Risk for Serious mental illness following inpatient CAMHS admission (RiSC) study

Project reference: RAS-24-1

Approval date: 13 September 2024

Lay summary

This project will look at the medium and long term outcomes of patients of Child and Adolescent Mental Health Services (CAMHS) compared to their peers who do not attend CAMHS, including risk of mental or physical illness and death. It will also look at the relationship between medical treatments in childhood and outcomes in adulthood.

Public benefit statement

Psychotic disorders, such as schizophrenia, are amongst the leading causes of disability in the population and improved early intervention for psychosis is one of Healthcare Improvement Scotland’s seven mental health improvement priorities. Current approaches to identify people at elevated risk of psychosis capture only a small proportion of future psychotic disorders. If we are to improve our ability for early identification of psychosis risk, we need additional approaches to identify young people at risk.

We recently showed, using Finnish national health register data, that 40-50% of psychotic disorders emerge in young people who, at some stage in childhood (age <18) had attended Child and Adolescent Mental Health Services (CAMHS). This identifies important opportunities for early identification and intervention. We would like to replicate our study in Scotland to see if this is similarly the case here. Outpatient CAMHS data are, unfortunately, not (yet) available but we can at least look at inpatient CAMHS data in Scotland and risk of psychotic disorder when followed to adulthood. We would also like to look at the relationship between medication treatments and whether particular medications could increase or reduce risk for psychotic disorders, using causal inference research methods. We will identify the numbers of patients and treatments in order to determine whether it is possible to look at this.

Team members from Healthcare Improvement Scotland (HIS) are part of the study team, which will give us the opportunity to consider the implications of our findings for HIS and for the NHS.

Datasets used

• Scottish Morbidity Records (SMR) 00 - Outpatient Appointments and Attendances
• Scottish Morbidity Records (SMR) 01 - General Acute Inpatient and Day Case
• Scottish Morbidity Records (SMR) 04 - Mental Health Inpatient and Day Case
• Prescribing Information System (PIS)
• Scotland Accident and Emergency (A&E)
• National Records of Scotland (NRS) - Births Data
• National Records of Scotland (NRS) - Deaths Data