ArticleBMJ mental health2026
Building consensus on the core clinical competencies and outcomes related to effective child and adolescent mental health services (CAMHS) crisis team provision: findings from a Delphi study.
Article in BMJ mental health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundYoung peoples' mental health is worsening, increasing demands on Child and Adolescent Mental Health Services (CAMHS) crisis teams. However, evidence is lacking regarding the effectiveness of such services. To pave the way for service developments and robust evaluation, it is crucial to establish a consensus on the core competencies for CAMHS crisis clinicians and the most desirable outcomes from their input.
objectiveTo elicit and establish consensus among experts, including those with relevant lived experience, regarding the most important staff competencies and outcomes in this service context.
methodsA three-round Delphi study was conducted with young people (aged 18-25 years with relevant lived experience of CAMHS crisis team input), parents/carers and mental health clinicians/academics. The study aimed to establish consensus (≥70% agreement) on which core staff competencies and outcomes were perceived as 'essential'/'very important' in relation to CAMHS crisis services.
findingsOf 69 initial participants, 43 (62%, mainly young people) completed all three rounds. A broad consensus was reached, with over 90% of proposed items meeting the consensus threshold. The strongest agreement was found for competencies in the
conclusionsOur results demonstrate a clear stakeholder consensus prioritising relational, validating and personalised approaches to assessment and intervention over an emphasis on administrative or diagnostic processes in CAMHS crisis care. The findings also highlight a desire to move from a perception of a paternalistic risk management style to collaborative, community-based support. CLINICAL IMPLICATIONS: These findings underscore the need for crisis team clinicians to be trained and supported to deliver care that is relationship-based, trauma-informed and culturally responsive. These should potentially translate into better outcomes for young people, their families and the crisis team workforce itself.
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