scholarly journals Patterns of use of secondary mental health services before and during COVID-19 lockdown: observational study

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Samuel Tromans ◽  
Verity Chester ◽  
Hannah Harrison ◽  
Precina Pankhania ◽  
Hanna Booth ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
Child And Adolescent ◽  
Time Frame ◽  
Service Utilisation ◽  
Patterns Of Use ◽  
The Impact

Background The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on both the physical and mental well-being of the global population. Relatively few studies have measured the impact of lockdown on utilisation of secondary mental health services in England. Aims To describe secondary mental health service utilisation pre-lockdown and during lockdown within Leicestershire, UK, and the numbers of serious incidents during this time frame. Method Data pertaining to mental health referral and hospital admissions to adult mental health, child and adolescent mental health, intellectual disability and mental health services for older people were collated retrospectively from electronic records for both 8 weeks pre-lockdown and the first 8 weeks of lockdown in England. Serious incidents during this time frame were also analysed. Results Significantly (P < 0.05) reduced referrals to a diverse range of mental health services were observed during lockdown, including child and adolescent, adult, older people and intellectual disability services. Although admissions remained relatively stable before and during lockdown for several services, admissions to both acute adult and mental health services for older people were significantly (P < 0.05) reduced during lockdown. Numbers of serious incidents in the pre-lockdown and lockdown periods were similar, with 23 incidents pre-lockdown, compared with 20 incidents in lockdown. Conclusions To the best of our knowledge, this is the first UK-based study reporting patterns of use of mental health services immediately prior to and during COVID-19 lockdown. Overall numbers of referrals and admissions reduced following commencement of COVID-19 lockdown. Potential reasons for these observations are discussed.

scholarly journals Understanding and evaluating new models of Child and Adolescent Mental Health Services in South-East England: a study protocol for an observational mixed-methods study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024230 ◽  
Author(s):  
Stephen Rocks ◽  
Melissa Stepney ◽  
Margaret Glogowska ◽  
Mina Fazel ◽  
Apostolos Tsiachristas
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Resource Utilisation ◽  
South East England ◽  
The Impact

IntroductionIncreased demand for Child and Adolescent Mental Health Services (CAMHS), alongside concerns that services should be better commissioned to meet the needs of the most vulnerable, has contributed to a requirement to transform services to improve accessibility, quality of care and health outcomes. Following the submission of government-mandated transformation plans for CAMHS, services in England are changing in how, where and by whom they are delivered. This protocol describes the research methods to be applied to understand CAMHS transformations and evaluate the impact on the use of mental health services, patient care, satisfaction, health outcomes and health resource utilisation costs.Methods and analysisA mixed-methods approach will be taken in an observational retrospective study of CAMHS provided by a large National Health Service (NHS) mental health trust in South-East England (Oxford Health NHS Foundation Trust). Quantitative research will include descriptive analysis of routinely collected data, with difference-in-differences analysis supplemented with propensity score matching performed to assess the impact of CAMHS transformations from 2015 onwards. An economic evaluation will be conducted from a healthcare perspective to provide commissioners with indications of value for money. Qualitative research will include observations of services and interviews with key stakeholders including CAMHS staff, service users and guardians, to help identify mechanisms leading to changes in service delivery, as well as barriers and enabling factors in this phase of transformation.Ethics and disseminationThis project has been registered with NHS Oxford Health Foundation Trust as a service evaluation. Informed consent will be sought from all stakeholders partaking in interviews according to good clinical practice. A local data sharing protocol will govern the transfer of quantitative data. Study findings will be published in professional journals for NHS managers and peer-reviewed scientific journals. They will be discussed in seminars targeting CAMHS providers, managers and commissioners and presented at scientific conferences.

scholarly journals Mentally disordered young offenders in transition from child and adolescent to adult mental health services across England and Wales

2017 ◽  
Vol 19 (4) ◽  
pp. 301-308 ◽  
Author(s):  
Maria I. Livanou ◽  
Vivek Furtado ◽  
Swaran P. Singh
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Young Offenders ◽  
England And Wales ◽  
Content Type ◽  
Health And Wellbeing ◽  
The Impact

