Vulnerable young people’s experiences of child and adolescent mental health services

Abstract

Purpose The purpose of this paper is to explore the experiences of vulnerable young people in using a local child and adolescent mental health service (CAMHS). Design/methodology/approach A mixed methods design was employed in which participants completed the self-report Experience of Service Questionnaire (CHI ESQ) (n=34), and a subgroup completed individual semi-structured interviews (n=17). CHI ESQ satisfaction data were also compared with a national data sample provided by the Child Outcomes Research Consortium (n=621). Findings Many young people appeared to have a mixed or negative experience of the CAMHS service. They strongly emphasised that feeling listened to, cared for, and supported, in addition to access and continuity of care, are key methods to enhance their experience. They also reported a lack of knowledge and stigma associated with mental health as key barriers to engagement with services more widely. Research limitations/implications Purposive sampling was used to recruit a carefully defined group of vulnerable young people from one school using a single CAMHS service. Practical implications A number of recommendations were identified that could enhance the service experience of young people. Originality/value There is a significant paucity of knowledge regarding young people’s views and experiences of CAMHS, especially those with high vulnerability for mental health difficulties. This exploratory study offers methods for capturing the opinions of underrepresented young people to inform future service design.

What Type of Helping Relationship Do Young People Need? Engaging and Maintaining Young People in Mental Health Care—A Narrative Review

“…Young people can need different types of professional boundaries depending on their risk or resilience profiles (Ungar et al, 2018). Importantly, young people want the time and opportunity to build positive rapports and establish stable relationships as these are crucial to ongoing engagement and maintaining participation in mental health care (Davison et al, 2017; Jones et al, 2017; Persson et al, 2017). This supportive rapport, built on trust and confidentiality, provides a young person with the necessary context to engage in collaborative care.…”

“…The third theme identified in this review concerns findings regarding the ability of the helper to discuss, inform, and offer an individualized and collaborative treatment plan to young people. Young people want to be involved in decisions about their care and have a choice of which intervention they would like to try; if they are excluded from this decision-making process, then there is a greater chance they will disengage from treatment (Davison et al, 2017; Draucker, 2005; Gilchrist & Sullivan, 2006; Neilson et al, 2014; Persson et al, 2017; Quinn et al, 2009; Simmons et al, 2011; Wilson & Deane, 2001). In particular, young people reported wanting a helper that was knowledgeable about mental health, providing them with information and high-quality guidance (Draucker, 2005; Gilchrist & Sullivan, 2006; Neilson et al, 2014; Quinn et al, 2009; Simmons et al, 2011; Williams, 2012; Wilson & Deane, 2001).…”

“…The studies in this review were published between 1998 and 2018. The most frequent locations were Australia ( n = 6) (de Anstiss & Ziaian, 2010; Gilchrist & Sullivan, 2006; Medlow et al, 2010; Rickwood et al, 2005; Simmons et al, 2011; Wilson & Deane, 2001), the United Kingdom ( n = 6) (Collins & Barker, 2009; Davison et al, 2017; Fargas-Malet & McSherry, 2017; Fox & Butler, 2007; Jones et al, 2017; Quinn et al, 2009), and the United States of America ( n = 4) (Cniro et al, 2005; Draucker, 2005; Gonzalez et al, 2005; Lindsey & Kalafat, 1998). The remaining studies included three from Canada (Hackett et al, 2018; Neilson et al, 2014; Ungar et al, 2018), one from Sweden (Persson et al, 2017), and one from Portugal (Loureiro et al, 2013).…”

“…The studies in this review were predominantly qualitative ( n = 13) (Collins & Barker, 2009; de Anstiss & Ziaian, 2010; Draucker, 2005; Fargas-Malet & McSherry, 2017; Gilchrist & Sullivan, 2006; Jones et al, 2017; Lindsey & Kalafat, 1998; Medlow et al, 2010; Neilson et al, 2014; Persson et al, 2017; Quinn et al, 2009; Simmons et al, 2011; Wilson & Deane, 2001), with four studies using quantitative methodologies (Cniro et al, 2005; Gonzalez et al, 2005; Loureiro et al, 2013; Williams, 2012) and five using mixed methodologies (Davison et al, 2017; Fox & Butler, 2007; Hackett et al, 2018; Rickwood et al, 2005; Ungar et al, 2018). The qualitative research used either focus groups ( n = 4) or interviews ( n = 9), with one study using interviews and a codesign event.…”

Psychosocial outcomes of mental illness stigma in children and adolescents: A mixed-methods systematic review

“…Two participants felt they could not seek help for fear of what others may think (Flack, 2018), with adolescents in another study reporting reluctance to access a post-traumatic stress intervention due to peers not wanting attention brought to the friend group (van der Water et al, 2018). Others reported that seeking counselling was 'weird' or 'crazy' and would encourage social exclusion or judgement (Davison, Zamperoni, & Stain, 2017;Lindsey et al, 2013), contrasting with others' views of help-seeking as encouraging independence in youth (Lindsey et al, 2013). A lack of understanding of OCD-related difficulties was found to delay help seeking in adolescents from 3 months to 8 years (Keyes et al, 2017).…”