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Leahy D, McNicholas F. Systematic review of effectiveness and satisfaction evaluation in child and adolescent mental health services in Ireland. Ir J Psychol Med 2024; 41:107-118. [PMID: 33757610 DOI: 10.1017/ipm.2021.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Increasing numbers of youth experience mental illness, and also require and benefit from specialist child and adolescent mental health services (CAMHS). Worldwide, such services are underfunded and under-resourced, and services in Ireland are no different. It is vital that existing services are regularly reviewed for both efficacy and acceptability. Our objective was to review published studies evaluating service user satisfaction with CAMHS in Ireland and CAMHS therapeutic efficacy. METHODS MEDLINE, PsycINFO and CINAHL databases were systematically searched. Studies were included if they reported on service user satisfaction or an evaluation of CAMHS in Ireland. RESULTS From an initial 125 articles identified, 15 studies meet the inclusion criteria: four reporting on overall CAMHS satisfaction, three on satisfaction where a specific diagnosis was present, while eight evaluated various interventions offered. Whilst most service users perceived services to be satisfactory, important issues relating to accessibility were present. Evidence of efficacy was present for a small number of interventions, but studies were limited by methodological issues. CONCLUSIONS There is a dearth of studies evaluating CAMHS in Ireland. The extant literature suggests a positive experience once accessed, but long waiting times and poor collaboration are seen to limit services users' experience. More robust methodologically sound studies are urgently required. Given the expected increased demand linked to the current COVID-19 pandemic, coupled with the resultant compromised financial position, it is essential that scant resources are appropriately directed.
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Affiliation(s)
- D Leahy
- Department of Child and Adolescent Psychiatry North Lee North, Unit 9 St Stephen's Hospital, Glanmire, Cork, Ireland
| | - F McNicholas
- Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Lucena CAMHS, SJOG, Rathgar, Dublin 6, Ireland
- CHI Crumlin, Dublin 12, Ireland
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2
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Joulaei H, Fatemi M, Joulaei R, Heydari MR, Pourmontaseri AR, Foroozanfar Z. Determinants of unmet needs for mental health services amongst adolescents in Shiraz, Iran: a cross-sectional study. Front Public Health 2024; 12:1265611. [PMID: 38379675 PMCID: PMC10876837 DOI: 10.3389/fpubh.2024.1265611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/10/2024] [Indexed: 02/22/2024] Open
Abstract
Background Mental disorders are increasingly prevalent among adolescents without appropriate response. There are a variety of reasons for unmet mental health needs, including attitudinal and structural barriers. Accordingly, we investigated perceived mental health needs, using mental health services, and their barriers in adolescents. Method This cross-sectional study was conducted in 2022 in Shiraz, Iran. Demographic characteristics, the Adolescent Unmet Needs Checklist, and the Young Schema Questionnaire were administered to 348 adolescents aged 13-19 years. Adolescents were classified as having no needs, fully met needs, partially met needs, or wholly unmet needs. Logistic regression analysis was used to determine factors associated with perceived unmet need and refer participants to healthcare centers. Results 193 (55.5%) adolescents reported perceived need for mental healthcare out of whom, 21.6% reported fully and 21.6% partially unmet needs. Noticeably, only 12.4% of needy participants reported met need. "Reluctance to seek mental healthcare" and "asked but not receiving help" were common barriers to using the services. Conclusion The present study reveals unmet mental healthcare needs as a significant public health concern among the adolescents. To address this significant concern, reorientation of primary care, removing economic barriers from mental healthcare services, and improving health literacy in the community are recommended.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Fatemi
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Razieh Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Heydari
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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3
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Alyousef SM, Alhamidi SA. Nurse views of obstacles encountered by nurses in Saudi Arabia during the provision of psychiatric care. Arch Psychiatr Nurs 2023; 44:8-17. [PMID: 37197867 DOI: 10.1016/j.apnu.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 02/13/2023] [Accepted: 03/11/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Nursing staff within the mental health sector are major actors in delivering healthcare. They face considerable obstacles that may hinder the provision of high-quality care to patients with mental health challenges. AIM The current study offers a description of mental health nurses' viewpoints, insights into obstacles encountered during their experiences, and recommendations for enhancing psychiatric inpatient nursing care and achieving progress toward the goals set out by Saudi Vision 2030. METHODS The study employed a phenomenological qualitative design. Semistructured interviews were conducted with 10 currently practicing mental health nurses during two focus group sessions. The inductive data produced underwent member and peer checking. Emergent themes and subthemes were extracted. RESULTS Two main themes and related subthemes were identified. The first theme-obstacles faced by mental health nurses-was composed of the following subthemes: policy at institutions; clear job roles; low professional self-confidence and inadequate support; stressed, insecure, and unsafe; and stigmatization. The second theme-recommendations to improve the quality of mental health nursing-was composed of two subthemes: to enhance mental health awareness and improve professional skills and education. CONCLUSION The data suggest that maintaining high-quality nursing standards within an inpatient psychiatric facility requires a consistent and accountable organizational structure, which can lead to fostering the development and improvement of relevant nursing skills through continuing education, improved awareness of mental health disorders and care within the community, and initiatives to combat the stigma of mental disorders among patients, families, and communities.
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Affiliation(s)
- Seham Mansour Alyousef
- Community and Psychiatric Department, Nursing College, King Saud University, P.O. Box 54995, Riyadh 11524, Saudi Arabia.
| | - Sami Abdulrahman Alhamidi
- Department of Maternal and Child Health, Nursing College, Postgraduate and Research Center, King Saud University, P.O. Box 54995, Riyadh 11524, Saudi Arabia.
