A QUARTER of children referred to mental health services in Scotland have been thinking about or attempted suicide, new research has shown.
Scotland has the highest rate of suicides among children in the UK although the number referred to mental health services for suicidality, and the care they receive, is largely unknown.
Researchers at the University of Stirling have tried to address this lack of evidence by reviewing referrals to Child and Adolescent Mental Health Services (CAMHS) in two of Scotland’s NHS board areas.
They found that 25% of all referrals – those made to both boards across a six-month period – were for children who had been thinking about or had attempted suicide.
A third of these were under the age of 12.
The study was led by Dr Lynne Gilmour alongside colleagues from the Nursing, Midwifery and Allied Health Professions Research Unit at the University of Stirling.
Gilmour said: “Our research sought to understand how the children referred for suicidality are processed, assessed and treated.
“Overall, we found that one in four referrals to CAMHS involved children who had either attempted suicide or had suicidal ideation – and 33% of those were under 12.
“We also identified a variation within and between health boards in terms of assessment, referral outcomes and care pathways for these children – with most, in one area, not receiving a face-to-face assessment, let alone treatment or support.
“This highlights the often-missed yet vital opportunity for early intervention with very young suicidal children.”
The study highlighted a significant disparity in the response of health boards to children referred for suicidality.
Using anonymised data, the research team examined referrals made – often by medical professionals, schools, or social workers – to two CAMHS sites situated in different parts of Scotland (Sites A and B) between January and June 2019.
In the first health board, more than two-thirds (69%) were not offered a face-to-face assessment whilst just 8% of those assessed were offered treatment immediately.
By contrast, the second health board – which had a dedicated suicide and self-harm team – offered face-to-face assessments to most people (82%), with 66% being offered treatment.
At site A, 104 of all 397 referrals (26%) to CAMHS were identified as being for suicidality, and 180 of 762 (24%) at site B. Around 40% of those referrals were for males and 60% for females, and ages spanned from five to 17.
Researchers said that there was a “considerable difference” between the sites in terms of the numbers who were offered assessments and treatment, reflecting the structural differences between the teams.
At site A, just 31% of children were offered a face-to-face assessment – which generally involves meeting a clinician who will conduct a risk assessment, safety planning exploration of family circumstances, and underlying issues. This compared to 82% at site B.
Gilmour presented the team’s findings to the Scottish Government and added: “Our study highlights vast differences in how referrals for suicidality in children are processed and responded to.
“We found little difference in the issues being identified by referrers, the age range of children, and the behaviours they present; yet there were very different outcomes and pathways of care.
“The data presented here is novel and will provide a vital source of information for decision-makers and service providers in their consideration of service structures and allocation of resources.
“This is particularly important given the growing number of referrals to CAMHS and the excessively long waiting times in many areas: it is vital that those identified as being at risk of suicide be provided with clear and consistent pathways of care at the earliest possible opportunity.”
