The impact of mental health services at outreach clinics and non-clinic sites on the attendance of Deaf children and young people and families

Aishah Iqbal, Jared G. Smith, Victoria Fernandez


Deaf children show high rates of mental health disorders, with difficulties getting access to appropriate health care. The National Deaf Child and Adolescent Mental Health Service (ND-CAMHS) was set up to provide specialist mental health care to Deaf young people and hearing children of Deaf adults in the UK. This study retrospectively examined the impact of the introduction of ND-CAMHS at outreach clinics and non-clinic sites on attendance rates at clients and carers’ first and follow-up appointments over a three-and-a-half-year period. In all, 4177 appointments, 372 first and 3805 follow-up, associated with 369 clients were considered for analyses. First appointments were much more likely to be clinic-based than follow-up appointments (78.2% versus 34.3%, p < 0.001), which were administered in a variety of sites, most frequently at the client’s school or home. The overall attendance rates for first and follow-up appointments were 68.5% and 79.2%, respectively. There was no significant effect of appointment location on attendance rates for first appointments. However, multivariate analyses indicated that clients at follow-up appointments were more likely to attend when appointments occurred at non-clinic sites compared with clinic-based appointments (81.9% versus 74.1%; odds ratio (OR) = 1.39, 95% confidence interval (CI) 1.17, 1.65). Improved attendance rates were a function of significant decreases in ‘did not attends’ (DNA) and client/carer cancellations at non-clinic sites. There was also an increased attendance rate for follow-up appointments held in outreach clinics relative to hospital-based sites (79.0% versus 72.2%), although this failed to achieve significance after adjusting for other relevant factors (OR = 1.27, 95% CI 0.93, 1.73). The findings indicate that providing specialised mental health services for Deaf children and young people into schools and other locations that are easier to access can improve service accessibility and continuity of care.


Keywords: Deaf, Child and Adolescent Mental Health Service, Outreach, Attendance, Engagement

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