Increase in active caseload following the implementation of a centralized demand-management platform in child and adolescent public mental health services in a French metropolitan area

Child and adolescent psychiatry faces persistent challenges in meeting demand and providing timely access to care. Following the COVID-19 pandemic, many health systems sought to reorganize the management of increasing first referrals to child and adolescent mental health services (CAMHS). In this context, a centralized intake platform (POP) was implemented in one of the largest French metropolitan areas. This study describes the development and functioning of POP and presents preliminary findings on trends in annual active caseloads following its implementation. The study consisted of two components: (1) the iterative development of the POP logic model and (2) a descriptive analysis of trends in annual active caseload in the CAMHS of the POP hospital before and after implementation. The logic model was developed from project documents and refined by professionals to ensure fidelity and contextual relevance. Annual active caseload data were extracted from the French national clinical information system. Active caseload was defined as the number of patients with at least one recorded outpatient mental health contact during the calendar year. Trends were presented graphically alongside those observed in the CAMHS of the nine other French hospital centers with the largest active caseloads over the period 2016–2024. POP is a multidisciplinary platform providing first-line assessment, clinical guidance and coordinated referrals. It aims to prioritize urgent cases, streamline access, and enhance timely care while optimizing public resources. Following the COVID-19-related decline in 2020, all participating centers showed a post-pandemic recovery in 2021. In 2022, the first full calendar year following POP implementation, the annual outpatient active caseload at the POP hospital increased further and rose above the weighted median across the 10 study centers, while the median trend remained broadly stable. The POP hospital trajectory continued to increase, exceeding the third quartile of the distribution across centers in 2023 and remaining above this threshold in 2024. POP implementation was followed by a sustained increase in recorded annual outpatient active caseload relative to selected high-volume comparator centers. These descriptive findings do not establish causality and support further evaluation of the model’s implementation and effectiveness.