Four in ten children who attend Child and Adolescent Mental Health Services (CAMHS) in Scotland go on to attend specialist psychiatric services as adults, according to new research released on Aug. 4. The study also found that half of those attending CAMHS as teenagers access adult mental health services by their early 30s, a figure higher than previous research has suggested.
The findings highlight the significant mental health burden experienced by children who use CAMHS and indicate a need for better understanding of the long-term impact of childhood treatments. Researchers at the University of Edinburgh conducted the longest follow-up to date of young people attending mental health services in the United Kingdom, studying every child born in Scotland between 1991 and 1998 until 2023—almost half a million people. They found that eight percent attended CAMHS before age 18.
This group accounted for 46 percent of all adult psychiatric inpatient bed days and 41 percent of all National Health Service adult mental health outpatient appointments by age 32. Former CAMHS patients represented large proportions of severe mental illness diagnoses in adult psychiatric hospitals, including personality disorders (49 percent), eating disorders (50 percent), schizophrenia (39 percent), and opioid use disorders (39 percent).
Professor Ian Kelleher, Chair of Child and Adolescent Psychiatry at the University of Edinburgh, who led the study, said, "We know about long-term outcomes for 27 types of cancer in Scotland, but we've known very little about long-term outcomes for children who attend our CAMHS services because there is no equivalent monitoring system for mental health. This is more important now than ever, given the rising number of children and young people presenting with mental health problems.
"CAMHS is not just a childhood treatment service – it identifies a population that will go on to be high-intensity users of specialist adult mental health services. From a health, societal and economic perspective, we need to robustly evaluate whether existing CAMHS interventions are leading to long-term benefits."
Dr. Jane Morris, Chair of the Royal College of Psychiatrists in Scotland, said, "This important work underlines the importance of identifying mental health conditions as early as possible to prevent irreversible damage to people's healthy development. It goes further by highlighting the need for further intensive supports in our adult services to maintain those benefits through life. We and our colleagues in the field of public mental health would support the establishment of a Mental Health Observatory to ensure delivery of the best possible care to people in Scotland."
