Journal of the American Academy of Child & Adolescent Psychiatry
ARTICLESLining Up for Children's Mental Health Services: A Tool for Prioritizing Waiting Lists
Section snippets
Priority Criteria
In response to the need for better management of waiting lists, an increasing number of clinicians and health authorities are adopting point-count measures for assessing patients’ relative clinical urgency or priority (Hadorn and the Steering Committee of the Western Canada Waiting List Project, 2000). Similar point-count measures are used in many settings throughout medicine to assess severity of illness and risk of adverse events, including assessment of neonatal stability (Apgar score) and
METHOD
The CMH panel was composed of three child and adolescent psychiatrists, one general psychiatrist, one family physician, two psychologists, one pediatrician, two mental health administrators, one social worker, and one health services researcher. Panelists were drawn from British Columbia, Alberta, and Saskatchewan, and the panel was cochaired by the authors of this paper. The panel was in place from October 1999 through June 2000 and met formally four times during that period, with considerable
RESULTS
The panel elected to develop priority criteria to cover the entire case-mix of children and youths (aged 5–18) for CMH services. Although this approach presented challenges in terms of the broad range of diagnoses covered, it was acknowledged that mental health workers currently set priorities on waiting lists across all patients and that any instrument intended to assist in this task should be sufficiently broad. Similar generic, service-wide criteria were developed by two other WCWL panels:
DISCUSSION
The WCWL represents the first effort to develop quantitative criteria for assessing the relative urgency of wait-listed CMH services. CMH panel members and project staff were unsure at the outset of the project whether priority criteria of this kind could successfully capture clinicians’ judgments of relative urgency in this setting. However, by the end of the project, the panelists and participating clinicians were satisfied, on the basis of the results described above, that the CMH criteria
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Accepted November 6, 2001.
The WCWL was supported by a financial contribution from the Health Transition Fund (Health Canada) as Project NA489. The authors are indebted to the 19 partner organizations of WCWL and to the panel members and their colleagues who contributed to the project. The authors recognize Dr. N.G. Prasad, Dr. Barbara Conner-Spady, Ms. Elaine Dunn, Ms. Helen Roman-Smith, and Ms. Anne-Marie Pedersen for their contributions to data collection and analysis.
The views expressed herein do not necessarily represent the official policy of federal, provincial, or territorial governments.
Members of the Steering Committee: (Chair) Dr. Tom Noseworthy, Professor and Chair, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta; Dr. Morris L. Barer, Director, Centre for Health Services and Policy Research, and Professor, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia; Dr. Charlyn Black, Co-Director, Manitoba Centre for Health Policy and Evaluation, and Associate Head and Associate Professor, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba; Ms. Lauren Donnelly, Acting Executive Director, Acute and Emergency Services Branch, Saskatchewan Health, Regina, Saskatchewan; Dr. David Hadorn, Research Director, Western Canada Waiting List Project; Dr. Isra Levy, Director, Health Programs, Canadian Medical Association, Ottawa, Ontario; Mr. Steven Lewis, Partner, Access Consulting, Saskatoon, Saskatchewan; Dr. Sam Sheps, Head, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia; Dr. Mark C. Taylor, Assistant Professor, Department of Surgery, University of Manitoba; Mr. Laurence Thompson, Chief Executive Officer, Health Services Utilization and Research Commission, Saskatoon, Saskatchewan; Mr. Darrell Thomson, Director, Economics and Policy Analysis, British Columbia Medical Association, Vancouver, British Columbia; Ms. Barbara Young, Regional Utilization Consultant, Clinical Evaluation Services, Calgary Regional Health Authority, Calgary, Alberta; Mr. John McGurran, Director, Western Canada Waiting List Project, and Lecturer, Department of Public Health Sciences, University of Toronto.