Four in ten children who attend Child and Adolescent Mental Health Services (CAMHS) in Scotland go on to attend specialist psychiatric services as adults, according to new research.
This figure increases for teenagers, with half of those attending CAMHS as teens going on to access adult mental health services by their early 30s – far more than previous research has suggested.
The findings shed light on the often severe mental health burden experienced by children who come to CAMHS and highlight the need for a better understanding of the long-term impact of childhood treatments, experts say.
CAMHS are a cornerstone of public mental health strategies, providing vital opportunities for early intervention. Studies on CAMHS treatments, however, have focused on short-term outcomes. Little is known about the long-term effects of treatments delivered, which can include medication and psychological therapies.
The study marks the longest follow-up to date of young people attending mental health services in the UK.
Researchers at the University of Edinburgh studied every child born in Scotland between 1991 and 1998 until 2023 – almost half a million people. They found that eight per cent attended CAMHS before the age of 18.
This small group went on to account for 46 per cent of all adult psychiatric inpatient bed days and 41 per cent of all NHS adult mental health outpatient appointments by the age of 32.
Former CAMHS patients account for large proportions of all severe mental illness diagnoses in adult psychiatric hospitals, including personality disorders (49 per cent), eating disorders (50 per cent), schizophrenia (39 per cent) and opioid use disorders (39 per cent).
Long-term treatment outcomes are routinely tracked across other conditions, such as cancer care, where the effects of interventions can be monitored for years after treatment, experts say.
The research team is calling for the Scottish Government to bring mental health in line with other areas of the NHS by establishing a Mental Health Observatory, routinely linking childhood and adulthood mental health records to evaluate the impact of services and policy changes.
Professor Ian Kelleher, Chair of Child and Adolescent Psychiatry at the University of Edinburgh, who led the study, said: “We know about long-term outcomes for 27 types of cancer in Scotland, but we’ve known very little about long-term outcomes for children who attend our CAMHS services because there is no equivalent monitoring system for mental health. This is more important now than ever, given the rising number of children and young people presenting with mental health problems.
“CAMHS is not just a childhood treatment service – it identifies a population that will go on to be high-intensity users of specialist adult mental health services. From a health, societal and economic perspective, we need to robustly evaluate whether existing CAMHS interventions are leading to long-term benefits.”
Dr Jane Morris, Chair of the Royal College of Psychiatrists in Scotland, said: “This important work underlines the importance of identifying mental health conditions as early as possible to prevent irreversible damage to people’s healthy development. It goes further by highlighting the need for further intensive supports in our adult services to maintain those benefits through life. We and our colleagues in the field of public mental health would support the establishment of a Mental Health Observatory to ensure delivery of the best possible care to people in Scotland.”
The study is published in the journal European Child and Adolescent Psychiatry: https://www.nature.com/articles/s42004-026-01942-7. It was funded by the Academy of Medical Sciences, the UK Department for Science, Innovation and Technology, and Research Data Scotland.
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Journal reference:
DOI: 10.1007/s00787-026-03135-y