Factors that influence decision making by 8-12 year olds in child and adolescent mental health services (CAMHS): a systematic review

Abstract

There is significant legal guidance and case law available to support clinicians in assessing whether young people aged over 13 years are able to make informed decisions about their own healthcare; however when working with children aged 8-12 years, the guidance is unclear. In order to assess whether 8-12 year olds are able to make decisions in their own healthcare, we first need to understand the factors that influence this process. A systematic literature review of five electronic databases (PsycINFO, EBSCO, Science Direct, Science Full Text, Web of Science All Databases) was conducted. The search identified 12 studies and one piece of government guidance. The studies were identified from a variety of health and social research journals. The six factors that were identified were: 1) consent, competence and capacity, 2) best interests, 3) communication, 4) risks and conflicts, 5) legal frameworks, and, 6) parental role. The review concludes that it is possible for some children 8-12 years of age to make decisions regarding their own healthcare. The necessary conditions are that age specific language is used through a variety of mediums which will include risks, benefits and options for the proposed interventions. Clinicians need to be skilled in the assessment of the child’s ability to make decisions and be effective communicators with a commitment to children’s involvement. Further research in both these areas is needed.