CAMHS and Social Prescribing Applications (CASPA)

University College London (UCL)

Status: Not yet enrolling

Conditions: Mental Health

Treatments: Behavioral: Signposting; Behavioral: Social Prescribing

Study type: Interventional

Funder types: Other

Identifiers

NCT07143383

177012

Details and patient eligibility

About

Background: Social prescribing (SP) is a mechanism for linking patients with non-medical forms of community support and has demonstrated mental health benefits for adults and young people (YP). However, SP is predominantly based in primary care, which limits accessibility for YP who typically engage less with this setting. Within CAMHS (Child and Adolescent Mental Health Services), SP has only recently begun to be trialed, mainly as a pre-treatment option while waiting for care. The CASPA study will pilot a novel SP pathway embedded after the start of psychological treatment in CAMHS, aiming to test its feasibility, acceptability, and potential impact on mental health and wellbeing through a randomized controlled trial.

Methods: CASPA is a two-group (intervention vs. active control) parallel randomized pilot study with YP as the unit of randomization. A total of 120 YP aged 11-18, who have started psychological treatment for emotional difficulties in one of three CAMHS sites in England, will be recruited. Participants in the intervention group will receive a co-produced, person-centered SP pathway involving up to six sessions with a trained Link Worker (LW). These sessions will help identify 'what matters to them' and connect YP with locally mapped community activities and support (e.g. arts, sports, volunteering). Participants in the control group will receive signposting to the same community resources via a leaflet from CAMHS staff or researchers. Quantitative data will be collected at baseline, 3-month and 6-month follow-up, including measures of resilience, mental health, wellbeing, service use, and quality of life. Primary outcomes include feasibility, acceptability, and appropriateness of the intervention, assessed through validated measures and participation metrics, alongside any evidence of impact. Qualitative interviews with YP, CAMHS staff, and LWs will explore implementation experiences, barriers, facilitators, and mechanisms of impact.

Discussion: The CASPA study will generate preliminary evidence regarding the feasibility, acceptability, and appropriateness of offering SP after psychological treatment within CAMHS has started. It will also provide early insights into whether this approach can improve outcomes for YP with emotional difficulties. Findings will inform decisions on the design and justification for a future full-scale clinical and cost-effectiveness trial.

Enrollment: 120 estimated patients

Sex: All

Ages: 11 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Eligibility criteria

Inclusion criteria:

(i) CAMHS

• Wish to participate in CASPA
• Located in England

(ii) YP Participants

• Aged between 11 to 18 years
• Capacity to give assent (if under 16), or
• Capacity to give informed consent (if aged 16 or over or has Gillick competence if aged under 16)
• Have started psychological treatment in CAMHS for an emotional difficulty (e.g. depression, anxiety)

(iii) Parent/Guardian Participants

• Aged 18 or over
• Capacity to give informed consent for YP involvement in CASPA (when the YP is aged between 11-15 and lacks Gillick competence)

(iv) CAMHS staff and LWs:

• Aged 18 or over
• Capacity to give informed consent to participate in CASPA

Exclusion criteria (i) YP participants

• YP with emotional difficulties put on an enhanced specialist pathway due to another severe and complex difficulty which requires intensive input (e.g. anorexia, psychosis or severe and complex difficulties (as judged by the assessing clinician))

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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120 participants in 2 patient groups

Social Prescribing

Experimental group

Description:

SP is a person-centered approach to wellbeing involving the co-development of a non-clinical prescription, between an individual (i.e. young person) and Link Workers (LWs), based on the perceived difficulties for the referral and the YPs values, needs and preferences. LWs have a good knowledge of their local areas, via community asset mapping and networking, allowing them to connect individuals with different types of available support and activities. Typically, SP ranges from 6-12 sessions (average 8 sessions: unpublished data from sites) with a LW over an 8-week period. Sessions may take place online, via phone call, or in person. As part of this process, LWs draw on psychological skills such as motivational interviewing and behavioral activation as well as employ problem solving and goal setting. Following the identification of issues and preferences, the LW will discuss with the YP what the available local activities and support structures are that match their preferences.

Treatment:

Behavioral: Social Prescribing

Signposting

Active Comparator group

Description:

Those in the control group will receive signposting to activities and local sources of support in their communities. This will consist of a CAMHS clinician or researcher meeting with YP identified and providing them with a leaflet detailing the same local sources of support identified by the LW from asset mapping.

Treatment:

Behavioral: Signposting