Child and Adolescent Mental Health Services: An Operational Handbook (2nd edn), Greg Richardson, Ian Partridge & Jonathan Barrett (eds), RCPsych Publications, 2010, £30.00 pb, 352 pp. ISBN: 9781904671800

This is an updated edition of a justifiably popular ‘how to do it’ manual. As with most multi-author books, there is some variability between chapters but this has clearly been minimised by the three editors being authors of a remarkable number of the chapters (20 of 33). Two-thirds of the authors work in Yorkshire. This gives the book a striking degree of coherence but there does remain a fundamental tension between two quite different models of service delivery. Chapters 11 and 13 make a systemic, ideologically satisfying argument for the withering away of the very concept of referral to secondary care by the concentration of energy and resources on tier 1 child and adolescent mental health services (CAMHS). Several subsequent chapters, especially those describing service delivery to specific population and diagnostic groups, adhere to the traditional model of referral from primary to secondary care. Sitting somewhat uncomfortably alongside this dichotomous tension is York & Kingsbury's chapter on demand and capacity management, which accepts the concept of referrals but suggests quite a different approach to processing them. Absent almost entirely is a discussion of contract currency development – one suspects this is because it is very difficult to reconcile the fee for service principles of ‘payment by results’ with a consultation to primary care staff model of service delivery.

Nevertheless, this book is a gold mine of good practical advice. It is so dense with information that it bears repeated reading. Some of the chapters are gems – chapter 4 on management structure, chapter 6 on clinical governance and chapter 10 on ‘a comprehensive CAMHS’. These should be in the briefcases of every clinician, manager and commissioner attending meetings on CAMHS. Any area that provided all the services described in this book would be extraordinarily well served. For most of us, especially in the current dire economic situation for public services, this will be impossible. We will at least know what we should be doing.

Finally, this is a book where it pays to read the preface. This clearly delineates between mental disorder and emotional well-being and defines the role of CAMHS as dealing with the former by minimalist interventions aimed at empowering children and families and enhancing resilience. Every chapter in this book should be read with this in mind.