The intervention was delivered by two teams, one based in London and one in a rural area in Kent. Each team included one consultant child and adolescent psychiatrist, one administrator, two to four whole-time equivalents of Child and Adolescent Mental Health Services (CAMHS) practitioners with nursing backgrounds, and two to four whole-time equivalents of clinical support workers. The nature of the work included intensive case management, community (including home) treatment, day care in hospital, or any combination of these approaches according to need. The intensity of care was flexible, up to a maximum of daily contacts. Staff tasks included assisting young people with creating customised care plans, psychiatric care, psychological interventions, helping with school reintegration, and optimising physical health care and social support. Further details of care are available online.
Usual care was delivered by inpatient services and followed by a return to standard outpatient care, delivered primarily by CAMHS, with or without an interim period of hospital day care.
A commentary notes that this and previous studies are small with quite short follow-up, and adolescents have high rates of spontaneous short-term symptom remission, thus longer-term follow-up is needed to assess whether benefits of early interventions are sustained for disorders that might relapse and recur over the course of decades. It adds that understanding about who will benefit from more intensive and systematic early interventions needs to be improved.