Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T15:00:50.543Z Has data issue: false hasContentIssue false

Tackling a long waiting list in a child and adolescent mental health service

Published online by Cambridge University Press:  13 June 2014

Gordon Lynch
Affiliation:
Athy Child Guidance Clinic, Woodstock Road, Athy, Co Kildare, Ireland
Elma Hedderman
Affiliation:
Athy Child Guidance Clinic, Woodstock Road, Athy, Co Kildare, Ireland

Abstract

Objective: Long waiting lists have a negative impact on client satisfaction, staff moral and referrer's opinion of the service. The aim of this project was to decrease a waiting list from a maximum wait of more than one year to a wait of no more than six weeks.

Method: We introduced three simultaneous initiatives to decrease a long waiting list; (i) an individually led triage system (ii) setting-up an attention deficit hyperactivity disorder (ADHD) specialist team and (iii) division of the residual waiting list between team members. These initiatives were introduced and analysed over a ten month period. The study period ran from 1/3/2004 to 31/12/2004.

Results: The waiting time to first appointment was significantly reduced. At the beginning of the study there were 62 people waiting to be seen and each had waited an average of 122 days with a waiting time range of 0-449 days. At the end of the study, there were 19 people waiting with a mean waiting time of 19 days and a range of 0-168 days.

Conclusions: The single most powerful intervention was the triage system. The ADHD clinic allowed referrals to be streamlined in a very structured and efficient way. The division of the residual waiting list was not as onerous as it first appeared. The service saw more referrals then ever during the study period. Referrers and families appreciated being seen more quickly. By removing the burden of the waiting list from staff the potential for creative thinking around further development of the service increased.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

iJones, E, Lucey, C, Wadland, L. Triage: a waiting list initiative in a child mental health service. Psych Bulletin 2000; 24: 5759.CrossRefGoogle Scholar
iiSubotski, F, Berelowitz, M. Consumer views at a child guidance clinic. Newsletter of Association for Child Psychology and Psychiatry 1990; 12: 812.Google Scholar
iiiTucker, JA, Davison, JW. Waiting to see the doctor: the role of time constraints in the utilisation of health and behavioural health services. Bickel, WK, Vuchinich, RE, eds. Reframing Health Behaviour Change with Behavioural Economics. Lawrence Erlbaum Associates: 2000; 219–64.Google Scholar
ivBryce, G. Managing child and adolescent mental health problems: the views of general practitioners. Health Bulletin 2000; 58(3): 224226.Google ScholarPubMed
vForeman, DM, Hanna, M. How long can a waiting list be? Psych Bulletin 2000; 24: 211213.CrossRefGoogle Scholar
viJones, SM, Bhadrinath, BR. GPs' views on prioritisation of child and adolescent mental health problems. Psych Bulletin 1998; 22: 484486.CrossRefGoogle Scholar
viiMcNicholas, F. Attitudes of general practitioners to child psychiatry services. Ir J Psych Med 1997; 14(2): 4346.CrossRefGoogle Scholar
viiiParkin, A, Frake, C, Davison, I. A triage clinic in a child and adolescent mental health service. Child and Adolescent mental health 2003; 8(4): 177.CrossRefGoogle Scholar
ixMunjal, A, Latimer, M, McCune, N. Attendance at child psychiatry new patient clinics. Ir J Psych Med 1994; 11: 182184.CrossRefGoogle Scholar
xWenning, K, King, S. Parent orientation meeting to improve attendance and access at a child psychiatric clinic. Psychiatric Services 1995; 46: 831833.Google Scholar
xiGeekie, J. Preliminary evaluation of one way of managing a waiting list. Clinical Psychology Forum 1995; 3335.Google Scholar
xiiPotter, R, Darwish, A. Predicting attendance at child and adolescent clinics. Psych Bulletin 1996; 20: 717718.CrossRefGoogle Scholar
xiiiRoberts, S, Partridge, I. Allocation of referrals within a child and adolescent mental health service. Psych Bulletin 1998; 22: 487489.CrossRefGoogle Scholar
xivStallard, P, Sayers, J. An opt-in appointment system and brief therapy: Perspectives on a waiting list initiative. Clinical Child Psychology and Psychiatry 1998; 3: 199212.CrossRefGoogle Scholar
xvTerry, J. Brief intervention: A pilot initiative in a child and adolescent mental health service. Mental Health Practice 2003; 6(5) 1819.CrossRefGoogle Scholar
16Wilkinson, RA. Triage in accident and emergency 1: An overview of the literature. British Journal of Nursing. 1999; 8(2): 86–8, 101–2.CrossRefGoogle ScholarPubMed
17Doody, B, Burke, A, Dowling, B, O'Leary, F, Tyndall, P, Buckley, S. A better future now. Position paper on psychiatric services for children and adolescents in Ireland. Irish College of Psychiatrists 2005, Occasional paper OP 60Google Scholar
18Fitzpatrick, C, Halpin, C, Doody, B. Response of the Royal College of Psychiatrists (Irish Division) – child and adolescent section to: Report on Attention Deficit Disorder in Ireland prepared by the joint committee on Health and Children, 1999. http://www.irishpsychiatry.com/adhd%20response.pdfGoogle Scholar
19Kat, H, Frake, C, Sawtell, R. Multi-disciplinary assessment of attention-deficit hyperactivity disorder: a tertiary assessment package. Psych Bulletin 1999; 23: 421–24.CrossRefGoogle Scholar
20Conners, CK. Conner's Parent Rating Scales. Multi Health Systems 1997: New York.Google Scholar
21Conners, CK. Conner's Teacher Rating Scales. Multi Health Systems 1997: New York.Google Scholar
22Goodman, R. The strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 1997; 38(5): 581–6.CrossRefGoogle ScholarPubMed