The Bermuda Triangle of child and adolescent mental health in remote regions

Introduction: Long waiting times and confusion about which service is appropriate, can mean that children and young people with mental health problems can become caught in the triangle of Child and Adolescent Mental Health Services (CAMHs), Paediatrics and Social Work Services. At worst this can be potentially damaging and at least, it causes frustration for families and service providers.
Objective: To establish the utility of the DAWBA in the early assessment of children and young people.
Methods: We recently introduced a pilot rapid diagnostic service. The service involves completion of the structured Developmental and Well-being Assessment (DAWBA) interview followed by a psychiatric assessment of the data and feedback to family doctors who can then make a more informed decision about which service is most appropriate. We think that children and adolescents may be less likely to get caught in the triangle if that happens.
Results: As a result of this pilot work, we have reconfigured the pilot service to include the use of fully online DAWBA assessments and suggestions by psychiatrists about the likely best service for the family.
Conclusions: The EU Northern Periphery and Arctic Programme is funding a multi-national randomised controlled trial of DAWBA. The challenges in ensuring appropriate and efficient referral to CAMHS and related services are international, and despite different service configurations in Sweden, Finland and Norway, colleagues from these countries are collaborating in this trial. Here we present the key issues which have emerged from the pilot and the early progress of the trial.

This abstract was presented at the Innovative Solutions in Remote Healthcare - 'Rethinking Remote' conference, 23-24 May 2016, Inverness, Scotland.