Disparities in accessing mental health services for young people in contact with children’s social work: a retrospective analysis of over 71,700 clinical records.

Aims: Many children and young people with social work involvement (CYPwSW) experience a higher prevalence of mental health difficulties with an increased likelihood of referral to mental health services than their peers. Yet little is known about their likelihood of accessing mental health support following referral. This observational study aims to address this gap, examining how social work status is associated with service access. Methods: Data were extracted from young people’s first referral to mental health services in South London and Maudsley NHS Foundation Trust between 2007 to 2023 and included social work and sociodemographic characteristics. Multilevel logistic regression modelling was used to calculate adjusted odds ratios (OR) and to estimate the associations between social work status (no involvement; other current social work involvement without a formal recorded intervention; past social work involvement; child protection plan; being looked after) and service access. Results: A total of N=71,740 referrals were extracted. Children with current or past social work involvement had significantly higher adjusted odds of not accessing mental health services compared to their peers. The highest adjusted odds were observed among children with other current social work involvement (OR=2.65 [95% CI=2.43, 2.88]) and on child protection plans (OR=2.03, [95% CI=1.88, 2.20]). Past social work involvement (OR=1.14 [95% CI=1.07, 1.23]) and being looked after (OR=1.13 [95% CI=1.04, 1.22]) were also associated with higher adjusted odds, though to a lesser extent.Conclusions: Findings from this study suggest that children with current and past social work involvement experience disparities in accessing mental health services. The underlying reasons for this are yet to be confirmed, but overall, mental health inequities in social work experienced populations may be amplified at the point of access to mental health support.