scholarly journals Therapeutic relationships in child and adolescent mental health services: A Delphi study with young people, carers and clinicians

2021 ◽  
Author(s):  
Rachael Ryan ◽  
Katherine Berry ◽  
Heather Law ◽  
Samantha Hartley
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Delphi Study ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Therapeutic Relationships

scholarly journals Incidence of anorexia nervosa in young people in the UK and Ireland: a national surveillance study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e027339 ◽  
Author(s):  
Hristina Petkova ◽  
Mima Simic ◽  
Dasha Nicholls ◽  
Tamsin Ford ◽  
A Matthew Prina ◽  
...  
Keyword(s):  
Mental Health ◽  
Anorexia Nervosa ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Young Women ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Surveillance Study ◽  
The Uk

ObjectivesThis study aimed to estimate the incidence of DSM5 anorexia nervosa in young people in contact with child and adolescent mental health services in the UK and Ireland.DesignObservational, surveillance study, using the Child and Adolescent Psychiatry Surveillance System, involving monthly reporting by child and adolescent psychiatrists between 1st February 2015 and 30th September 2015.SettingThe study was based in the UK and Ireland.ParticipantsClinician-reported data on young people aged 8–17 in contact with child and adolescent mental health services for a first episode of anorexia nervosa.Main outcome measuresAnnual incidence rates (IRs) estimated as confirmed new cases per 100 000 population at risk.Results305 incident cases of anorexia nervosa were reported over the 8-month surveillance period and assessed as eligible for inclusion. The majority were young women (91%), from England (70%) and of white ethnicity (92%). Mean age was 14.6 years (±1.66) and mean percentage of median expected body mass index for age and sex was 83.23% (±10.99%). The overall IR, adjusted for missing data, was estimated to be 13.68 per 100 000 population (95% CI 12.88 to 14.52), with rates of 25.66 (95% CI 24.09 to 27.30) for young women and 2.28 (95% CI 1.84 to 2.79) for young men. Incidence increased steadily with age, peaking at 15 (57.77, 95% CI 50.41 to 65.90) for young women and 16 (5.14, 95% CI 3.20 to 7.83) for young men. Comparison with earlier estimates suggests IRs for children aged 12 and under have increased over the last 10 years.ConclusionThese results provide new estimates of the incidence of anorexia nervosa in young people. Service providers and commissioners should consider evidence to suggest an increase in incidence in younger children.Trial registration numberISRCTN12676087.

scholarly journals Outcomes of young people who reach the transition boundary of child and adolescent mental health services: a systematic review

2019 ◽  
Vol 28 (11) ◽  
pp. 1431-1446 ◽  
Author(s):  
Rebecca Appleton ◽  
Catriona Connell ◽  
Emma Fairclough ◽  
Helena Tuomainen ◽  
Swaran P. Singh
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Transition Boundary

scholarly journals Incorporating Children and Young People’s Voices in Child and Adolescent Mental Health Services Using The Family Model

2017 ◽  
Vol 5 (3) ◽  
pp. 183-194 ◽  
Author(s):  
Benjamin Hoadley ◽  
Freya Smith ◽  
Cecilia Wan ◽  
Adrian Falkov
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Children And Young People ◽  
Family Model ◽  
The Family ◽  
Family Focused Practice

Mental illness in children and young people is increasing in frequency and complexity, is emerging earlier and is persisting into adulthood. This is a global issue with implications for research, policy and practice. Children and young people require the experience of safe, nurturing relationships for optimal lifelong outcomes. Despite awareness of this in Child and Adolescent Mental Health services, a focus on the relational context in which children and young people present is not universal. A challenge in family focused practice is to ensure that no individual’s voice is ‘too loud’ and that children and young people’s voices are heard. This article illustrates how a balance between individual and systems understanding can be achieved in therapeutic work by incorporating the voices of children and young people and concerns of other family members. This article describes an approach to improving family focused practice in a public Child and Adolescent Mental Health service. Use of The Family Model, as a family focused practice tool, is presented across three service settings. The Family Model intervention is briefly described, outlining the way in which it supports collaborative practice and assists clinicians to achieve the balance described above. Vignettes will demonstrate how children and young people’s voices are explicitly incorporated in formulating mental health issues with two generations to generate developmentally informed care plans.

The management of young people who self-harm by New Zealand Infant, Child and Adolescent Mental Health Services: cutting-edge or cutting corners?

