Predictors of child and adolescent mental health treatment outcome

BACKGROUND: To examine the predictors of treatment outcome or improvement in mental health difficulties for young people accessing child and adolescent mental health services. METHODS: We conducted a secondary analysis of routinely collected data from services in England using the Mental Health Services Data Set. We conducted multilevel regressions on N = 5907 episodes from 14 services (M(age) = 13.76 years, SD(age) = 2.45, range = 8–25 years; 3540 or 59.93% female) with complete information on mental health difficulties at baseline. We conduct similar analyses on N = 1805 episodes from 10 services (M(age) = 13.59 years, SD(age) = 2.33, range = 8–24 years; 1120 or 62.05% female) also with complete information on mental health difficulties at follow up. RESULTS: Girls had higher levels of mental health difficulties at baseline than boys (β = 0.28, 95% CI = 0.24–0.32). Young people with higher levels of mental health difficulties at baseline also had higher levels of deterioration in mental health difficulties at follow up (β = 0.72, 95% CI = 0.67–0.76), and girls had higher levels of deterioration in mental health difficulties at follow up than boys (β = 0.09, 95% CI = 0.03–0.16). Young people with social anxiety, panic disorder, low mood, or self-harm had higher levels of mental health difficulties at baseline and of deterioration in mental health difficulties at follow up compared to young people without these presenting problems. CONCLUSIONS: Services seeing higher proportions of young people with higher levels of mental health difficulties at baseline, social anxiety, panic disorder, low mood, or self-harm may be expected to show lower levels of improvement in mental health difficulties at follow up.