Rejected referrals to child and adolescent mental health services: audit

A qualitative and quantitative audit of rejected referrals to Child and Adolescent Mental Health Services (CAMHS).

Key findings

  • During the period of the audit, across all Health Boards 1 in 5 children and young people’s referrals to CAMHS were rejected
  • Decisions on rejecting referrals usually happen quickly. Most decisions are made on the basis of paper referrals, without a face to face assessment. Children, young people and their families expect they will receive help after a referral, so a swift rejection without a face to face assessment is distressing and frustrating
  • The Audit Boards report that 66% of the 285 rejected referrals include signposting. Yet there is a disparity between this and the extent to which children, young people and their families themselves recognised being signposted. Of the 253 people who participated in an online survey of their experiences, just 42% feel they have been signposted
  • Children, young people and their families report that signposting is generic, unhelpful and often points to resources they have already explored. This research did not examine the type of signposting that is provided or the availability of the services to which people are signposted
  • Some young people whose referral has been rejected report a belief that they will not be seen by CAMHS unless they are suicidal or at immediate risk of harm. There is a strong indication of a gap in services for children and young people who do not meet the criteria for the most specialist help


An easy-read version is available on request from

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