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Kirk S, Fraser C, Evans N, Lane R, Crooks J, Naughton G, Pryjmachuk S. Perceptions of the key components of effective, acceptable and accessible services for children and young people experiencing common mental health problems: a qualitative study. BMC Health Serv Res 2023; 23:391. [PMID: 37095463 PMCID: PMC10123588 DOI: 10.1186/s12913-023-09300-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/16/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Children and young people's (CYP) mental health is a major public health concern internationally and the recent Covid-19 pandemic has amplified these concerns. However, only a minority of CYP receive support from mental health services due to the attitudinal and structural barriers they and their families encounter. For over 20 years, report after report has consistently highlighted the shortcomings of mental health services for CYP in the United Kingdom and attempts to improve services have been largely unsuccessful. The findings reported in this paper are from a multi-stage study that aimed to develop a model of effective, high-quality service design for CYP experiencing common mental health problems. The aim of the stage reported here was to identify CYP's, parents' and service providers' perceptions of the effectiveness, acceptability and accessibility of services. METHODS Case studies were conducted of nine different services for CYP with common mental health problems in England and Wales. Data were collected using semi-structured interviews with 41 young people, 26 parents and 41 practitioners and were analysed using the Framework approach. Patient and Public Involvement was integrated throughout the study with a group of young co-researchers participating in data collection and analysis. RESULTS Four key themes defined participants' perceptions of service effectiveness, acceptability and accessibility. Firstly, open access to support with participants highlighting the importance of self-referral, support at the point of need and service availability to CYP/parents. Secondly, the development of therapeutic relationships to promote service engagement which was based on assessment of practitioner's personal qualities, interpersonal skills and mental health expertise and underpinned by relational continuity. Thirdly, personalisation was viewed as promoting service appropriateness and effectiveness by ensuring support was tailored to the individual. Fourthly, the development of self-care skills and mental health literacy helped CYP/parents manage and improve their/their child's mental health problems. CONCLUSIONS This study contributes to knowledge by identifying four components that are perceived to be central to providing effective, acceptable and accessible mental health services for CYP with common mental health problems irrespective of service model or provider. These components could be used as the foundations for designing and improving services.
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Affiliation(s)
- Susan Kirk
- School of Health Sciences, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Claire Fraser
- School of Health Sciences, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Nicola Evans
- School of Healthcare Sciences, Cardiff University, Heath Park Campus, Cardiff, CF14 4XN, UK
| | - Rhiannon Lane
- School of Healthcare Sciences, Cardiff University, Heath Park Campus, Cardiff, CF14 4XN, UK
| | - Jodie Crooks
- The McPin Foundation, 7-14 Great Dover Street, London, SE1 4YR, UK
| | - Georgia Naughton
- The McPin Foundation, 7-14 Great Dover Street, London, SE1 4YR, UK
| | - Steven Pryjmachuk
- School of Health Sciences, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
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Taylor H. “The Parallel Dialogue”: Parental experience of their role in the relationship with their child's counsellor/psychotherapist. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- Helen Taylor
- Counselling & Psychotherapy University of East London London UK
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6
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A M, K LBC, E S, S C, P F. A protocol for a multi-site cohort study to evaluate child and adolescent mental health service transformation in England using the i-THRIVE model. PLoS One 2023; 18:e0265782. [PMID: 37155627 PMCID: PMC10166497 DOI: 10.1371/journal.pone.0265782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/14/2023] [Indexed: 05/10/2023] Open
Abstract
The National i-THRIVE Programme seeks to evaluate the impact of the NHS England-funded whole system transformation on child and adolescent mental health services (CAMHS). This article reports on the design for a model of implementation that has been applied in CAMHS across over 70 areas in England using the 'THRIVE' needs-based principles of care. The implementation protocol in which this model, 'i-THRIVE' (implementing-THRIVE), will be used to evaluate the effectiveness of the THRIVE intervention is reported, together with the evaluation protocol for the process of implementation. To evaluate the effectiveness of i-THRIVE to improve care for children and young people's mental health, a cohort study design will be conducted. N = 10 CAMHS sites that adopt the i-THRIVE model from the start of the NHS England-funded CAMHS transformation will be compared to N = 10 'comparator sites' that choose to use different transformation approaches within the same timeframe. Sites will be matched on population size, urbanicity, funding, level of deprivation and expected prevalence of mental health care needs. To evaluate the process of implementation, a mixed-methods approach will be conducted to explore the moderating effects of context, fidelity, dose, pathway structure and reach on clinical and service level outcomes. This study addresses a unique opportunity to inform the ongoing national transformation of CAMHS with evidence about a popular new model for delivering children and young people's mental health care, as well as a new implementation approach to support whole system transformation. If the outcomes reflect benefit from i-THRIVE, this study has the potential to guide significant improvements in CAMHS by providing a more integrated, needs-led service model that increases access and involvement of patients with services and in the care they receive.
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Affiliation(s)
- Moore A
- The Anna Freud National Centre for Children and Families, London, United Kingdom
- Psychoanalysis Unit, Division of Psychology and Language Sciences, University College London, London, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Lindley Baron-Cohen K
- Psychoanalysis Unit, Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Simes E
- The Anna Freud National Centre for Children and Families, London, United Kingdom
- Psychoanalysis Unit, Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Chen S
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Fonagy P
- The Anna Freud National Centre for Children and Families, London, United Kingdom
- Psychoanalysis Unit, Division of Psychology and Language Sciences, University College London, London, United Kingdom
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Ishay GH, Zisman-Ilani Y, Roe D. A longitudinal study of headspace youth oriented mental health service satisfaction, service utilization and clinical characteristics. Early Interv Psychiatry 2022; 17:404-411. [PMID: 35981970 DOI: 10.1111/eip.13347] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/21/2022] [Accepted: 07/05/2022] [Indexed: 11/28/2022]
Abstract
AIM This study examined satisfaction with accessibility, staff attitudes, personal outcomes service components of youth-oriented mental health service, Headspace, and those components' associations with psychological distress and functional status at intake, service utilization patterns and demographic characteristics at middle and end of treatment. METHODS Data were collected between March 2016 and June 2018 from 112 participants (12-25 years) who consented and completed at least seven sessions at the Headspace youth integrated-care centre in Israel using the centre's registries and the Youth Service Satisfaction Scale. RESULTS Headspace participants attended an average of 12 sessions (SD = 3.12), they waited up to 2 weeks for their first intake (n = 57; 73%), after which most were offered a psychotherapy session (n = 80, 71%) within 2 months. Participants' satisfaction with Headspace was above the mid-point for all service aspects. The overall effect for time was not significant, F(1) = 1.14, p > .05. However, a significant increase in satisfaction with personal outcomes was found between the middle and the end of treatment, F(2,4) = 3.11, p < .05 compared to all other aspects. The length of waiting time, level of distress, number of sessions attended by parents and age were correlated with satisfaction. Correlations were found with waiting time, distress level, number of sessions attended by parents and age. CONCLUSIONS High levels of satisfaction with Headspace service aspects strengthens the evidence for areas of importance in designing youth mental health services: youth-friendly staff, general environment, accessibility and outcomes achievement.
