satisfied' ' 47% 'mostly satisfied' 23% 'mildly dissatisfied' and 6% 'very dissatisfled). The main barriers and sources of dissatisfaction that schools identified were CAMHS waiting lists, set-vice availability and lack of flexibility. Practices from the team with the highest percentage of satisfied school respondents formed a constructive basis for service-wide quality improvement. These changes focused on flexibility in emergency responses, communication with schools and process of care with students. Conclusions: Surveying referrer satisfaction can be useful for quality improvement within regional mental health services through the identification of good practice which can be transferred across teams.