Participation, Engagement and Change: A Study of the Experiences of Service Users of the Unified Adolescent Team

Facilitators and Barriers to Person‐centred Care in Child and Young People Mental Health Services: A Systematic Review

“…Nonetheless, several studies did not provide sufficient detail on issues such as justification of the research design ( n = 3; Iachini, Hock, Thomas, & Clone, ; Molesworth & Crome, ; Street, ), recruitment strategy ( n = 6; Lee et al, ; LeFrançois, ; Ma & Lai, ; Molesworth & Crome, ; Offord, Turner, & Cooper, ; Street, ), data collection ( n = 3; LeFrançois, ; Molesworth & Crome, ; Street, ), the relationship between researcher and participants ( n = 14; Buckley et al, ; Harper, Dickson, & Bramwell, ; Hart, Saunders, & Thomas, ; Iachini et al, ; Kovshoff et al, ; Lee et al, ; LeFrançois, ; Molesworth & Crome, ; Offord et al, ; Oruche, Downs, Holloway, Draucker, & Aalsma, ; Pelto‐Piri, Engstrom, K., & Engstrom, ; Street, ; Tam‐Seto & Versnel, ; Wisdom, Clarke, & Green, ), ethical issues ( n = 4; Abrines‐Jaume et al, ; LeFrançois, ; Molesworth & Crome, ; Wisdom et al, ) and rigour of data analysis ( n = 4; Hart et al, ; LeFrançois, ; Molesworth & Crome, ; Street, ). Finally, contribution to research, knowledge or policy was not discussed in two studies (Molesworth & Crome, ; Street, ), new areas of research were not identified in six studies (Buckley et al, ; Hart et al, ; Lee et al, ; Molesworth & Crome, ; Pycroft, Wallis, Bigg, & Webster, ; Street, ) and generalizability of findings was not taken into account in nine studies (Buckley et al, ; Bury, Raval, & Lyon, ; Coyne et al, ; Kovshoff et al, ; LeFrançois, ; Molesworth & Crome, ; Offord et al, ; Pelto‐Piri et al, ; Street, ).…”

“…At the service level, professionals, service users and carers reported a lack of resources and extensive policy regulations as key barriers to PCC, which reduce the flexibility with which professionals can provide treatment aiming to address the individual needs of the service users (Buckley et al, ; Grealish, Tai, Hunter, & Morrison, ; Idenfors, Kullgren, & Salander Renberg, ; Ma & Lai, ; Oruche, Downs, Holloway, Draucker, & Aalsma, ; Pelto‐Piri, Engstrom, K., & Engstrom, ; Pycroft, Wallis, Bigg, & Webster, ; Simmons, Hetrick, & Jorm, , ; Street, ).…”

“…Equally valued as a factor influencing PCC was when service users and carers were listened to and their opinions respected and validated. When this occurred, it was perceived as a facilitator to PCC and was reported from studies examining healthcare professionals' young people's and carers' perspectives (Grealish, Tai, Hunter, & Morrison, 2013;Hart et al, 2005;Iachini et al, 2015;Idenfors, Kullgren, & Salander Renberg, 2015;Offord, Turner & Cooper, 2006;Pelto-Piri, Engstrom, K., & Engstrom, 2013;Pycroft, Wallis, Bigg, & Webster, 2015;Simmons et al, 2011;Wisdom et al, 2006) but as a barrier when they did not (Buckley et al, 2012;Coyne et al, 2015;Grealish et al, 2013;Wisdom et al, 2006). Professionals reported apprehension to changing practice because of potential safeguarding concerns and also feeling 'clunky' or unskilled in how to involve service users in decision-making (Abrines-Jaume et al, 2014).…”

“…The importance of the quality of the relationship between professionals and services as well as support from professionals for service users and carers were consistently mentioned as key factors influencing PCC, which can be attributed as facilitators to PCC (Buckley et al, 2012;Coyne et al, 2015;Grealish, Tai, Hunter, & Morrison, 2013;Lee et al, 2006;Oruche, Downs, Holloway, Draucker, & Aalsma, 2014;Pelto-Piri, Engstrom , K., & Engstrom, 2013;Pycroft, Wallis, Bigg, & Webster, 2015;Tam-Seto & Versnel, 2015;Wisdom, Clarke, & Green, 2006) but also barriers when relationships and support were poor (Buckley et al, 2012;Oruche et al, 2014;Tam-Seto & Versnel, 2015). According to service users, communication between professionals and service users was an important determinant of a high-quality relationship; thus, its presence was cited as a facilitator to PCC (Grealish et al, 2013;Lee et al, 2006;Pycroft et al, 2015), whereas the absence of communication was a barrier to PCC (Lee et al, 2006;Simmons, Hetrick, & Jorm, 2011). Finally, power imbalance between service users and professionals (Bury, Raval, & Lyon, 2007;Harper, Dickson, & Bramwell, 2014) and a lack of continuity in relationships, resulting in service users seeing a number of different professionals, were reported as being barriers to PCC (Harper et al, 2014).…”

“…Professionals, service users and carers reported limited resources (e.g., staff and time) and a lack of information in age-appropriate language/materials as barriers to PCC (Buckley et al, 2012;Ma & Lai, 2014;Oruche, Downs, Holloway, Draucker, & Aalsma, 2014;Pelto-Piri, Engstrom, K., & Engstrom, 2013;Pycroft, Wallis, Bigg, & Webster, 2015;Simmons, Hetrick, & Jorm, 2011;Street, 2004). Treatment options were also considered by professionals and service users to be limited (Lee et al, 2006;Simmons, Hetrick, & Jorm, 2013).…”