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User satisfaction with child and adolescent mental health services

Impact of the service unit level

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Abstract

Background

Child and adolescent mental health service units (CAMHS) play an important role in the supply of services to children and adolescents with mental illness. The purpose of this study was to examine the service unit effect on parent satisfaction with outpatient treatment.

Method

The study was undertaken in 49 of 72 Norwegian outpatient CAMHS in 2004. A total of 2253 of the parents who were asked to participate (87%) responded. Parent satisfaction was measured using two summated scales: clinician interaction/information and treatment outcome. Multilevel analyses were used to assess the contribution of the service units to satisfaction and to investigate patient level predictors of parent satisfaction.

Results

About 96−98% of the parent satisfaction variance could be attributed to factors within CAMHS, leaving only 2–4% of the variance attributable to the CAMHS level. Parents of patients aged 0–6 years were more satisfied than older patients’ parents. Longer treatment episodes were positively associated with satisfaction. Parents whose children had been referred with externalizing symptoms were less satisfied with treatment outcome than those referred for internalizing symptoms. Waiting time was negatively associated with treatment outcome satisfaction. Adjustments for patient characteristics did not substantially change the relative effect of CAMHS on satisfaction ratings.

Conclusion

The results indicate that information from user satisfaction surveys has clear limitations as an indicator of CAMHS quality. From a quality improvement perspective, the factors affecting the variance within CAMHS are of dominating importance compared to factors affecting between CAMHS variance.

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Acknowledgments

The collection of data was funded by the Social and Health Directorate in Norway. The writing of the paper was funded by the Norwegian Council for Mental Health and the Norwegian Foundation for Health and Rehabilitation. The views expressed are those of the authors.

Declaration of interests No conflict of interest.

Author information

Authors and Affiliations

  1. SINTEF Health Services Research, 7465, Trondheim, Norway

    Johan Håkon Bjørngaard MA, Helle Wessel Andersson MA, PhD & Solveig Osborg Ose MA, PhD

  2. Centre for Child and Adolescent Mental Health Eastern and Southern Norway, Oslo, Norway

    Ketil Hanssen-Bauer MD

Authors
  1. Johan Håkon Bjørngaard MA
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  2. Helle Wessel Andersson MA, PhD
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  3. Solveig Osborg Ose MA, PhD
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  4. Ketil Hanssen-Bauer MD
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Corresponding author

Correspondence to Johan Håkon Bjørngaard MA.

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Bjørngaard, J.H., Wessel Andersson, H., Osborg Ose, S. et al. User satisfaction with child and adolescent mental health services. Soc Psychiat Epidemiol 43, 635–641 (2008). https://doi.org/10.1007/s00127-008-0347-8

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