The mental health of children and young people (CYP) is a national and international priority, with around one in ten UK CYP having a mental health difficulty that requires professional help. Most of this need lies with CYP experiencing a ‘common’ mental health problem (CMHP). These are commonly occurring problems like anxiety, depression, obsessive-compulsive disorder (OCD), self-harm, psychological trauma, issues relating to gender, sex and sexuality, and problems with emotions and behaviour that are often called ‘personality disorder’. CYP with these problems typically do not need to be admitted to hospital; if they do, it tends to be for a very short time or a very severe form of the problem.
More CYP with CMHPs are asking for help (or their parents, carers or teachers are) but it is often difficult to get help because services do not exist, are oversubscribed or depend on where the service user lives. When a service is available and used, it may turn out to be poor quality or unsuitable for the service user.
We want to explore the services available to these CYP in England & Wales. Most of these services will be community or out-patient services. We want to find out what services exist, how CYP and their families/carers find out about and access these services, what the services actually do, whether they are any good, and whether they offer value for money.
Our study has 4 work streams. In Stream 1 we will conduct an ‘evidence syntheses’. This involves us looking at the literature on services for CYP with CMHPs. This helps identify what services exist, what CYP and their families like about these services and what seems to work. In Stream 2, we will use a survey and the literature from Stream 1 to try to map all of the available services for CYP with CMHPs in England & Wales. Streams 1 & 2 combined will help us group services according to things they have in common or things they differ on, e.g. who provides the service (NHS or other), who it is for (a general service for CMHPs or one for a specific condition), how it is delivered (face-to-face, telephone or online, etc.), whether appointments are required or whether you can simply drop in. In Stream 3, we will pick 8-10 services from our Stream 2 service map and visit each one, talking to 5-10 service users (CYP and their families/carers), staff and managers in each service. We plan to take some young service users, who we will train as ‘co-researchers’, with us when we visit these services.
We will ask users of the services we visit to tell us their stories of trying to get help. We will also try to speak to people who couldn’t get help or didn’t want the particular help offered. We will look at relevant documents (e.g. policies and procedures) and, if possible and with permission from those involved, observe team or referral meetings. We will analyse our data using an approach called ‘framework’ to get some insights into how CYP and their families/carers find and access help and whether they found that help useful or not.
In Stream 4, the analyses from Streams 1-3 will be explored, compared and contrasted in order to create a model of effective and acceptable services for CYP with CMHPs that takes into account how these services are accessed, navigated and used.
Throughout our study, we will talk to young people and their parents/carers and to those who commission and provide services for them to ensure what we are doing remains relevant to them.