蛇梯棋：被转介至儿童及青少年心理健康服务机构并接受诊治的经历

Snakes and Ladders: The experience of being referred to and seen by Child and Adolescent Mental Health Services.

作者信息

Newman Kristina L, Sayal Kapil, Ewart Colleen, Lang Alexandra, Bhardwaj Anupam, Dubicka Bernadka, Marshall Tamsin, Thomson Louise

机构信息

Institute of Mental Health, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK.

Nottingham Trent University, Nottingham, UK.

出版信息

SSM Ment Health. 2024 Dec;6:100343. doi: 10.1016/j.ssmmh.2024.100343.

DOI:10.1016/j.ssmmh.2024.100343

PMID:39678451

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11635093/

Abstract

BACKGROUND

Referral processes in Child and Adolescent Mental Health Services (CAMHS) have been reported as stressful and inadequate by young people and parents/carers, who struggle during waiting periods for the referral outcome decision. The Covid19 pandemic was an unprecedented time of distress for young people, parents/carers, and healthcare staff, with increased mental health challenges and stretched staff having to adapt modes of care, thus exacerbating difficulties for CAMHS.

AIM

This qualitative study aimed to capture the unique lived experiences of young people, parents/carers, and CAMHS staff during the referral process in the peak of the Covid19 pandemic.

METHODS

As part of the STADIA trial, between 2020 and 2022, 109 semi-structured interviews across 8 NHS sites were conducted with young people (aged 16-17), parents/carers, and NHS staff including clinicians, commissioners, managers, and researchers embedded in clinical services. Interviews were analysed using thematic analysis.

RESULTS

Three themes were elicited to express young people, staff, and parents/carer experiences of the referral process, CAMHS, and the impact of Covid19: 1) referral as a starting point; 2) changes to methods of appointment delivery and their effect on CAMHS experience; and 3) experiences and evaluation of services.

CONCLUSION

Although CAMHS was seen as the pinnacle of mental health support, there was dissatisfaction with waiting times, limited communication, unclear referral processes, and limited clinical capacity and resources for young people, parent/carers, and staff. Covid19 forced CAMHS into adapting to a hybrid model of care, increasing accessibility for young people, parents/carers and staff and highlighting areas for improvement. Secure and consistent support and increases in staff resources are essential to address challenges with CAMHS delivery and improve the experiences of young people, parent/carers, and staff.

摘要

背景

儿童和青少年心理健康服务（CAMHS）的转诊流程据年轻人及其父母/照顾者反映，压力大且不完善，他们在等待转诊结果决定期间备受煎熬。新冠疫情对年轻人、父母/照顾者和医护人员来说是前所未有的困境时期，心理健康挑战增加，人手紧张的工作人员不得不调整护理模式，这加剧了CAMHS的困难。

目的

这项定性研究旨在捕捉新冠疫情高峰期年轻人、父母/照顾者和CAMHS工作人员在转诊过程中的独特生活经历。

方法

作为STADIA试验的一部分，2020年至2022年期间，在8个国民保健服务（NHS）站点对年轻人（16 - 17岁）、父母/照顾者以及包括临床医生、专员、管理人员和临床服务研究人员在内的NHS工作人员进行了109次半结构化访谈。采用主题分析法对访谈进行分析。

结果

得出了三个主题，以表达年轻人、工作人员和父母/照顾者在转诊过程、CAMHS以及新冠疫情影响方面的经历：1）转诊作为起点；2）预约方式的变化及其对CAMHS体验的影响；3）服务体验与评价。

结论

尽管CAMHS被视为心理健康支持的巅峰，但年轻人、父母/照顾者和工作人员对等待时间、沟通有限、转诊流程不清晰以及临床能力和资源有限表示不满。新冠疫情迫使CAMHS适应混合护理模式，提高了年轻人、父母/照顾者和工作人员的可及性，并突出了需要改进的领域。提供安全一致的支持和增加工作人员资源对于应对CAMHS服务挑战以及改善年轻人、父母/照顾者和工作人员的体验至关重要。