WCWL - Children's Mental Health

The Western Canada Waiting List Project (WCWL) is a federally funded partnership of 19 health-related organizations that was created to develop tools to manage waiting lists for five types of health services. The children’s mental health (CMH) panel developed and tested a set of standardized clinical criteria for setting priorities among patients awaiting CMH services. The criteria were applied to 817 patients by 92 mental health professionals in three western provinces. Regression analysis was used to determine the set of criteria weights that collectively best predicted clinicians’ global urgency ratings. To assess reliability, raters used the criteria to score six standardized "paper cases." The criteria accounted for about 40 percent of the observed variance in overall urgency ratings (R2 = 41.7%). The panel modified the criteria based on the initial empirical work. Reliability assessment of the revised tool indicated that one-half of the items had excellent or fair/good inter-rater agreement; test-retest reliability was good. Priority criteria were able to capture clinicians’ judgments of relative urgency in the CMH setting. A number of operational challenges remain with the use of priority criteria for scheduling CMH services.