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Affiliation(s)
- Gili Hoter Ishay
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Yaara Zisman-Ilani
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - David Roe
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Kirker RS, Brown J, Clarke S. Children and Young People’s Experiences of Mental Health Services in Healthcare Settings: An Integrated Review. Compr Child Adolesc Nurs 2022. [DOI: 10.1080/24694193.2021.1974605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Rachael Sarah Kirker
- School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, Belfast, UK
| | - Julie Brown
- School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, Belfast, UK
| | - Sonya Clarke
- School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, Belfast, UK
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Barratt M, Bail K, Paterson C. Children living with long-term conditions and their experiences of partnership in nursing care: An integrative systematic review. J Clin Nurs 2022. [PMID: 35768938 DOI: 10.1111/jocn.16429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/01/2022] [Accepted: 06/09/2022] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVE To describe the experiences of nursing care and partnership nursing as expressed by children living with long-term conditions. BACKGROUND Children with long-term conditions have higher rates of hospitalisations and adverse events in hospital, yet little is known about their experiences of nursing care. How children perceive partnership in care with their families and nurses is of interest in the achievement of safe and effective care DESIGN: An integrative review following Joanna Briggs Institute protocols for systematic reviews. METHOD An integrative review was chosen following Joanna Briggs Institute protocols for systematic reviews. A total of 5150 articles were screened, with 251 full-text publications reviewed. A total of 21 studies were included, three mixed-method studies and 18 qualitative studies. This review has been reported as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Four integrated findings were identified: "Children are aware of their surroundings and needs," "Children value positive communication," "Children want to be recognised as an individual in the triadic relationship, and this can be done through nurses using tailored play;" and "Children seek a shared decision-making process." DISCUSSION Children wanted to be seen as an individual in Children and Young People's nursing as well as a child who craves security, fun and comfort, both from their families and nursing staff. Children described observing partnership between nursing staff and parents but felt uninvolved, with some children craving more knowledge and power to better understand their long-term condition. RELEVANCE TO CLINICAL PRACTICE Further research is required on how Children and Young People's nursing staff can better support children and empower them to be active members in the shared decision-making process if the child wishes to be involved.
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Affiliation(s)
- Macey Barratt
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Kasia Bail
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, Australian Capital Territory, Australia.,Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate Level 3, Canberra Hospital, Canberra, Australia.,Prehabilitation, Activity, Cancer Exercises and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Australia.,Robert Gordon University, Aberdeen, UK
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Gugglberger L, Flaschberger E, Degelsegger-Márquez A. [Children's rights in Austrian hospitals: implementation factors for children's participation]. Monatsschr Kinderheilkd 2022:1-7. [PMID: 35578683 PMCID: PMC9097564 DOI: 10.1007/s00112-022-01505-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/24/2022] [Indexed: 11/28/2022]
Abstract
Background Various studies show that it is important for children and adolescents (as well as their parents) to be involved and have a say in decisions regarding treatment. Nevertheless, it seems that participation processes are not necessarily implemented into hospital routines everywhere. So far, no study has been conducted on the implementation of children's rights or participation in Austrian hospitals. Objective Our study aimed at investigating the extent to which children's rights (especially the right to participation) and the European Association of Children in Hospital (EACH) Charter are known in Austrian hospitals, how they are implemented, and which facilitating and hindering factors can be identified. Methods A questionnaire survey was conducted among the chief medical and nursing staff on wards where children and adolescents are treated (n = 133), and qualitative interviews were conducted with experts on children's rights, medical and nursing staff, parents and one adolescent girl (n = 15). The results and recommendations for action that were derived from the data were discussed and validated in an expert workshop. Results The medical and nursing staff in Austrian children's and adolescents' wards are already doing a lot to implement and uphold children's rights. There is awareness of the need for child-centered treatment and the need to allow children and adolescents to participate during their hospital stay. Nevertheless, the interviews with parents show that there are large differences between hospitals and that there is still a lot to be done. Conclusion Based on the results, three areas for recommendations for action were identified: 1) anchoring children's rights, both legally and in the training of medical and nursing staff, 2) strengthening the team and feedback culture, e.g., through more staff resources for good teamwork and 3) good health information and good conversation quality. This means that health information for children and adolescents should be quality assured, comprehensible, evidence-based and on aspects relevant to them. Conversations between health professionals and patients and their relatives, should be patient-centered, which can be promoted through training, introduction of quality standards and guidelines.
