This second edition is a ‘how to do’ text and an update of the evidential and operational base for child and adolescent mental health services (CAMHS) delivery, and about organising intervention into the lives of children and their families, into their functioning and relationships. It is a parochial rather than a universal text – it addresses CAMHS in a particular country, the UK and primarily England, at a particular time, although we hope the principles of service delivery will have a more universal resonance. Service delivery is bound by the interacting contexts of healthcare delivery, attitudes to mental health, attitudes to children and broader social mores, locally and regionally, and the wider social, political and economic context as well as the tension between a demand for and supply of clinical provision. This book describes ways of delivering services to young people and their families within, and with full awareness of, those contexts.

This book is about the operation of services for children and young people who have been identified as having mental disorders or psychological problems. It is not about the emotional well-being of all children, although it recognises and acknowledges factors in our society that influence that emotional well-being. The difference between treating mental disorder and ensuring emotional well-being are clarified by the two questions those of us interested in the welfare of children need to address.

1. How do we as a society support, respect and develop self-esteem in those who in turn will do the same for their children? This question belongs in the arena of nurturing the mental health of the community, of society.

2. How do those of us working in CAMHS assess and manage those children and their families who are suffering because of their mental disorder or psychological difficulties?

Unfortunately, the answers to these two questions have become confused.