What next for adolescent forensic mental health research?

Hales, Heidi; Holt, Clare; Delmage, Enys; Lengua, César

doi:10.1002/cbm.2124

Cited by 6 publications

(1 citation statement)

References 30 publications

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“…However, only 16% of young people receive mental health treatment in secure hospitals in England, despite increased rates of 46%–81% custody youth presenting with mental health problems (Hindley et al., 2017). Adolescents in secure hospitals (Tier 4) present with high‐risk, emerging personality disorders (Hill et al., 2014), complex mental health issues, developmental trauma (Mcara & Mcvie, 2010) and offending histories (Livanou, Furtado, & Singh, 2017), which are additional risk factors to poor mental health, high reoffending, and reinstitutionalisation rates (Hales, Holt, Delmage, & Lengua, 2019). Adolescent secure hospitals provide inpatient care, specifically tailored to these high‐risk youth, where treatment and nursing address acute needs which are otherwise not manageable in general adolescent inpatient hospitals (National Health Service; NHS, 2018).…”

Section: Introductionmentioning

confidence: 99%

Co‐producing a complex psychosocial intervention during COVID‐19 with young people transitioning from adolescent secure hospitals to adult services in England: Moving Forward intervention (MFi)

Livanou

Bull

Manitsa

et al. 2023

Child Adoles Ment Health

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BackgroundYoung people moving from adolescent secure hospitals to adult care present with multiple and complex needs which often remain unmet during transition periods. This paper delineates the process of developing and co‐producing the moving forward intervention (MFi), which aims to address the psychosocial needs of transitioning youth who have limited access to well‐researched and tailored service provisions.MethodAn extensive search of the relevant literature was conducted to generate themes and guide the co‐production phase. Fourteen Advisory Group Meetings were held virtually during COVID‐19 to design the MFi module content with 17 keyworkers, 2 parents and 13 young people aged 17–18 years across six adolescent secure hospitals in England. Thematic analysis was used to reflect on the field notes discussed in the Advisory Groups.ResultsCo‐produced themes from the literature and the Advisory Groups informed the development of the proposed intervention. Three overarching themes pertinent to expectations in adult services, improving communication gaps between services and facilitating the letting go period emerged from the co‐production phase. It was suggested the MFi is co‐delivered by a peer with lived experience to build trust and create hopefulness among young people. The importance of promoting graded transitions through standardised procedures was highlighted.ConclusionsThe current findings promote evidence‐based initiatives and build robust practice frameworks that inform treatment and policy guidelines. The young people, parents and keyworkers found the MFi supportive and valued the co‐production experience. As such, co‐production has been a vital tool in promoting patient engagement and empowerment, and reducing service inequalities, especially in adolescent secure hospitals.

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Section: Introductionmentioning

confidence: 99%

Co‐producing a complex psychosocial intervention during COVID‐19 with young people transitioning from adolescent secure hospitals to adult services in England: Moving Forward intervention (MFi)

Livanou

Bull

Manitsa

et al. 2023

Child Adoles Ment Health

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Identifying studies examining the validity of instruments for use as outcome measures in child and adolescent forensic mental health services: a systematic review

Walker,

Wilson,

Allely

et al. 2024

Eur Child Adolesc Psychiatry

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Background Outcome measurement in child and adolescent forensic mental health services can support service improvement, research, and patient progress evaluation. This systematic review aimed to identify studies which validate structured instruments available for use as outcome measures in the child and adolescent forensic mental health service cohort and assess the quality of these studies. Methods A systematic review was conducted following PRISMA guidelines. Studies were identified by searching six online databases in November 2023. The quality and risk of bias of each study meeting inclusion criteria was independently assessed by two authors using the Crowe Critical Appraisal Tool. Results were synthesised narratively. Results A total of eight studies were identified which met inclusion criteria. These looked at six instruments which primarily focused on outcome measures in the areas of treatment motivation, level of functioning, psychiatric symptoms, care needs and response to social situations. Papers scored between 17/40 and 30/40 on the Crowe Critical Appraisal Tool. Studies were rated as low (n = 1), moderate (n = 6), high (n = 1) or very high quality (n = 0). Conclusions Despite the large number of structured instruments potentially available, evidence for their use as outcome measures in child and adolescent forensic mental health services is limited. Future research should aim to validate current structured instruments for use in the forensic child and adolescent setting, with consideration of whether new instruments should be developed specifically for this group. Such instruments should be developed with both young people as service users and professionals who will be utilising the instrument in mind.

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Challenges and Facilitators During Transitions from Adolescent Medium Secure Units to Adult Services in England: Interviews with Mental Healthcare Professionals

Livanou

D’Souza

Lane

et al. 2021

Adm Policy Ment Health

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Young people moving from child and adolescent secure hospitals present with complex needs and vulnerabilities and are more likely to experience poor transition outcomes. Previous research has indicated the presence of several risk factors in periods of transition, such as poor liaison among services, lack of proper planning, shortage of beds in adult services, multiple transitions and lack of emotional readiness. However, little evidence exists about the processes and outcomes of transitions from adolescent secure services to adult settings. This study aims to bridge the gap in the existing literature by exploring the views and experiences of key professionals involved in the transition process from six adolescent medium secure units to nine adult secure and community services in England. Thirty-four key workers from 15 child and adolescent (N = 21) and adult (N = 13) forensic hospitals were interviewed to provide information about potential barriers and facilitators to transitions. Face-to-face semi-structured interviews were conducted between January 2016 and December 2017. Thematic analysis was used to identify challenges and facilitators to transitions. Three primary themes were identified: (1) transition processes and preparation; (2) transition barriers and challenges; (3) success factors to transition. Key differences in adult and adolescent service care-models and lack of emotional and developmental readiness to moving onto adult-oriented settings constitute major barriers to positive transition outcomes. Practice and policy implications are considered to address the need for service transformations.

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What next for adolescent forensic mental health research?

Cited by 6 publications

References 30 publications

Co‐producing a complex psychosocial intervention during COVID‐19 with young people transitioning from adolescent secure hospitals to adult services in England: Moving Forward intervention (MFi)

Co‐producing a complex psychosocial intervention during COVID‐19 with young people transitioning from adolescent secure hospitals to adult services in England: Moving Forward intervention (MFi)

Identifying studies examining the validity of instruments for use as outcome measures in child and adolescent forensic mental health services: a systematic review

Challenges and Facilitators During Transitions from Adolescent Medium Secure Units to Adult Services in England: Interviews with Mental Healthcare Professionals

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