Architecture and functioning of child and adolescent mental health services: a 28-country survey in Europe
Open accessAbstract
The WHO Child and Adolescent Mental Health Atlas, published in 2005, reported that child and adolescent mental health services (CAMHS) in Europe differed substantially in their architecture and functioning. We assessed the characteristics of national CAMHS across the European Union (EU), including legal aspects of adolescent care. Using an online mapping survey aimed at expert(s) in each country, we obtained data for all 28 countries in the EU. The characteristics and activities of CAMHS (ie, availability of services, inpatient beds, and clinicians and organisations, and delivery of specific CAMHS services and treatments) varied considerably between countries, as did funding sources and user access. Neurodevelopmental disorders were the most frequent diagnostic group (up to 81%) for people seen at CAMHS (data available from only 13 [46%] countries). 20 (70%) countries reported having an official national child and adolescent mental health policy, covering young people until their official age of transition to adulthood. The heterogeneity in resource allocation did not seem to match epidemiological burden. Substantial improvements in the planning, monitoring, and delivery of mental health services for children and adolescents are needed.
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Even in the highest-resourced countries, child and adolescent mental health services are overwhelmed, with only a small percentage of children and adolescents able to gain any access to care.
“Even in the highest-resourced countries, these services are overwhelmed, with only a small percentage of children and adolescents able to gain any access to care. 221”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [221]
Appendix 7 reports that small proportions of young people were new cases accessing specialist child and adolescent mental health services in the last available year. That supports a narrower observation about new service contacts, not the claim that only a small percentage can gain any care. The cited passages do not establish that services are overwhelmed even in the highest-resourced countries. (LLM, conf=0.78)
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The Lancet Psychiatry Commission on youth mental health
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- Authors
- Signorini, G., Singh, S. P., Boricevic-Marsanic, V., Dieleman, G., Dodig-Ćurković, K., Franic, T., Gerritsen, S. E., Griffin, J., Maras, A., McNicholas, F., O'Hara, L., Purper-Ouakil, D., Paul, M., Santosh, P., Schulze, U., Street, C., Tremmery, S., Tuomainen, H., Verhulst, F., Warwick, J., & de Girolamo, G.
- Affiliations
- Centro San Giovanni di Dio Fatebenefratelli (IT)
- University of Warwick (GB)
- Erasmus MC (NL)
- University College Dublin (IE)
- National Health Service (GB)
- Universität Ulm (DE)
- KU Leuven (BE)
- Corresponding author
- Signorini, Giulia
- ORCID
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 4
- Issue
- 9
- Pages
- 715-724
- ISSN
- 2215-0366 (ISSN-L)
- OpenAlex
- W2623656794
- Cited by
- 153
- References
- 7
- Citations by year
- 2026: 12 · 2025: 23 · 2024: 18 · 2023: 11 · 2022: 17 · 2021: 13 · 2020: 25 · 2019: 13 · 2018: 14 · 2017: 6
- FWCI
- 18.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- HAL (submittedVersion)
- Funders
- Seventh Framework Programme (602442)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- child and adolescent mental health services, service architecture, mental health service delivery, mental health policy, neurodevelopmental disorders, mental health funding, inpatient beds, coming of age, resource allocation, EU member states
- MeSH terms
- Adolescent, Child, Child Health Services, Europe, Health Resources, Humans, Mental Health, Mental Health Services, Patient Acceptance of Health Care, Surveys and Questionnaires, Adolescent Health Services, Transition to Adult Care
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