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The Royal College of Psychiatrists Improving the lives of people with mental illness

CR182. Building and sustaining specialist CAMHS to improve outcomes for children and young people

Price: £0.00

Approved: Dec 2012

Published: Nov 2013

Status: current

Number of pages: 80

Review by: 2017

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This report is only available online – there are no printed copies available to buy.

Please use the link above to view and download a PDF file of the report.

This report provides an update of guidance on workforce, capacity and functions of specialist child and adolescent mental health services (CAMHS) in the UK. It aims to give a ‘rule of thumb’ tool that can be applied to any region in any jurisdiction of the UK.  It can be recommended to anyone who is struggling to answer the questions, ‘what should specialist CAMHS be doing and how many people does it need to do it?’


Its purpose is to help colleagues working in specialist CAMHS to be clear with those planning/commissioning services (as well as service providers and partner agencies) about the workforce/resources required to meet the needs of a population of children and young people. This is key to improving outcomes for children and young people in the UK. Child and adolescent mental health service clinicians and managers can also use this report to support discussions as to what is achievable within a particular resource allocation.


The report has been written at a time of financial austerity and significant changes in health policy. As such, it focuses heavily on how to improve the situation for children, young people and their families, by really putting them at the heart of what we do and working in a truly

collaborative way.


It provides current indicative figures for workforce capacity and function of specialist CAMHS at Tier 2, 3 and 4. The evidence presented here – which gives quantitative guidance on the core work of specialist CAMHS – has changed very little since the last report (CR137, 2006), but the report has expanded into some new areas and now includes recommendations for specialist CAMHS for 16- and 17-year-olds, CAMHS for children and young people with intellectual disabilities, and those with forensic and substance misuse problems. It also includes recommendations for alternatives to hospital admission.


This is a constructive, easy-to-read report that will be invaluable to commissioners, service providers and all professionals across health and social care, education and justice sectors.


This report updates and replaces Building and Sustaining Specialist Child and Adolescent Mental Health Services (College Report CR137; Royal College of Psychiatrists, 2006).


  • Working group
  • Acknowledgements
  • Abbreviations
  • Foreword - Professor Sue Bailey
  • Executive summary
  • The need for guidance
  • Specialist CAMHS across the UK jurisdictions
  • Where we are now
  • Evidence-based practice and outcome-focused CAMHS
  • Minority ethnic groups
  • Calculating capacity of specialist CAMHS
  • Guidance for provision of specialist CAMHS
  • Conclusions
  • References


  1. Definitions
  2. NICE guidance
  3. Methodology on streamlining and process-mapping specialist CAMHS
  4. Specialist CAMHS capacity adjusted for number of sessions seen
  5. Professional guidance on skill mix in Tier 2/3 specialist CAMHS up to the 16th birthday
  6. Examples of skill mix in Tier 2/3 specialist CAMHS WTE per 100 000 total population (per 250 000)
  7. Summary of a ‘five-star’ CAMHS
  8. Service descriptions of differing Tier 2/3 specialist CAMHS
  9. Calculations for CAMHS for 16- and 17-year-olds
  10. Examples of calculating number of in-patient beds for children and adolescents
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