At some point, one in five children and adolescents in the UK will suffer
distress or disorganisation of their behaviour sufficient to be considered
‘disordered’ (Office for National Statistics, 2005). Much of this ‘disorder’
will be dealt with informally and resolve or persist at a low level,
accumulating over time to present at a later stage. Some children and
adolescents will be dealt with by various professionals in various capacities
– teachers, school nurses, general practitioners (GPs), social workers – and
never come to the attention of ‘specialists’. Some will be helped by child
and adolescent mental health services (CAMHS), without ever needing
hospital services. However, some children and adolescents will present
at an emergency department in a crisis, they and their families and carers
fraught with anguish, expecting the professionals they encounter to have
the answers to make things better. Yet what they often encounter is a service
stretched to capacity, staff trying to get the job done within a strictly limited
time frame, with limited experience of and training in child and adolescent
mental health problems and a lack of clarity over what can be done and
how to get it done.