Risk Behaviours and Service Use Intensity in Child Mental Health Care

Abstract Objective Little is known regarding factors that predict Child and Adolescent Mental Health Services (CAMHS) use. The current study examined risk behaviours (e.g., danger to self, danger to others) among children with mental health issues as predictors of service use intensity (i.e., total visits) over 1 year, and across time (i.e., number of visits per two-month period). Methods Secondary data analyses of CAMHS chart review data spanning a 5-year period at 6 children’s mental health agencies across Ontario from youth between the ages of 4 and 11 (N = 356) were conducted. Child risk behaviours were measured using the Child and Adolescent Needs and Strengths Scale – Mental Health (CANS-MH; Lyons, 1999) and examined as a predictor of service use intensity and patterns of service use intensity over a 1-year period. Results About one third (35.4%) of children presented with 1 or more risk behaviours. Of these, most (84.9%) presented with the risk behaviour “Danger to Others”. Children who presented with Danger to Others had significantly higher service use than children who did not present with this risk behaviour (X2 = 6.93, p \u3c .05). Children who presented with only Danger to Others also had different temporal patterns of service use. For example, children with Danger to Others had higher service use intensity than children without this risk behaviour in only later months of the year. Conclusions Danger to Others appears to play an important role in predicting how intensely children and their families use mental health services. Children who present with this risk behaviour seem to need persistently more intense mental health services than children who do not