2018 ◽  
Vol 26 (2) ◽  
pp. 152-159
Author(s):  
Hiran Thabrew ◽  
Ernest Gandeza ◽  
Giselle Bahr ◽  
David Bettany ◽  
Chris Bampton ◽  
...  
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Evidence Based ◽  
Behaviour Therapy ◽  
Self Harm

Objectives: Self-harm is common in New Zealand (NZ) young people and can have short-term and long-term consequences, including suicide. This study was undertaken to examine the extent to which evidence-based approaches for addressing self-harm are offered by Infant, Child and Adolescent Mental Health Services (ICAMHS). Methods: A national survey of ICAMHS practitioners working with young people who self-harm was undertaken between May and July 2016. Results: Responses from 23 out of 30 ICAMHS confirmed self-harm was a familiar presentation and most commonly associated with diagnoses of depression, anxiety and borderline personality disorder. Cognitive behavioural therapy (47.1%, n = 8), dialectical behaviour therapy (47.1%, n = 8) and acceptance and commitment therapy (5.9%, n = 1) were the treatments of choice, but variably delivered. There were significant training gaps for all types of therapy. Conclusions: Although it is reassuring that many ICAMHS are using evidence-based approaches to address self-harm in young people, there is concerning variability in the way these therapies are delivered. Improvement in training in key modalities, further research into therapist performance and continuous evaluation of workforce development are needed to maximise the effectiveness of proven interventions and provide NZ young people with the state-of-the-art service they deserve.

scholarly journals Problem severity and waiting times for young people accessing mental health services

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Julian Edbrooke-Childs ◽  
Jessica Deighton
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Waiting Times ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Area Deprivation ◽  
Multinomial Regression

Background Access to timely care is a quality standard underpinning many international healthcare models, and long waiting times for child and adolescent mental health services are often reported as a barrier to help-seeking. Aims The aim of this study was to examine whether young people with more severe problems have shorter waiting times for mental health services. Method Multilevel multinomial regression analysis controlling for service-area deprivation, age, gender, ethnicity, referral source and contextual factors was conducted on N = 21 419 episodes of care (mean age 12.37 years (s.d. = 3.71), 11 712 (55%) female) using data from child and adolescent mental health services. Results There was high variation in waiting times, which ranged from 0 days to 1629 days (mean 50.65 days (s.d. = 78.03), median 32 days). Compared with young people with less severe problems young people with severe problems, self-harm, psychosis or eating disorders were less likely to experience longer waiting times. Moreover, referrals from sources other than primary care were generally less likely to have longer waiting times than referrals from primary care sources, especially referral from accident and emergency services. Conclusions The findings suggest that young people with more severe problems had shorter waiting times. Intermediary information and resources for support before access to services is needed to prevent escalation of problems and to support individuals and families while waiting for care. Interventions to reduce waiting times should be considered without compromising on the quality and experience of care that young people and families deserve when seeking help.

scholarly journals Delphi study to identify key features of community-based child and adolescent mental health services in the East of England

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e022936 ◽  
Author(s):  
Emma Howarth ◽  
Maris Vainre ◽  
Ayla Humphrey ◽  
Chiara Lombardo ◽  
Ainul Nadhirah Hanafiah ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Delphi Study ◽  
Well Being ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Eastern Region ◽  
Community Based ◽  
The Public

ObjectiveTo identify priorities for the delivery of community-based Child and Adolescent Mental health Services (CAMHS).Design(1) Qualitative methods to gather public and professional opinions regarding the key principles and components of effective service delivery. (2) Two-round, two-panel adapted Delphi study. The Delphi method was adapted so professionals received additional feedback about the public panel scores. Descriptive statistics were computed. Items rated 8–10 on a scale of importance by ≥80% of both panels were identified as shared priorities.SettingEastern region of England.Participants(1) 53 members of the public; 95 professionals from the children’s workforce. (2) Two panels. Public panel: round 1,n=23; round 2,n=16. Professional panel: round 1,n=44; round 2,n=33.Results51 items met the criterion for between group consensus. Thematic grouping of these items revealed three key findings: the perceived importance of schools in mental health promotion and prevention of mental illness; an emphasis onhowspecialist mental health services are delivered rather thanwhatis delivered (ie, specific treatments/programmes), and the need to monitor and evaluate service impact against shared outcomes that reflect well-being and function, in addition to the mere absence of mental health symptoms or disorders.ConclusionsAreas of consensus represent shared priorities for service provision in the East of England. These findings help to operationalise high level plans for service transformation in line with the goals and needs of those using and working in the local system and may be particularly useful for identifying gaps in ongoing transformation efforts. More broadly, the method used here offers a blueprint that could be replicated by other areas to support the ongoing transformation of CAMHS.

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