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Gilmartin D, McElvaney R, Corbally M. “Talk to me like I’m a human” An interpretative phenomenological analysis of the psychotherapy experiences of young people in foster care in Ireland. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2062702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Daire Gilmartin
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Five Rivers Fostering, Blanchardstown, Dublin 15, Ireland
| | - Rosaleen McElvaney
- School of Nursing, Psychotherapy and Communty Health, Dublin City University. St. Clare's Unit, Children's Health Ireland at Connolly, Blanchardstown, Dublin 15, Ireland
| | - Melissa Corbally
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Ireland
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Viksveen P, Bjønness SE, Cardenas NE, Game JR, Berg SH, Salamonsen A, Storm M, Aase K. User involvement in adolescents' mental healthcare: a systematic review. Eur Child Adolesc Psychiatry 2022; 31:1765-1788. [PMID: 34089383 PMCID: PMC9666298 DOI: 10.1007/s00787-021-01818-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/31/2021] [Indexed: 12/29/2022]
Abstract
More than one out of ten adolescents suffer from mental illness at any given time. Still, there is limited knowledge about their involvement in mental healthcare. Adolescents have the right to be involved in decisions affecting their healthcare, but limited research focuses on their engagement and decision-making. Therefore, this systematic review aims to explore the existing experiences with, the effectiveness of, and safety issues associated with user involvement for adolescents' mental healthcare at the individual and organizational level. A systematic literature review on user involvement in adolescents' mental healthcare was carried out. A protocol pre-determined the eligibility criteria and search strategies, and established guidelines were used for data extraction, critical appraisal, and reporting of results. Quantitative studies were analysed individually due to heterogeneity of the studies, while qualitative studies were analysed using thematic synthesis. A total of 31 studies were included in the review. The experiences with user involvement were reported in 24 studies with three themes at the individual level: unilateral clinician control versus collaborative relationship, capacity and support for active involvement, the right to be involved; and two themes at the organizational level: involvement outcomes relevant to adolescents' needs, conditions for optimal involvement. The effectiveness of user involvement was reported in seven studies documenting fragmented evidence related to different support structures to facilitate adolescents' involvement. The safety associated with user involvement was not reported in any studies, yet a few examples related to potential risks associated with involvement of adolescents in decision-making and as consultants were mentioned.
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Affiliation(s)
- Petter Viksveen
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
| | - Stig Erlend Bjønness
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Nicole Elizabeth Cardenas
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Faculty of Health Sciences, University of Aberdeen, Aberdeen, Scotland
| | - Julia Rose Game
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Faculty of Medicine, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Siv Hilde Berg
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
| | - Anita Salamonsen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North (RKBU North), Faculty of Health Sciences, UiT The Arctic University of Norway, Langnes, P.O. Box 6050, Tromsø, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Karina Aase
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
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Longhurst P, Sumner AL, Smith S, Eilenberg J, Duncan C, Cooper M. ‘They need somebody to talk to’: Parents' and carers' perceptions of school‐based humanistic counselling. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Phaedra Longhurst
- British Association for Counselling and Psychotherapy (BACP) Lutterworth UK
| | | | - Stephanie Smith
- National Children's Bureau (NCB) University of Roehampton London UK
| | - Jon Eilenberg
- National Children's Bureau (NCB) University of Roehampton London UK
| | - Charlie Duncan
- British Association for Counselling and Psychotherapy (BACP) Lutterworth UK
| | - Mick Cooper
- School of Psychology University of Roehampton London UK
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Davison G, Kelly MA, Conn R, Thompson A, Dornan T. How do children and adolescents experience healthcare professionals? Scoping review and interpretive synthesis. BMJ Open 2021; 11:e054368. [PMID: 34244289 PMCID: PMC8273482 DOI: 10.1136/bmjopen-2021-054368] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/22/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Explore children's and adolescents' (CADs') lived experiences of healthcare professionals (HCPs). DESIGN Scoping review methodology provided a six-step framework to, first, identify and organise existing evidence. Interpretive phenomenology provided methodological principles for, second, an interpretive synthesis of the life worlds of CADs receiving healthcare, as represented by verbatim accounts of their experiences. DATA SOURCES Five key databases (Ovid Medline, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Web of Science), from inception through to January 2019, reference lists, and opportunistically identified publications. ELIGIBILITY CRITERIA Research articles containing direct first-person quotations by CADs (aged 0-18 years inclusive) describing how they experienced HCPs. DATA EXTRACTION AND SYNTHESIS Tabulation of study characteristics, contextual information, and verbatim extraction of all 'relevant' (as defined above) direct quotations. Analysis of basic scope of the evidence base. The research team worked reflexively and collaboratively to interpret the qualitative data and construct a synthesis of children's experiences. To consolidate and elaborate the interpretation, we held two focus groups with inpatient CADs in a children's hospital. RESULTS 669 quotations from 99 studies described CADs' experiences of HCPs. Favourable experiences were of forming trusting relationships and being involved in healthcare discussions and decisions; less favourable experiences were of not relating to or being unable to trust HCPs and/or being excluded from conversations about them. HCPs fostered trusting relationships by being personable, wise, sincere and relatable. HCPs made CADs feel involved by including them in conversations, explaining medical information, and listening to CADs' wider needs and preferences. CONCLUSION These findings strengthen the case for making CADs partners in healthcare despite their youth. We propose that a criterion for high-quality child-centred healthcare should be that HCPs communicate in ways that engender trust and involvement.
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Affiliation(s)
- Gail Davison
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- Children's Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Martina Ann Kelly
- Department of Family Medicine, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada
| | - Richard Conn
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- General Paediatrics Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Andrew Thompson
- General Paediatrics Department, Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Tim Dornan
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
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15
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Farr J, Moore A, Bruffell H, Hayes J, Rae JP, Cooper M. The impact of a needs-based model of care on accessibility and quality of care within children's mental health services: A qualitative investigation of the UK i-THRIVE Programme. Child Care Health Dev 2021; 47:442-450. [PMID: 33559932 DOI: 10.1111/cch.12855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 09/28/2020] [Accepted: 02/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The i-THRIVE Programme is a needs-based model of care, based on the THRIVE Framework, that is being implemented across the United Kingdom with the aim of improving outcomes for children and young people's mental health and wellbeing. This study aimed to investigate the impact that this programme has on accessibility and quality of care, as viewed by key stakeholders. METHODS Interviews with professionals and service users were conducted during the implementation of the THRIVE Framework in four sites of one mental health and community service provider. RESULTS Three themes are identified: 'impact of needs-based groupings on referral', 'impact of collaborative and interagency approach' and 'impact of i-THRIVE on clinical practice'. Findings suggest that accessibility was seen to be promoted through the integration of a needs-based approach, flexible re-referral, signposting and information sharing, the use of goal-orientated interventions and collaboration over risk and treatment endings. Shared decision making was perceived to improve the experience of care for young people, as was interagency working. Goal-focused interventions and upfront discussion of treatment endings were seen to help clinicians manage expectations and discharge but could also compromise effectiveness and engagement. Obstacles to impact were resistance to interagency working and a shortage of resources across the system. CONCLUSIONS i-THRIVE is a promising approach with the potential to facilitate the accessibility and quality of mental health care. However, a tension exists between enhancing accessibility and quality of care, which points towards the importance of outcome and satisfaction monitoring. Obstacles to impact point to the importance of a whole-system approach supported by sufficient resources across the locality.
