Implementing the THRIVE Framework for System Change in Greater Manchester: A mixed-methods service evaluation

Student thesis: Phd


This thesis documents a commissioned service evaluation of the implementation of the THRIVE Framework for System change, in the context of devolved child and adolescent mental health service transformation in the Greater Manchester area. Known locally as GM i-THRIVE, this nationwide initiative hopes to address the shortcomings of previous models of service provision, including that which was allocated under the well-established CAMHS tiered model. The key aims of the framework are ensuring that more children and young people (CYP) receive the support that they need, and that the options available are diversified. This thesis evaluated GM i-THRIVE from various angles, utilising a range of research methods. These areas of focus were pragmatically selected as the most important conduits through which positive changes to the CYP mental health landscape could be made. Two of the four studies in the thesis focussed on staff training. Through a qualitative systematic literature review (Study 1), the barriers to, and facilitators of, mental health training for all CYP-facing professionals were identified. Following this, a qualitative content analysis (Study 2) explored the extent to which these factors were evident in the experiences of those trained under GM i-THRIVE. The key aim of Study 3 was to establish whether reports of implementation progress from Greater Manchester localities matched whether "THRIVE-like" care was experienced by CYP. It also assessed the quality of evaluation tools used by GM i-THRIVE, to draw overarching meta-inferences on progress made. Finally, Study 4 interviewed a range of professionals on the topic of sustainable practice within GM i-THRIVE. Ensuring that an intervention is "built to last" during the earliest stages of implementation is vital if changes made are to be widespread and enduring. Areas of strength and weakness identified in these testimonies were highlighted using qualitative framework analysis. The discussion section of the thesis collates and contextualises the findings from all four studies in terms of what we know (and do not know) following this evaluation. Elements from the introductory chapter of the thesis, which placed models of mental health provision within the current social, political, and economic climate, are drawn upon in light of the insights produced.
Date of Award1 Aug 2023
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorNeil Humphrey (Supervisor) & Pamela Qualter (Supervisor)

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