School of Health Sciences, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
School of Healthcare Sciences, Cardiff University, Heath Park Campus, Cardiff, CF14 4XN, UK.
BMC Health Serv Res. 2023 Apr 24;23(1):391. doi: 10.1186/s12913-023-09300-2.
Children and young people's (CYP) mental health is a major public health concern internationally and the recent Covid-19 pandemic has amplified these concerns. However, only a minority of CYP receive support from mental health services due to the attitudinal and structural barriers they and their families encounter. For over 20 years, report after report has consistently highlighted the shortcomings of mental health services for CYP in the United Kingdom and attempts to improve services have been largely unsuccessful. The findings reported in this paper are from a multi-stage study that aimed to develop a model of effective, high-quality service design for CYP experiencing common mental health problems. The aim of the stage reported here was to identify CYP's, parents' and service providers' perceptions of the effectiveness, acceptability and accessibility of services.
Case studies were conducted of nine different services for CYP with common mental health problems in England and Wales. Data were collected using semi-structured interviews with 41 young people, 26 parents and 41 practitioners and were analysed using the Framework approach. Patient and Public Involvement was integrated throughout the study with a group of young co-researchers participating in data collection and analysis.
Four key themes defined participants' perceptions of service effectiveness, acceptability and accessibility. Firstly, open access to support with participants highlighting the importance of self-referral, support at the point of need and service availability to CYP/parents. Secondly, the development of therapeutic relationships to promote service engagement which was based on assessment of practitioner's personal qualities, interpersonal skills and mental health expertise and underpinned by relational continuity. Thirdly, personalisation was viewed as promoting service appropriateness and effectiveness by ensuring support was tailored to the individual. Fourthly, the development of self-care skills and mental health literacy helped CYP/parents manage and improve their/their child's mental health problems.
This study contributes to knowledge by identifying four components that are perceived to be central to providing effective, acceptable and accessible mental health services for CYP with common mental health problems irrespective of service model or provider. These components could be used as the foundations for designing and improving services.
儿童和青少年的心理健康是国际上一个主要的公共卫生关注点，最近的新冠疫情加剧了人们对这一问题的担忧。然而，由于儿童及其家庭面临的态度和结构障碍，只有少数儿童能够获得心理健康服务的支持。20 多年来，一份又一份报告持续强调了英国儿童和青少年心理健康服务的不足，而改善服务的尝试在很大程度上并未取得成功。本文报告的研究结果来自一项多阶段研究，旨在为有常见心理健康问题的儿童和青少年设计一种有效的、高质量的服务模式。本文报告的研究阶段旨在确定儿童和青少年、家长和服务提供者对服务的有效性、可接受性和可及性的看法。
在英格兰和威尔士，对九种不同的针对有常见心理健康问题的儿童和青少年的服务进行了案例研究。研究采用半结构式访谈收集数据，共访谈了 41 名年轻人、26 名家长和 41 名从业者，采用框架法进行分析。患者和公众参与是整个研究的一部分，一组年轻的共同研究人员参与了数据收集和分析。
四个关键主题定义了参与者对服务有效性、可接受性和可及性的看法。首先，支持的开放获取，参与者强调了自我推荐、在需要时获得支持以及服务对儿童和青少年/家长的可及性的重要性。其次，发展治疗关系以促进服务参与，这是基于对从业者个人素质、人际交往能力和心理健康专业知识的评估，并以关系连续性为基础。第三，个性化被视为通过确保支持针对个人来促进服务的适当性和有效性。第四，培养自我保健技能和心理健康素养有助于儿童和青少年/家长管理和改善他们的心理健康问题。
本研究通过确定四个被认为是为有常见心理健康问题的儿童和青少年提供有效、可接受和可及的心理健康服务的核心组成部分，为知识做出了贡献，无论服务模式或提供者如何。这些组成部分可以用作设计和改进服务的基础。
