Closing the Gap

  • Research

    • Miranda Wolpert
    • Jasmine Hoffman (EBPU)
    • Neus Abrines (EBPU)
    • Amy Feltham (Very Important Kids at YoungMinds)
    • Lisa Baird (Very Important Kids at YoungMinds)
    • Duncan Law (CORC)
    • Kate Martin (YoungMinds)
    • Andrew Constable (Berkshire Consulting)
    • Katy Hopkins (EBPU)           
    • Erin Wright


    • Evidence Based Practice Unit (EBPU)
    • Child Outcomes Research Consortium (CORC)
    • YoungMinds 
  • Background

    Young people attending specialist Child and Adolescent Mental Health Services (CAMHS), for a range of problems including self-harm, depression, anxiety, family relationship difficulties and assessment for neurological disorders, are often bewildered and disempowered.

    This project attempted to close the gap between current practice and the rhetoric of “collaborative working” and “user participation” in order to ensure young people become active participants in their care by developing and promoting models of shared decision making (herein referred to as “SDM”). “Closing the Gap: Shared Decision Making in CAMHS” involved a collaboration of service users and professionals who set out to develop innovative practice in relation to SDM across four UK CAMHS (one outreach centre, two outpatient services and one inpatient unit).

  • Aims

    • To transform the dynamic between service users and their practitioners in CAMHS by April 2013, drawing upon “Shared Decision Making” as a conceptual framework for empowering children and young people to play an active part in decisions about their care.
    • To improve the quality of care for children and young people in CAMHS by April 2013, in three domains of quality: effectiveness, efficiency and person-centeredness
  • Methodology

    Four CAMHS were selected to be part of the learning collaborative on the basis of their interest in developing their already innovative practice in SDM further.

    Children and families in these sites were given accessible information about the evidence for different treatments, and encouraged to become active collaborators in treatment choices.

    Progress in treatment was continually reviewed and monitored against agreed goals and treatment options collectively agreed.

  • Results

    As a result of this project we have developed a high level conceptualisation of what shared decision making in CAMHS might look like.

    This has marked the first attempt to enhance this way of working with young people and families in this context.

    Our learning indicates the need for adaptation of current models of discrete shared decision making to make it applicable in the complex environment of mental health and child work where multiple perspectives may be involved, decisions are not one offs and on-going relationships are key.