Although service data are crucial for estimating the resources required by Child and Adolescent Mental Health Services (CAMHS) and to improve their quality, no studies have yet been conducted in Italy to this aim, and even in other countries health services research in this area has been extremely limited in scope and magnitude.

To collect data on the physical characteristics, staffing arrangements, and activities of CAMHS in Emilia-Romagna, a densely populated Italian region with 633,725 inhabitants aged 0–17 years.

Unit Chiefs of all the CAMHS filled in a structured ‘Facility Form’, with activity data referring to 2008 (for inpatient facilities we referred to 2009).

Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0–17 years. All outpatient units were well equipped and all granted free service access. In 2008, approximately 6% of the target population was in contact with CAMHS; first-ever contacts accounted for 30% of annual visits. Hospital bed availability was 5 per 100,000 inhabitants aged 0–17 years.

The overall number of child psychiatrists per 100,000 inhabitants is one of the highest in Europe and is comparable with the most well equipped areas in the US. This comparison should be interpreted with caution, however, because in Italy, child psychiatrists also treat neurological disorders. Critical areas requiring improvement are: the uneven utilisation of standardised assessment procedures and the limited availability of dedicated emergency services during non-office hours.