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Affiliation(s)
- Joanna Farr
- Department of Psychology, University of Roehampton, London, UK
| | - Anna Moore
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Department of Psychiatry, University of Cambridge, UK
| | - Hilary Bruffell
- Department of Psychology, University of Roehampton, London, UK
| | | | - John P Rae
- Department of Psychology, University of Roehampton, London, UK
| | - Mick Cooper
- Department of Psychology, University of Roehampton, London, UK
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16
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Merayo-Sereno B, Fernández-Rivas A, de Oliveira-Silva KL, Sánchez-Andérez FJ, Sesma-Pardo E, Vivanco-González E, González-Torres MÁ. The experience of parents faced with the admission of their adolescent to a child and adolescent psychiatric inpatient unit. A qualitative study with focus groups. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01901-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractThe admission of an adolescent to a child and adolescent psychiatric inpatient unit has a serious impact on the entire family unit. The emotional experience of those primary caregivers has been scarcely studied qualitatively despite being recommended by previous research. This study aims to examine the experience of parents of adolescents with mental health needs that required psychiatric hospitalization in a child and adolescent unit. Qualitative cross-sectional research was carried out under the recommendations of Grounded Theory with three Focus Groups of parents (N = 22) of adolescents who required psychiatric hospitalization in a child and adolescent ward. The COREQ quality criteria were applied. The parental experience implies a high level of emotional suffering modulated by feelings of guilt, stigma, parental awareness of their child’s illness and the passage of time. The use of Prochaska’s and Diclemente’s trans-theoretical model of health behavior change is useful in understanding the parental experience.
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17
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Hawke LD, Thabane L, Wilkins L, Mathias S, Iyer S, Henderson J. Don't Forget the Caregivers! A Discrete Choice Experiment Examining Caregiver Views of Integrated Youth Services. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 14:791-802. [PMID: 33855684 PMCID: PMC8046579 DOI: 10.1007/s40271-021-00510-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 11/21/2022]
Abstract
Background The design and implementation of community-based integrated youth service hubs (IYSHs) is burgeoning around the world. This collaborative model of care aims to address barriers in youth service access by designing services that meet the needs of youth and caregivers. However, heterogeneity across models requires a better understanding of the preferences for key service characteristics. Method A discrete choice experiment was conducted among 274 caregivers of youth aged 14–29 years with mental health challenges. The experiment consisted of 12 attributes with four levels each, representing different service components; additional measures were collected, including demographics and burden assessments. Utility values were calculated, representing the degree of preference for a given level of an attribute. Latent class analysis was conducted to understand subgroups with different service preferences, identifying three latent classes with differing IYSH service preferences. Results The largest class (n = 173, 63.1%), entitled ‘Comprehensive, Integrative Service Access’, strongly valued practical aspects of service design, such as rapid access and support for a wide range of needs. The ‘Service Process Features’ class (n = 67, 24.5%) expressed a relative prioritization of process features of service access, while the smaller ‘Caregiver Involvement’ (n = 34, 12.4%) class most highly prioritized caregiver involvement in their youths’ services. Similar demographic characteristics and caregiver burden were found across classes, although participants in the Caregiver Involvement latent class were supporting younger youth. Discussion and Conclusions Caregivers have diverse youth service preferences and relative priorities that should be taken into account when designing services. System designers and service providers are encouraged to take caregivers’ preferences and priorities into account, alongside youth priorities, whether designing service delivery models or an individual service plan for a youth. Supplementary Information The online version contains supplementary material available at 10.1007/s40271-021-00510-6.
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Affiliation(s)
- Lisa D Hawke
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health; University of Toronto, Toronto, ON, Canada
| | - Lehana Thabane
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Leanne Wilkins
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Srividya Iyer
- McGill University; ACCESS Open Minds (Youth Mental Health Services Research Network), Montreal, QC, Canada
| | - Joanna Henderson
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health; University of Toronto, Toronto, ON, Canada.
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18
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Partizipation von Patienten im Kontext der stationären Kinder- und Jugendpsychiatrie – ein Scoping Review. Prax Kinderpsychol Kinderpsychiatr 2020; 69:700-719. [DOI: 10.13109/prkk.2020.69.8.700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Sheng Q, Zhang X, Cai C, Shi Y. Parents' Experiences of Caring for Their Only Child With Mental Illness in China: A Qualitative Study. J Psychosoc Nurs Ment Health Serv 2020; 59:29-37. [PMID: 33095263 DOI: 10.3928/02793695-20201001-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022]
Abstract
The current study explored Chinese parents' experiences of caring for their only child with mental illness. Face-to-face interviews with semi-structured questions were conducted to learn about the care experiences of parents whose only child had mental illness. Purposeful sampling was used to recruit parents (n = 14) and thematic analysis was used. Five themes were identified: (1) Having Responsibility to Care for Children, (2) Feeling Guilt and Self-Blame, (3) Experiencing Loneliness and Helplessness, (4) Drained by Caregiving, and (5) Worrying About the Future. Parents who cared for their only child with mental illness experienced considerable emotional and physical challenges. Professionals and health care providers should recognize and understand the experiences of these parents to identity their needs and provide adequate support. Targeted support services and appropriate professional information should be developed and provided for parents to relieve them of negative caregiving experiences and improve their psychological and physical well-being. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 29-37.].
