Service Evaluation of a Central and North West London Adolescent Home Treatment Team: A Five-Year Review

This service evaluation reviews the first five years of the Adolescent Community Treatment Service (ACTS), an intensive community treatment team developed by Central and North West London (CNWL) NHS Foundation Trust to support children and young people (CYP) aged 13-17 in mental health crisis. Between July 2019 and July 2024, ACTS worked with 163 CYP. The service aimed to prevent psychiatric admissions and facilitate early discharge from inpatient units. ACTS avoided psychiatric inpatient admission for 58.2% of referrals to inpatient hospitals and supported 43 discharges of CYP from inpatient settings. Post-intervention, significant clinical improvements were observed, including reduced symptom severity, improved functioning, and enhanced educational engagement. Although primary diagnosis did not significantly relate to discharge destination, CYP presenting with greater symptom severity tended to require inpatient care. Findings support ACTS as a flexible, least-restrictive model for crisis intervention to inpatient care. This is consistent with NHS Long Term Plan priorities, but also underscores the ongoing need for inpatient services for those whose safety cannot be managed in the community. Further research is needed to explore long-term outcomes, economic impact, and tailored pathways for neurodivergent and minoritised groups.