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

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CAMHS Inpatient Referral Study

What happens to young people refused admission to an inpatient unit?

Although admission to hospital is a last resort for young people with mental health problems, it is important for a bed to be available when needed. This project tracks young people who are referred, but not admitted. By finding out what happens to these young people, the study will identify gaps in service provision.

Detailed information

Short title: CAMHS Inpatient Referral Study (CIRS)

Long title: The Care Pathways of those Referred but not admitted to In-patient Adolescent Psychiatric Services in England

Funded by Policy Research Programme in the Department of Health

Ethical approval reference: MREC 03/4/078




Read the report

Final  Report


  • Appendix 1 – attached to the final report
  • Appendix 2 – attached to the final report
  • Appendix 3 – Data Collection Tools
  • Appendix 4.1 – A 55 kg paper mountain: The impact of new research governance and ethics processes on mental health services research in England.
  • Appendix 4.2 – Provision of child and adolescent mental health in-patient services in England between 1999 and 2006
  • Appendix 5.1 – CAMHS in North Central London SHA
  • Appendix 5.2 – CAMHS in Norfolk, Suffolk and Cambridge SHA






The Government pledged to meet the mental health needs of all young people and committed to put in place comprehensive child and adolescent mental health services (CAMHS) by 2006.  Inpatient (IP) mental health care is an important part of this provision.  Despite this, there is some evidence that a proportion of young people who are referred to IP CAMHS are denied admission because of a lack of available beds in an appropriate setting.  One consequence of this is that at least one-third of all admissions of young people for the treatment of a mental disorder are to an adult psychiatric ward or paediatric ward.  The new amendments to the 1983 Mental Health Act (Mental Health Act, 2007-Section 31) require that, in future, young people are only admitted to an age appropriate environment.


Research question:


To explore what happens to young people who are referred but not admitted to inpatient CAMHS, we aimed to examine:


a) The demand for adolescent CAMHS beds in areas of England with high and low provision of IP CAMHS.

b) The reasons for admission and non-admission,

c) The care paths of those not admitted

d) The care path experiences of those not admitted and their parents

e) Factors that influenced decisions to admit

f) Agreement among clinicians about the criteria that constitutes ‘appropriateness’ for admission.




Health Services Research, Royal College of Psychiatrists, 4th Floor Standon House, 21 Mansell Street, London E1 8AA    





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