CAMHS and Social Prescribing Applications
- Conditions
- Mental Health
- Registration Number
- NCT07143383
- Lead Sponsor
- University College, London
- Brief Summary
Background: Social prescribing (SP) is a mechanism for linking patients with non-medical forms of community support and has demonstrated mental health benefits for adults and young people (YP). However, SP is predominantly based in primary care, which limits accessibility for YP who typically engage less with this setting. Within CAMHS (Child and Adolescent Mental Health Services), SP has only recently begun to be trialled, mainly as a pre-treatment option while waiting for care. The CASPA study will pilot a novel SP pathway embedded after the start of psychological treatment in CAMHS, aiming to test its feasibility, acceptability, and potential impact on mental health and wellbeing through a randomised controlled trial.
Methods: CASPA is a two-group (intervention vs. active control) parallel randomised pilot study with YP as the unit of randomisation. A total of 120 YP aged 11-18, who have started psychological treatment for emotional difficulties in one of three CAMHS sites in England, will be recruited. Participants in the intervention group will receive a co-produced, person-centred SP pathway involving up to six sessions with a trained Link Worker (LW). These sessions will help identify 'what matters to them' and connect YP with locally mapped community activities and support (e.g. arts, sports, volunteering). Participants in the control group will receive signposting to the same community resources via a leaflet from CAMHS staff or researchers. Quantitative data will be collected at baseline, 3-month and 6-month follow-up, including measures of resilience, mental health, wellbeing, service use, and quality of life. Primary outcomes include feasibility, acceptability, and appropriateness of the intervention, assessed through validated measures and participation metrics, alongside any evidence of impact. Qualitative interviews with YP, CAMHS staff, and LWs will explore implementation experiences, barriers, facilitators, and mechanisms of impact.
Discussion: The CASPA study will generate preliminary evidence regarding the feasibility, acceptability, and appropriateness of offering SP after psychological treatment within CAMHS has started. It will also provide early insights into whether this approach can improve outcomes for YP with emotional difficulties. Findings will inform decisions on the design and justification for a future full-scale clinical and cost-effectiveness trial
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 120
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Primary Outcome Measures
Name Time Method Feasibility LW and CAMHS staff: 6 months YP: post intervention (at least 3 months) Link workers (LW) and CAMHS staff: Feasibility of Intervention Measure (FIM) is assessed using 4 questions each on a five-point Likert scale (scoring between 4-20). Higher scores indicate higher intervention feasibility (Weiner et al., 2017).
YP will be asked about the feasibility of the intervention via qualitative interviewing where questions can be appropriately framed for their age and experience.Acceptability YP: 3 and 6 months LW and CAMHS staff: 6 months YP: Acceptability will be assessed using an item from the Friends and Family test, which asks individuals to rate how likely they would be to recommend the service (in this instance, the SP pathway). It is assessed on a five-point Likert Scale, ranging from '1' Extremely Unlikely to '5' Extremely Likely. Higher scores indicate better acceptability.
LW and CAMHS staff: Acceptability of Intervention Measure (AIM) is assessed using 4 questions each on a five-point Likert scale (scoring between 4-20).Appropriateness YP: 3 and 6 months LW and CAMHS staff: 6 months YP: Appropriateness will be assessed by the proportion of sessions offered versus the number the young person attends
LW and CAMHS staff: Intervention Appropriateness Measure (IAM) is assessed using 4 questions each on a five-point Likert scale (scoring between 4-20). Higher scores indicate higher intervention appropriateness (Weiner et al., 2017).
- Secondary Outcome Measures
Name Time Method Wellbeing: ONS Personal Wellbeing Questions (ONS, 2003) Baseline, 3 and 6 months The Office for National Statistics ONS3 are three subjective measures designed to capture key aspects of personal well-being in the general population. These questions assess three core domains of well-being: evaluative, eudemonic, and affective. Respondents are asked to rate the following questions on a scale from 0 (not at all) to 10 (completely):
1. "Overall, how satisfied are you with your life nowadays?"
2. "Overall, to what extent do you feel the things you do in your life are worthwhile?"
3. "Overall, how happy did you feel yesterday?"
Higher scores reflect greater well-beingDepression: Short Mood and Feelings Questionnaire (Angold, 1995). Baseline, 3 and 6 months The SMFQ is a 13-item scale questionnaire. Each item reflects core symptoms of depression based on DSM criteria, such as sadness, tiredness, irritability, and feelings of worthlessness. Respondents rate how true each statement has been over the past two weeks on a 3-point Likert scale: "Not True", "Sometimes True", or "True"
Higher scores reflect greater levels of depressive traits.Anxiety: Generalised Anxiety Disorder-7 Questionnaire (Spitzer, 2006). Baseline, 3 and 6 months The GAD-7 includes 7 items, each reflecting a DSM-IV symptom of generalized anxiety disorder such as excessive worry, nervousness, and difficulty relaxing. Respondents are asked how often they were bothered by each symptom over the past two weeks, using a 4-point Likert scale ranging from "Not at all" to "Nearly every day." Total scores range from 0 to 21, with cutoff points identifying mild (5), moderate (10), and severe (15) anxiety.
Stress: Perceived Stress Scale-4 (Demkowicz, 2019) Baseline, 3 and 6 months The PSS-4 includes four questions evaluating how unpredictable, uncontrollable, and overloaded individuals find their lives. Responses are given on a 5-point Likert scale ranging from 0 ("Never") to 4 ("Very often"). Higher scores indicate greater perceived stress.
Service Use: Short-Client Service Receipt of Inventory (Beecham and Knapp, 2001) Baseline, 3 and 6 months The CSRI gathers detailed information on service contacts, informal care, medication use, employment, and accommodation over a specified recall period, in this instance, 3 months.
Scoring involves multiplying reported service use by standardised unit costs to generate total and domain-specific cost estimates. Higher scores reflect greater service utilisation and associated costs.Quality of Life: Child Health Utility-9D (Stevens, 2009) Baseline, 3 and 6 months The Child Health Utility-9D (CHU-9D) was developed to address the lack of generic preference-based measures (GPBMs) specifically designed for children. The CHU-9D encompasses both shared and unique dimensions compared to other instruments. Common areas include pain and usual activities, while child-specific dimensions include schoolwork/homework, tiredness, and sleep. CHU9D is assessed using 9 questions on a five-point Likert scale (scoring between 1-5). Higher scores indicate higher quality of life.