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20
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Croucher L, Mertan E, Shafran R, Bennett SD. The Use of Mumsnet by Parents of Young People With Mental Health Needs: Qualitative Investigation. JMIR Ment Health 2020; 7:e18271. [PMID: 32880583 PMCID: PMC7499161 DOI: 10.2196/18271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There are high rates of mental health needs in children in the United Kingdom, and parents are increasingly seeking help for their children's needs. However, there is not enough access to child and adolescent mental health services and parents are seeking alternative forms of support and information, often from web-based sources. Mumsnet is the largest web-based parenting forum in the United Kingdom, which includes user-created discussions regarding child mental health. OBJECTIVE This qualitative investigation aimed to explore the emergent themes within the narratives of posts regarding child mental health on Mumsnet and to extrapolate these themes to understand the purpose of Mumsnet for parents of children and young people with mental health needs. METHODS A total of 50 threads from Mumsnet Talk Child Mental Health were extracted. Following the application of inclusion and exclusion criteria, 41 threads were analyzed thematically using the framework approach, a form of qualitative thematic analysis. RESULTS In total, 28 themes were extracted and organized into 3 domains. These domains were emotional support, emotional expression, and advice and information. The results suggested that parents of children with mental health needs predominantly use Mumsnet to offer and receive emotional support and to suggest general advice, techniques, and resources that could be applied outside of help from professional services. CONCLUSIONS This paper discusses the future of health information seeking. Future research is required to establish initiatives in which web-based peer-to-peer support and information can supplement professional services to provide optimum support for parents of children with mental health needs.
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Affiliation(s)
- Lauren Croucher
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Elif Mertan
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Roz Shafran
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Sophie D Bennett
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
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21
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Orchard F, Pass L, Chessell C, Moody A, Ellis J, Reynolds S. Adapting Brief CBT-I for Depressed Adolescents: A Case Illustration of the Sleeping Better Program. COGNITIVE AND BEHAVIORAL PRACTICE 2020. [DOI: 10.1016/j.cbpra.2019.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Hendrickx G, De Roeck V, Maras A, Dieleman G, Gerritsen S, Purper-Ouakil D, Russet F, Schepker R, Signorini G, Singh SP, Street C, Tuomainen H, Tremmery S. Challenges during the transition from child and adolescent mental health services to adult mental health services. BJPsych Bull 2020; 44:163-168. [PMID: 31931898 PMCID: PMC8058856 DOI: 10.1192/bjb.2019.85] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The transition from child and adolescent to adult mental health services for young people with mental health problems is of international concern. Despite the high prevalence of mental disorders during adolescence and their tendency to continue during adulthood, the majority of young people do not experience continuity of care. The aim of this review paper is to unravel the complexity of transitional mental healthcare to clinicians, policy makers and mental health service managers, and to address challenges to a smooth transition process at all levels.
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Affiliation(s)
- Gaelle Hendrickx
- Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Belgium
| | - Veronique De Roeck
- Department of Neurosciences, Child and Adolescent Psychiatry, KU Leuven, Belgium
| | - Athanasios Maras
- Yulius Academy, Yulius Mental Health Organization, The Netherlands
| | - Gwen Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, The Netherlands
| | - Suzanne Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, The Netherlands
| | - Diane Purper-Ouakil
- Child and Adolescent Psychiatry Unit, University Hospital of Montpellier, France
| | - Frédérick Russet
- Child and Adolescent Psychiatry Unit, University Hospital of Montpellier, France
| | | | - Giulia Signorini
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Italy
| | | | - Cathy Street
- Warwick Medical School, University of Warwick, UK
| | | | - Sabine Tremmery
- Department of Neurosciences, Child and Adolescent Psychiatry, KU Leuven, Belgium
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23
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Bjønness S, Viksveen P, Johannessen JO, Storm M. User participation and shared decision-making in adolescent mental healthcare: a qualitative study of healthcare professionals' perspectives. Child Adolesc Psychiatry Ment Health 2020; 14:2. [PMID: 31988656 PMCID: PMC6969458 DOI: 10.1186/s13034-020-0310-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/07/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Most mental health problems occur in adolescence. There is increasing recognition of user participation and shared decision-making in adolescents' mental healthcare. However, research in this field of clinical practice is still sparse. The objective of this study was to explore healthcare professionals' perspectives on user participation, and opportunities for shared decision-making in Child and Adolescent Mental Health Service (CAMHS) inpatient units. METHODS Healthcare professionals at CAMHS inpatient units participated in three focus group interviews. Fifteen participants with experience with user participation and shared decision-making were recruited from five hospitals in Norway. RESULTS Five themes emerged: (1) involvement before admission; (2) sufficient time to feel safe; (3) individualized therapy; (4) access to meetings where decisions are made; and (5) changing professionals' attitudes and practices. CONCLUSION User participation and shared decision-making require changes in workplace culture, and routines that allow for individualized mental health services that are adapted to adolescents' needs. This calls for a flexible approach that challenges clinical pathways and short-stay hospital policies. The results of this study may inform further work on strengthening user participation and the implementation of shared decision-making.Trial registration Norwegian Regional Committees for Medical and Health Research Ethics, reference number 2017/1195.
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Affiliation(s)
- Stig Bjønness
- Centre for Resilience in Healthcare (SHARE), Department for Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Petter Viksveen
- Centre for Resilience in Healthcare (SHARE), Department for Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Jan Olav Johannessen
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
- Department for Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marianne Storm
- Department for Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Ashcraft LE, Asato M, Houtrow AJ, Kavalieratos D, Miller E, Ray KN. Parent Empowerment in Pediatric Healthcare Settings: A Systematic Review of Observational Studies. THE PATIENT 2019; 12:199-212. [PMID: 30328069 PMCID: PMC6397702 DOI: 10.1007/s40271-018-0336-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Parent empowerment is often an expressed goal in clinical pediatrics and in pediatric research, but the antecedents and consequences of parent empowerment are not well established. OBJECTIVE The objective of this systematic review was to synthesize potential antecedents and consequences of parent empowerment in healthcare settings. ELIGIBILITY CRITERIA The inclusion criteria were (1) studies with results about parent empowerment in the context of children's healthcare or healthcare providers; and (2) qualitative studies, observational studies, and systematic reviews of such studies. INFORMATION SOURCES We searched the databases of PubMed, Web of Science, and Google Scholar (2006-2017) and reference lists. INCLUDED STUDIES Forty-four articles met the inclusion criteria. SYNTHESIS OF RESULTS We identified six themes within consequences of empowerment: increased parent involvement in daily care, improved symptom management, enhanced informational needs and tools, increased involvement in care decisions, increased advocacy for child, and engagement in empowering others. Six themes summarizing antecedents of empowerment also emerged: parent-provider relationships, processes of care, experiences with medical care, experiences with community services, receiving informational/emotional support, and building personal capacity and narrative. We synthesized these findings into a conceptual model to guide future intervention development and evaluation. STRENGTHS AND LIMITATIONS OF EVIDENCE Non-English articles were excluded. INTERPRETATION Parent empowerment may enhance parent involvement in daily care and care decisions, improve child symptoms, enhance informational needs and skills, and increase advocacy and altruistic behaviors. Parent empowerment may be promoted by the parent-provider relationship and care processes, finding the right fit of medical and community services, and attention to the cognitive and emotional needs of parents. CLINICAL REGISTRATION NO PROSPERO 2017:CRD42017059478.
