This total population birth cohort study linked national Scottish health records for 490,779 individuals born 1991–1998, following them up to age 32 to measure adult mental health service use, inpatient diagnoses, and prognostic factors among those who had previously attended CAMHS.
8.14% (n=9,970) of the cohort had a recorded CAMHS attendance; 40.46% of all CAMHS attendees — and 49.19% of adolescent attendees — later used adult mental health services. Former CAMHS patients accounted for 41.13% of all adult outpatient appointments (167,277/406,665) and 46.43% of all adult inpatient bed days (317,292/683,402) by age 32. CAMHS inpatients had markedly elevated hazard of adult inpatient admission, with key prognostic factors including schizophrenia spectrum disorder, personality disorder, bipolar disorder, ADHD, ASD, deprivation, and emergency admission type.
- Follow-up is capped at age 32, so longer-term outcomes beyond early adulthood are unknown. - The study is observational and cannot establish whether CAMHS attendance or specific interventions changed outcomes. - Childhood inpatient subgroup analysis (n=1,169) was not feasible due to model instability from small event numbers.
Nearly half of all adult psychiatric inpatient bed days in Scotland by age 32 are used by people who attended CAMHS — clinicians and health systems should prioritise long-term follow-up and transition planning for this group, especially adolescent inpatients and those with schizophrenia spectrum, personality, or bipolar disorders.
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