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Young people with mental disorders and their parents or guardians are in a vulnerable situation. The quality of the services and progress in the care pathway can have great importance for the result of treatment.

In 2013 and 2014, the Offices of the County Governors examined mental health care provided by the health trusts in out-patient clinics for children and adolescents. They looked at the quality of the services, continuity of care, and progress in the care pathway. All stages of the care pathway were examined, but the main focus was on assessment and diagnosis.

The results of supervision show that the health trusts did not have good enough control of the services. In many of the out-patient clinics, it was up to individual therapists to assess how the work should be carried out, and how the treatment should progress. Many of the managers did not have an adequate overview of the services provided, and did not correct practices that did not meet the required standards. Even if routines were available, they were not always implemented and used. More systematic management and clearer leadership were needed.

The Offices of the County Governors carried out supervision in 23 out-patient clinics. In addition, at 85 out-patient clinics, the staff looked at their own practice, and assessed whether this met the legislative requirements, using a check-list. Breaches of the regulations were detected in all the health trusts.
The health trusts have overall responsibility for ensuring that the legislative requirements are known and met. They need to follow the services up closely and systematically in order to achieve lasting quality improvement.