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Background Mobile phones play a central role in the lives of young people and are being increasingly recognized as valuable tools in health care. However, there is a paucity of studies exploring the use of mobile phones in youth outreach mental health services. Our outreach team's experience is that enabling youth to access their therapist directly through mobile phone improves engagement and retention, and short message service (SMS) in particular, is a useful tool for coordinating appointments. The purpose of this study was to audit the content of SMS exchanges between therapists and clients and to investigate the extent of inappropriate SMS use. Method An audit of SMS messages sent and received from an outreach youth mental health service was conducted over a 7-month period. Results The majority of SMS traffic sent to and received from clients was micro-coordinating face-to-face-meetings (76% and 61%, respectively), reflecting a practical real-time use of SMS. Only a small proportion of the client use of SMS was classified as inappropriate (2%). Conclusions The results demonstrate that mobile phones and SMS can be used as a safe, practical way of maintaining contact and coordinating meetings within a youth outreach service.

Objectives: This survey of primary, secondary and area schools investigated their referrer satisfaction with six Child and Adolescent Mental Health Service (CAMHS) teams, spread over two metropolitan and four rural centres, and servicing six corresponding metropolitan and rural education districts. The survey aimed to identify barriers to referral from schools to CAMHS and to generate domains for quality improvement across the six local areas. Method: School principals and counsellors completed the online Southern Schools Satisfaction Survey, which sought qualitative comment about aspects of the community mental health service in their area. Results: The response rate (65%) was reasonably good for a large online survey, with 149 schools participating (171 respondents: 113 principals and 58 counsellors). The majority of the respondents were satisfied with the service from CAMHS (24% were ‘very satisfied’, 47% ‘mostly satisfied’ 23% ‘mildly dissatisfied’ and 6% ‘very dissatisfied’). The main barriers and sources of dissatisfaction that schools identified were CAMHS waiting lists, service availability and lack of flexibility. Practices from the team with the highest percentage of satisfied school respondents formed a constructive basis for service-wide quality improvement. These changes focused on flexibility in emergency responses, communication with schools and process of care with students. Conclusions: Surveying referrer satisfaction can be useful for quality improvement within regional mental health services through the identification of good practice which can be transferred across teams.