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Affiliation(s)
- Laura Ellen Ashcraft
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, 4200 Fifth Avenue, Pittsburgh, PA, 15260, USA.
- University of Pittsburgh School of Social Work, Pittsburgh, PA, USA.
| | - Miya Asato
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | - Amy J Houtrow
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Dio Kavalieratos
- Section of Palliative Care and Medical Ethics, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Elizabeth Miller
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | - Kristin N Ray
- Department of Pediatrics, University of Pittsburgh, School of Medicine and Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
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Williamson V, Creswell C, Butler I, Christie H, Halligan SL. Parental Experiences of Supporting Children with Clinically Significant Post-Traumatic Distress: a Qualitative Study of Families Accessing Psychological Services. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2019; 12:61-72. [PMID: 32318180 PMCID: PMC7163877 DOI: 10.1007/s40653-017-0158-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to investigate the experiences of parents in providing support to their child following trauma exposure in cases where children are experiencing clinically significant levels of post-traumatic distress. Qualitative interviews were conducted with parents whose child was exposed to a trauma and referred for psychological treatment. Parents reported considerable anxiety in coping with their child's post-traumatic distress. Avoidance of trauma-related discussions was encouraged due to concerns that non-avoidant approaches may worsen children's post-trauma difficulties. Nonetheless, parents were often sensitive to their child's distress and offered reassurance and other forms of support. Many barriers existed to accessing psychological treatment, and perceptions of inadequate guidance from therapists on supporting child adjustment contributed to parental distress. The results illustrate the strategies used by parents in supporting their child post-trauma and may assist mental health professionals in providing acceptable guidance to parents following child trauma.
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Affiliation(s)
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6UA UK
| | - Ian Butler
- Department of Humanities and Social Sciences, University of Bath, Bath, BA2 7AY UK
| | - Hope Christie
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
| | - Sarah L. Halligan
- Department of Psychology, University of Bath, Bath, BA2 7AY UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, 7700 South Africa
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26
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Reinaldo AMDS, Pereira MO, Tavares MLDO, Henriques BD. Parents and children suffering from mental distress: coping mechanisms, understanding and fear of the future. CIENCIA & SAUDE COLETIVA 2018; 23:2363-2371. [PMID: 30020388 DOI: 10.1590/1413-81232018237.16332016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 08/04/2016] [Indexed: 11/22/2022] Open
Abstract
The aim of the study was to learn about the parents' coping experiences regarding the mental suffering of their children. This is an ethnographic study. Data was analyzed through content analysis. Three categories have been identified: 1. Coping with everyday situations 2. Understanding of mental suffering as a life situation; 3. Fear of the future, feeling of social and governmental helplessness. Mental suffering imposes situations that need to be quickly resolved on families and arrangements in an attempt to balance the family system; family members coexist with mental suffering in the perspective of a chronic illness, and seek coping mechanisms for day-to-day situations; lastly they fear the future of their sick relatives and feel helpless due to public policies. Research is needed in the area to assess the impact of this issue on the lives of families, institutions and public policies.
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Affiliation(s)
- Amanda Márcia Dos Santos Reinaldo
- Departamento Enfermagem Aplicada, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | - Maria Odete Pereira
- Departamento Enfermagem Aplicada, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena, Santa Efigênia. 30130-100 Belo Horizonte MG Brasil.
| | | | - Bruno David Henriques
- Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa. Viçosa MG Brasil
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Flood M, Hayden JC, Gavin B, McNicholas F. A qualitative study exploring the decision of parents to use medication in attention-deficit hyperactivity disorder. Res Social Adm Pharm 2018; 15:1095-1101. [PMID: 30459089 DOI: 10.1016/j.sapharm.2018.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/31/2018] [Accepted: 11/05/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Reported prevalence of ADHD in children varies greatly from country to country. There is a similar disparity between rates of medication prescriptions for ADHD, with significant variation existing between rates in USA and Europe. North American studies report that parents have concerns about starting and continuing ADHD medication in children, though little is known about experiences in other geographies and healthcare systems. These studies may inform supports required, and help understand if these concerns may result in different treatment patterns, in other geographies. OBJECTIVE To explore experiences of parents of children who used ADHD medication in Ireland. METHODS A qualitative methodology was employed. Data were gathered through in-depth semi-structured interviews with ten parents who had a child with ADHD and had commenced medication. Analysis was performed using a phenomenographic approach. RESULTS Four descriptive categories relating to parents' experiences of decision-making emerged. Symptom severity prior to diagnosis, duration of ADHD symptoms and parental struggle to make an informed risk/benefit decision influenced decision-making. The child's immediate response to medication was identified as an important factor facilitating persistence and adherence. Over time, parents sought to regain some control over and gain confidence in medication management and decision-making. CONCLUSIONS The decision to use medication in ADHD is difficult and dynamic for parents in Ireland. It is driven by a sense of urgency and powerlessness, mobilizing feelings of doubt, anxiety and guilt before concluding with a sense of autonomy and increased confidence. Lack of awareness of ADHD and treatments, alongside access to care issues, add to parental anxiety in Ireland. This is in contrast to previous North American studies. Current provisions of support and information at the time of ADHD diagnosis are insufficient. Initial reaction to medication options should be explored by clinicians and support continued over time.
