Bennett, Clare  ORCID: https://orcid.org/0000-0002-5144-3894, Fraser, Claire, Hannigan, Ben ORCID: https://orcid.org/0000-0002-2512-6721, Sawle, Leanne ORCID: https://orcid.org/0000-0001-8478-8816, Williams, Jessy, Jones, Aled, Elliott, Mair B., Elliott, Martin B. ORCID: https://orcid.org/0000-0002-8062-6913, Evans, Nicola ORCID: https://orcid.org/0000-0001-5154-0478, Hails, Euan, McMillan, Iain and Vaughan, Rachael ORCID: https://orcid.org/0000-0002-6951-8647
2025.
Towards a typology of mental health crisis care services for children and young people in England and Wales: a cross-sectional survey and analysis of implementation practices.
BMC Health Services Research
25
, 1587.
10.1186/s12913-025-13446-6
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Abstract
Background The mental health and wellbeing of children and young people is a global concern. Alongside approaches emphasising mental health promotion in schools, communities and in the home, many countries are also investing in crisis services. These aim to meet the needs of young people experiencing acute psychosocial distress. A recent synthesis of the international evidence found a paucity of research in this area. This study sought to address this gap while simultaneously situating the findings within the international context and drawing out implications for policymakers and practitioners. Methods A cross-sectional study aiming to describe and map approaches to the implementation and organisation of crisis care for children and young people was conducted across England and Wales. Complexity ideas, systems thinking and normalisation process theory conceptually underpinned the study. A bespoke survey captured service characteristics, service organisation and service user characteristics. It also incorporated the NoMAD tool to gather data on implementation. Usable data were received from 124 services. We used descriptive statistics and thematic analysis to summarise service characteristics and to develop a logic model. Typological analysis was used to develop a typology of service responses. NoMAD data were analysed using frequency analysis, item means and mean scale scores for each construct. Results The ‘community in-person rapid response’ is the most common approach to provision. However, our analysis captured a patchwork of diverse provision across the system, typified by an absence of consensus regarding definitions of ‘mental health crisis’, lack of common agreement relating to the goals of care, and multiplication of approaches to the organisation and provision of services. Despite this, high levels of within-service coherence, cognitive participation and reflexive monitoring were observed. Conclusions There is significant variation in the organisation and provision of crisis services for children and young people. Through situating our findings in a prevailing international policy context, we suggest that the variation we observe reflects an absence of a developed evidence base and a proliferation of strategies and frameworks which fail to provide clear guidance on how crisis care might best be organised and provided.
| Item Type: | Article |
|---|---|
| Date Type: | Published Online |
| Status: | Published |
| Schools: | Research Institutes & Centres > Children’s Social Care Research and Development Centre (CASCADE) Schools > Healthcare Sciences Schools > Social Sciences (Includes Criminology and Education) |
| Publisher: | BioMed Central |
| ISSN: | 1472-6963 |
| Date of First Compliant Deposit: | 9 September 2025 |
| Date of Acceptance: | 29 August 2025 |
| Last Modified: | 15 Dec 2025 09:44 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/180996 |
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