Help-seeking pathways prior to referral to outpatient child and adolescent mental health services.

AIM To investigate parental help-seeking patterns prior to referral to outpatient child and adolescent mental health services (CAMHS), and whether type of symptoms or duration of mental health problems prior to referral influence help-seeking. SETTING Child mental health services in Denmark involve several sectors collaborating based on stepped-care principles. Access to CAMHS is free of charge but requires a formal referral. METHODS In this cross-sectional observational study, parents of 250 children were interviewed about pathways to outpatient CAMHS using the Children's Services Interview. RESULTS The median parent-reported duration of mental health problems prior to referral to CAMHS was 6.0 (IQR 3.4-8.5) years for children referred for neurodevelopmental disorders compared to 2.8 (IQR 1.0-6.5) years for children referred for emotional disorders. Educational services were the first help-seeking contact for the majority (57.5%) but referrals to CAMHS were most frequently from healthcare services (56.4%), predominantly general practitioners. Educational services played a greater part in help-seeking pathways for children referred for neurodevelopmental disorders. CONCLUSION The majority of children referred to CAMHS have mental health problems for years before referral. The delay in time-to-referral was most pronounced for children referred for neurodevelopmental disorders. Help-seeking pathways differ by symptom duration and type of symptoms.