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'An evidence synthesis of risk identification, assessment and management for young people using tier 4 inpatient child and adolescent mental health services'

CI: Hannigan (SONMS), Edwards (SONMS), Evans (SONMS), Gillen (Information Services), Pryjmachuk (Manchester), Trainor (Greater Manchester West Mental Health NHS Foundation Trust), Longo (Glamorgan)

The needs of most children and young people experiencing mental health problems are safely and effectively met in the community. For those with the greatest need, highly specialised child and adolescent mental health services (CAMHS) are available at what is often referred to as 'tier 4'. In recent years services at tier 4 have diversified. However, hospitals continue to occupy an important place in overall systems of care, and it is hospital services which are the focus of this study. In this context very little is known about how risks are identified, assessed and managed. Whilst assessments and management of risk in the areas of harm to self or others are important for young people, other 'risks' receiving far less attention also exist. Examples include the risks that mental ill-health and hospital admission pose to the achievement of young people's developmental milestones, or their educational attainment and social integration. This study will therefore synthesise what is known about the identification, assessment and management of constellations of risk in their broadest sense. The overall aim is to bring together research and other evidence in this area for young people (aged 11-18) using inpatient mental health services, and to establish what is known about the costs and cost effectiveness to the NHS of different approaches.