Young voices in mental health care: Exploring children’s and adolescents’ service experiences and preferences

Abstract

The development of 'youth-friendly' services has become a priority across a wide range of healthcare contexts. However, relatively few studies have specifically examined users' experiences of, and preferences for, child and adolescent mental health care. The current study investigated young service users' views of outpatient and community mental health clinics in Sweden, based on two data sources. First, focus group interviews were conducted with seven children and adolescents (aged 10-18 years) to explore both positive and negative experiences of mental health care. Second, written suggestions about specific service improvements were obtained from 106 children and adolescents. Qualitative content analysis revealed three overarching themes: 'Accessibility', 'Being heard and seen' and 'Usefulness of sessions'. Young people's recommendations for improving practice included more convenient appointment times, offered in welcoming settings; opportunities to communicate more openly with clinical staff, enabling sensitive discussion of mental health and wider personal issues; and more structured treatments that offer greater credibility and relevance to young people's mental health and developmental needs. Young people also discussed being compelled by parents and school professionals to engage in treatment. Attending to young people's preferences must be a priority in order to overcome ambivalence about session attendance, and enhance treatment participation and outcomes.

What makes mental health and substance use services youth friendly? A scoping review of literature

“…Youth appreciate interpersonal interactions that make them feel safe and welcome in a MHSU service [40]. In order to provide a safe space, the key values of the MHSU service need to be identified and embedded in organizational policy.…”

“…For example, youth engagement teams can be engaged in the design of the space, such as choosing the color of the walls or making murals † . Service-seeking youth may also appreciate influencing their service environment, e.g., deciding to have music in the background during a session [40]. …”

“…They appreciate a non-clinical atmosphere, i.e., avoiding the white walls one might expect in a hospital setting [24, 40, 44]. There should be windows in the space # , and it should be brightly illuminated*.…”

“…There should be windows in the space # , and it should be brightly illuminated*. Youth have reported preferring bright colors and comfortable furniture like couches, which makes the space more informal and comfortable [37, 38, 40, 44]. Colorful artwork and posters of modern music and media personalities also create a vibrant atmosphere [24, 44].…”

“…Some youth may appreciate adult coloring books* or “Zines” (i.e., youth-published work) † . Similarly, music in the waiting room is considered to make the environment youth friendly [24, 40], since it relaxes youth and puts them at ease*, but the choice of music may be different for different youth* ,#,† . While designing a space, it is important to find a balance between a professional versus youth-oriented decor, since some youth may not appreciate services aimed excessively towards youth [38] †,# .…”