Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom.
Department of Nursing, Midwifery & Health, Faculty of Health & Life Sciences, Northumbria University, Newcastle, United Kingdom.
PLoS One. 2022 Jul 12;17(7):e0270782. doi: 10.1371/journal.pone.0270782. eCollection 2022.
The mental health needs of young people who offend have become more widely recognised and attempting to meet these needs is now a global priority for governments and health agencies. Young people who offend experience a range of complex difficulties and have significantly worse health and social outcomes than their mainstream counterparts. These problems usually persist and often increase in severity through adolescence and into later life. There is growing acceptance of the potential value of co-designing services that recognise and address problems to improve the outcomes of young people with mental health problems yet to date, this methodological approach remains relatively unexplored in forensic service provision. Experience-based co-design (EBCD) is an approach to healthcare improvement that enables staff and service users to jointly co-design services. Central to the approach is the idea that understanding the experiences of service users and the 'touchpoints' (e.g., critical points or moments) in their journey through a service are integral to service improvement. The aim of this study was to explore whether EBCD could be applied to facilitate recognition of, and service developments for, young people presenting in community forensic settings. Qualitative methods used in this study included: observational fieldwork in four police custody suites (n = 30 hours), in-depth interviews with staff in community forensic services (n = 13) and researcher staff (n = 7). In this paper, the challenges of applying EBCD in community forensic settings with this population were: working with and across agencies; gaining access to participants; understanding knowledge and power dimensions amongst participants and understanding the context. This paper argues that innovative approaches to discovering the touchpoints for young people who offend - a key component of the EBCD approach - through combining analyses of secondary data and direct observations in community forensic settings can facilitate engagement with these specialist services and so provide access to relevant information about a group (i.e., young people who offend) who may be unable to participate directly in the EBCD process.
年轻人犯罪的心理健康需求已得到更广泛的认识，满足这些需求现在是政府和卫生机构的全球优先事项。犯罪的年轻人经历了一系列复杂的困难，他们的健康和社会结果比主流同龄人差得多。这些问题通常会持续存在，并且在青少年时期和以后的生活中往往会变得更加严重。越来越多的人接受了共同设计服务的潜在价值，这些服务认识和解决问题，以改善有心理健康问题的年轻人的结果，但迄今为止，这种方法在法医服务提供中仍相对未得到探索。基于经验的共同设计（EBCD）是一种改善医疗保健的方法，使员工和服务用户能够共同设计服务。该方法的核心思想是，了解服务用户的经验以及他们在服务中经历的“接触点”（例如，关键点或时刻）对于服务改进至关重要。这项研究的目的是探讨 EBCD 是否可以应用于促进在社区法医环境中识别和服务发展年轻人。本研究中使用的定性方法包括：在四个警察拘留室进行观察性实地工作（n = 30 小时），对社区法医服务中的工作人员（n = 13）和研究人员（n = 7）进行深入访谈。在本文中，EBCD 在具有这种人群的社区法医环境中的应用面临以下挑战：与机构合作并跨越机构；获得参与者的机会；理解参与者之间的知识和权力维度；理解背景。本文认为，通过结合分析社区法医环境中的二手数据和直接观察，探索犯罪年轻人的接触点的创新方法-这是 EBCD 方法的关键组成部分-可以促进与这些专业服务的接触，从而为提供有关可能无法直接参与 EBCD 过程的人群（即犯罪的年轻人）的相关信息。
