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Service design for children and young people with common mental health problems: literature review, service mapping and collective case study

Pryjmachuk, Steven, Kirk, Susan, Fraser, Claire, Evans, Nicola ORCID:, Lane, Rhiannon, Neill, Liz, Camacho, Elizabeth, Bower, Peter, Bee, Penny and McDougall, Tim 2024. Service design for children and young people with common mental health problems: literature review, service mapping and collective case study. Health and Social Care Delivery Research 12 , 13. 10.3310/DKRT6293

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Background The mental health of children/young people is a growing concern internationally. Numerous reports and reviews have consistently described United Kingdom children’s mental health services as fragmented, variable, inaccessible and lacking an evidence base. Little is known about the effectiveness of, and implementation complexities associated with, service models for children/young people experiencing ‘common’ mental health problems like anxiety, depression, attention deficit hyperactivity disorder and self-harm. Aim To develop a model for high-quality service design for children/young people experiencing common mental health problems by identifying available services, barriers and enablers to access, and the effectiveness, cost effectiveness and acceptability of such services. Design Evidence syntheses with primary research, using a sequential, mixed-methods design. Inter-related scoping and integrative reviews were conducted alongside a map of relevant services across England and Wales, followed by a collective case study of English and Welsh services. Setting Global (systematic reviews); England and Wales (service map; case study). Data sources Literature reviews: relevant bibliographic databases and grey literature. Service map: online survey and offline desk research. Case study: 108 participants (41 children/young people, 26 parents, 41 staff) across nine case study sites. Methods A single literature search informed both reviews. The service map was obtained from an online survey and internet searches. Case study sites were sampled from the service map; because of coronavirus disease 2019, case study data were collected remotely. ‘Young co-researchers’ assisted with case study data collection. The integrative review and case study data were synthesised using the ‘weaving’ approach of ‘integration through narrative’. Results A service model typology was derived from the scoping review. The integrative review found effectiveness evidence for collaborative care, outreach approaches, brief intervention services and the ‘availability, responsiveness and continuity’ framework. There was cost-effectiveness evidence only for collaborative care. No service model appeared to be more acceptable than others. The service map identified 154 English and Welsh services. Three themes emerged from the case study data: ‘pathways to support’; ‘service engagement’; and ‘learning and understanding’. The integrative review and case study data were synthesised into a coproduced model of high-quality service provision for children/young people experiencing common mental health problems. Limitations Defining ‘service model’ was a challenge. Some service initiatives were too new to have filtered through into the literature or service map. Coronavirus disease 2019 brought about a surge in remote/digital services which were under-represented in the literature. A dearth of relevant studies meant few cost-effectiveness conclusions could be drawn. Conclusions There was no strong evidence to suggest any existing service model was better than another. Instead, we developed a coproduced, evidence-based model that incorporates the fundamental components necessary for high-quality children’s mental health services and which has utility for policy, practice and research.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Publisher: NIHR Journals Library
ISSN: 2755-0079
Date of First Compliant Deposit: 29 May 2024
Date of Acceptance: 17 April 2024
Last Modified: 11 Jun 2024 11:30

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