Potential Role of Community Child Health Paediatricians in improving case ascertainment in Surveillance Studies of Child and Adolescent Mental Health Conditions in United Kingdom - EAP 2021 Virtual Congress and MasterCourse

Michael Ogundele ² Hani Ayyash ¹ Richard Lynn ³ Tanja-Sabine Schumm ⁴ Cornelius Ani ⁵

¹Community Paediatrics, Mid and South Essex University Hospitals Group, Southend University Teaching Hospital, UK, Westcliff-on-Sea, UK
²Halton Community Paediatrics, Bridgewater Community Healthcare NHS Foundation Trust, Runcorn, UK, Runcorn, UK
³British Paediatric Surveillance Unit, Royal College of Paediatrics and Child Health, UK, London, UK
⁴Child and Adolescent Mental Health Service, NHS Greater Glasgow and Clyde, UK, Glasgow, UK
⁵Child and Adolescent Mental Health Services, Imperial College London and Surrey and Borders Partnership NHS Foundation Trust, UK, London, UK

We aimed to determine how to maximise case ascertainment in studies of children and young people with uncommon mental health difficulties in United Kingdom through joint or single surveillance by the Child and Adolescent Psychiatry Surveillance System (CAPSS) and British Paediatric Surveillance Unit (BPSU) by involving Community and Child Health (CCH) Paediatricians. .

Design: An online survey of the 1,120 British Association of Community Child Health (BACCH) members working in 169 CCH Services in the UK.

Results: A total of 245 CCH paediatricians responded to the survey from across several CCH units in the UK. The paediatricians were more likely to be involved in the care of CYP with Neurodevelopmental (including ADHD and Autism), Neurodisability disorders and Safeguarding/Child Protection. A sizeable proportion of CYP with emotional difficulties presented to paediatricians (e.g. 29.5% for anxiety / OCD, and 12.8% for depression) – mainly due to difficulty with accessing Child and Adolescent Mental Health Services (CAMHS). More than half of the community paediatricians are involved in the care of CYP with anxiety and OCD, while 32.3% are involved in the care of those with depression. CYP with Self-Harm/Suicidality, Anxiety including Obsessive Compulsive Disorder (OCD), Depression, Psychosis and Bipolar Disorder were more likely to be referred primarily to CAMHS.

Less than half of the respondents (42.7%) reported that their paediatric services are part of a multidisciplinary team or joint service with CAMHS.

Conclusion: Many CCH paediatricians are involved in the care of CYP with mental health conditions. This study confirms that joint BPSU and CAPSS is recommended for surveillance studies of neurodevelopmental conditions. Involvement of BACCH members in joint surveillance should be considered in some specific research questions relating to emotional disorders, with due consideration given to the relative trade-offs between case ascertainment, and the additional cost and reporting burden of joint surveillance.