Purpose This paper provides an overview of transitions across forensic child and adolescent mental health services in England and Wales. The purpose of this paper is to delineate the national secure services system for young people in contact with the youth justice system. Design/methodology/approach This paper reviews findings from the existing literature of transitions across forensic child and adolescent mental health services, drawing attention to present facilitators and barriers to optimal transition. The authors examine the infrastructure of current services and highlight gaps between child and adult service continuity and evaluate the impact of poor transitions on young offenders’ mental health and wellbeing. Findings Young offenders experience a broad range of difficulties, from the multiple interfaces with the legal system, untreated mental health problems, and poor transition to adult services. Barriers such as long waiting lists, lack of coordination between services and lack of transition preparation impede significantly smooth transitions. Research limitations/implications The authors need to develop, test and evaluate models of transitional care that improve mental health and wellbeing of this group. Practical implications Mapping young offenders’ care pathway will help to understand their needs and also to impact current policy and practice. Key workers in forensic services should facilitate the transition process by developing sustainable relationships with the young person and creating a safe clinical environment. Originality/value Transition of care from forensic child and adolescent mental health services is a neglected area. This paper attempts to highlight the nature and magnitude of the problems at the transition interface in a forensic context.

scholarly journals ADHD and Covid-19: current roadblocks and future opportunities

2020 ◽  
Vol 37 (3) ◽  
pp. 204-211 ◽  
Author(s):  
J. McGrath
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Evidence Base ◽  
Specific Reference ◽  
Health Services Need ◽  
The Impact

Attention deficit hyperactivity disorder (ADHD) is the commonest disorder presenting to Child and Adolescent Mental Health Services in Ireland. This article considers the impact of the Covid-19 pandemic on the provision of mental health services for young people with ADHD with specific reference to the difficulties that have been experienced in ADMiRE, a specialist ADHD service in Dublin, since the outbreak of Covid-19 in Ireland. Current guidelines and alternative ways of ensuring adequate service provision are discussed. Restrictions to mitigate the spread of Covid-19 are likely to continue for many months, and child and adolescent mental health services need to find new ways to provide a sustainable service to young people in Ireland. There is a growing evidence base for the use of telepsychiatry in the assessment and management of ADHD. Factors that should be considered when developing a telepsychiatry service for children and adolescents with ADHD are highlighted.

scholarly journals A Mixed-Methods Realist Evaluation of the Implementation and Impact of Community Forensic CAMHS to Manage Risk for Young People With Forensic and Mental Health Needs: Study Protocol

2021 ◽  
Vol 12 ◽  
Author(s):  
Rebecca Lane ◽  
Sophie D'Souza ◽  
Maria Livanou ◽  
Jenna Jacob ◽  
Wendy Riches ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Mental Health Services ◽  
Young People ◽  
Health Services ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Realist Evaluation ◽  
Research Association ◽  
The Impact

Introduction: Young people in contact with forensic child and adolescent mental health services present with more complex needs than young people in the general population. Recent policy has led to the implementation of new workstreams and programmes to improve service provision for this cohort. This paper aims to present the protocol for a national study examining the impact and implementation of Community Forensic Child and Adolescent Mental Health Services (F:CAMHS).Methods and analysis: The study will use a mixed-methods Realist Evaluation design. Quantitative service activity and feedback data will be collected from all 13 sites, as well as questionnaires from staff. Non-participant observations and qualitative interviews will be conducted with staff, young people and parents/guardians from four focus study sites. An economic evaluation will examine whether Community F:CAMHS provides good value for money. The results will be triangulated to gain an in-depth understanding of young people's, parents/guardians' and staff experiences of the service.Ethics and dissemination: Ethical approval was granted by the Health Research Association and UCL Ethics. The results will be disseminated via project reports, feedback to sites, peer-reviewed journal publications and conference presentations.

Family and caregivers’ experience of mental illness in migrants with intellectual disability – reflections on practice

2019 ◽  
Vol 13 (2) ◽  
pp. 76-88
Author(s):  
Jane Margrete Askeland Hellerud ◽  
Trine Lise Bakken
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Psychiatric Inpatient ◽  
Community Services ◽  
Cultural Dimensions ◽  
Content Type ◽  
The Impact

Purpose The purpose of this paper is to investigate the families’ and professional caregivers’ experience of mental health services for patients in the migrant population with intellectual disability (ID). Design/methodology/approach To highlight this rarely studied topic, the authors chose a qualitative approach, using a semi-structured interview guide. The authors performed a search for relevant articles. Three families of former patients of a specialized psychiatric inpatient unit and 12 professional caregivers were interviewed. The interviews were taped, transcribed and analyzed using a thematic analysis. Findings In total, 17 themes from the families’ answers and 14 themes from the caregivers’ answers were grouped into four main themes each. Two main themes were identical for both groups: perspectives on mental illness and “the Norwegian system.” Additionally, the families were concerned about the impact on the patient and family and coping strategies. The caregivers highlighted patient–caregiver interaction and family–caregiver interaction. Research limitations/implications Further research should include the patients’ opinions based on the findings of this study. Also, studies including larger samples from both specialist services and community services are needed to develop evidence-based services for these patients. Practical implications Proposed adaptations to enable assessment and treatment of mental illness in migrants with ID should be adapted to cultural preferences. The following adaptations are proposed: inclusion of the entire family, awareness of cultural dimensions, information about the health care system, education in mental illness, the use of interpreters and adequate time spent with the families. Originality/value Mental health services for this group are an understudied topic. Clinical experience indicates that professionals struggle when providing services for such patients.

scholarly journals Longitudinal Youth in Transition Study (LYiTS): protocol for a multicentre prospective cohort study of youth transitioning out of child and adolescent mental health services at age 18

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e035744 ◽  
Author(s):  
Kristin Cleverley ◽  
Kathryn J Bennett ◽  
Sarah Brennenstuhl ◽  
Amy Cheung ◽  
Joanna Henderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Psychiatric Symptoms ◽  
Child And Adolescent ◽  
Health Service Utilisation ◽  
Service Utilisation ◽  
Transition Study

IntroductionTransition between health services is widely recognised as a problematic hurdle. Yet, the factors necessary for successful transition out of child and adolescent mental health services (CAMHS) as youth reach the service boundary at age 18 are poorly understood. Further, fragmentation and variability among the services provided by mental health organisations serve to exacerbate mental illness and create unnecessary challenges for youth and their families. The primary aim of the Longitudinal Youth in Transition Study (LYiTS) is to describe and model changes in psychiatric symptoms, functioning and health service utilisation at the transition out of CAMHS at age 18 and to identify key elements of the transition process that are amendable to interventions aimed at ensuring continuity of care.Methods and analysisA prospective longitudinal cohort study will be conducted to examine the association between psychiatric symptoms, functioning and mental health and health service use of youth aged 16–18 as they transition out of child mental health services at age 18. We will recruit a sample of (n=350) participants from child and adolescent psychiatric programmes at two hospital and two community mental health sites and conduct assessments annually for 3 years using standardised measures of psychiatric symptoms, functioning and health service utilisation.Ethics and disseminationEthics approval has been obtained at all four recruitment sites. We will disseminate the results through conferences, open access publications and webinars.

scholarly journals Mixed-methods study protocol for an evaluation of the mental health transition navigator model in child and adolescent mental health services: the Navigator Evaluation Advancing Transitions (NEAT) study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051190
Author(s):  
Kristin Cleverley ◽  
Katye Stevens ◽  
Julia Davies ◽  
Emma McCann ◽  
Tracy Ashley ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Study Protocol ◽  
Transition Process ◽  
Adolescent Mental Health ◽  
Child And Adolescent ◽  
Service Utilisation ◽  
Community Or ◽  
University Of Toronto

IntroductionTransition from child and adolescent mental health services (CAMHS) to community or adult mental health services (AMHS) is a highly problematic health systems hurdle, especially for transition-aged youth. A planned and purposeful transition process is often non-existent or experienced negatively by youth and their caregivers. Stakeholders, including youth and their caregivers, have demanded interventions to support more effective transitions, such a transition navigator. The transition navigator model uses a navigator to facilitate complex transitions from acute care CAMHS to community or AMHS. However, despite the widespread implementation of this model, there has been no evaluation of the programme, hindering its scalability. This paper describes the study protocol of the Navigator Evaluation Advancing Transitions study that aims to collaborate with patients, caregivers and clinicians in the evaluation of the navigator model.Methods and analysisA pre and post mixed-method study will be conducted, using the Triple Aim Framework, to evaluate the navigator model. We will recruit participants from one large tertiary and two community hospitals in Toronto, Canada. For the quantitative portion of the study, we will recruit a sample of 45 youth (15 at each site), aged 16–18, and their caregivers at baseline (referral to navigator) (T1) and 6 months (T2). Youth and caregiver participants will complete a set of standardised measures to assess mental health, service utilisation, and satisfaction outcomes. For the qualitative portion of the study, semistructured interviews will be conducted at 6 months (T2) with youth, their caregivers and clinicians to better understand their experience and satisfaction with the model.Ethics and disseminationResearch Ethics Board (REB) approval has been obtained from the lead research sites, the University of Toronto and the Hospital for Sick Children. The results of the study will be reported in peer-reviewed publications, webinars and conferences and to all relevant stakeholders.

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