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Affiliation(s)
- Michelle Flood
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John C Hayden
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Blánaid Gavin
- Department of Child and Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Fiona McNicholas
- Department of Child and Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland; Lucena Clinic, Rathgar, Dublin, Ireland; Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
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28
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Brown J. Parents' experiences of their adolescent's mental health treatment: Helplessness or agency-based hope. Clin Child Psychol Psychiatry 2018; 23:644-662. [PMID: 29895179 DOI: 10.1177/1359104518778330] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This article explores some core findings from a qualitative investigation of parents' experiences of their child's treatment in an adolescent mental health service in Sydney, Australia. In particular, the research question was, "How does parents' involvement in the child/adolescent's treatment influence their perception of how they can be helpful in their child's recovery?" The theme of parent hope emerged from the broad qualitative exploration of parent's experience of their involvement in their adolescent's intensive treatment program. A purposive sample of 14 sets of parents participated, being interviewed at admission, discharge, and 6 months following their adolescent's discharge. A continuum of high, moderate, and low levels of hope were evident in this parent sample 6 months after their treatment involvement. The strongly emergent theme was the relationship between parents' hope and agency/self-efficacy. Parents who remained more passive in expecting expert helpers to fix their child experienced reduced hope months after finishing the program. When parents positively changed their interaction with their child, they felt a more sustained hopefulness. These findings generate the hypothesis that if parents are actively involved in changing themselves as part of their child's treatment, they experience increased hope and effectiveness in contributing to their child's recovery.
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Affiliation(s)
- Jenny Brown
- The Family Systems Institute, Australia.,Department of Social Science, University of New South Wales, Australia
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29
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Patel R, Harvey J, Forrester A. Systemic limitations in the delivery of mental health care in prisons in England. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 60:17-25. [PMID: 30217326 DOI: 10.1016/j.ijlp.2018.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 05/17/2018] [Accepted: 06/11/2018] [Indexed: 06/08/2023]
Abstract
There is a high prevalence of mental health need in prisons, much of which is currently unmet. Although considerable research has identified and described this mental health need, there has been limited research focussed on reviewing the delivery of mental health care in prisons. This study uses content analysis to review 36 unannounced prison inspection reports in England to establish whether mental health care was provided to an appropriate standard, and whether it is equivalent to services that are provided in the wider community. The analysis identified four main categories, each of which had further sub-categories: managing the process; staffing; range of services; and quality of service. Numerous concerns were identified, including: delays to service access; lack of appropriate interventions; low staffing levels; limited specialist support; and limited access to supervision, training and reflective practice. Despite these difficulties, many teams had adopted open referral systems to improve service access, had good working relationships and were thought to be providing care of good quality. The delivery of mental health care within prisons is still not equivalent to that which is provided in the community, and this study has identified a number of areas for further improvement.
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Affiliation(s)
- Ria Patel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Joel Harvey
- Lecturer in Clinical Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK
| | - Andrew Forrester
- Consultant and Honorary Senior Lecturer in Forensic Psychiatry, Offender Health Research Network, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
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Rodríguez-Meirinhos A, Antolín-Suárez L, Oliva A. Support Needs of Families of Adolescents With Mental Illness: A Systematic Mixed Studies Review. Arch Psychiatr Nurs 2018; 32:152-163. [PMID: 29413065 DOI: 10.1016/j.apnu.2017.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 09/03/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Ana Rodríguez-Meirinhos
- Department of Developmental and Educational Psychology, Universidad de Sevilla, Camilo José Cela, s/n, 41018 Seville, Spain.
| | - Lucía Antolín-Suárez
- Department of Developmental and Educational Psychology, Universidad de Sevilla, Camilo José Cela, s/n, 41018 Seville, Spain
| | - Alfredo Oliva
- Department of Developmental and Educational Psychology, Universidad de Sevilla, Camilo José Cela, s/n, 41018 Seville, Spain
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McNamara N, Coyne I, Ford T, Paul M, Singh S, McNicholas F. Exploring social identity change during mental healthcare transition. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2017. [DOI: 10.1002/ejsp.2329] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Niamh McNamara
- Department of Psychology; Nottingham Trent University; UK
| | - Imelda Coyne
- School of Nursing & Midwifery; Trinity College Dublin; Ireland
| | - Tamsin Ford
- University of Exeter Medical School, University of Exeter; UK
| | - Moli Paul
- Division of Mental Health & Wellbeing, Warwick Medical School; University of Warwick; UK
| | - Swaran Singh
- Division of Mental Health & Wellbeing, Warwick Medical School; University of Warwick; UK
| | - Fiona McNicholas
- School of Medicine & Medical Science; University College Dublin; Ireland
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Gondek D, Edbrooke-Childs J, Velikonja T, Chapman L, Saunders F, Hayes D, Wolpert M. Facilitators and Barriers to Person-centred Care in Child and Young People Mental Health Services: A Systematic Review. Clin Psychol Psychother 2016; 24:870-886. [DOI: 10.1002/cpp.2052] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 09/26/2016] [Accepted: 09/27/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Dawid Gondek
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| | | | - Tjasa Velikonja
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| | - Louise Chapman
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| | | | - Daniel Hayes
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
| | - Miranda Wolpert
- Evidence Based Practice Unit, UCL and Anna Freud Centre; London UK
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Abstract
BACKGROUND Client Satisfaction with services is an important predictor of health care seeking, treatment compliance and health status outcome. Given that both parents and young people may have different views of services offered, this study examines both perspectives with respect to Child and Adolescent Mental Health Services (CAMHS) in Ireland. METHOD Following ethical approval, the Client Satisfaction Questionnaire-8 (CSQ-8) were sent to all open cases attending three urban CAMHS. Returned questionnaires were received from 426 (280 parents and 146 adolescents) giving a response rate of 49%. RESULTS No significant differences were observed between parents and adolescents regarding general satisfaction with CAMHS (Mann-Whitney U-test; Z=-0.255; p=0.799) with a range of good and excellent ratings between 77.1% (for the extent that program met user's needs) and 93.1% (for recommendation of program to a friend). Significant positive associations were found between age of child (Spearman's ρ=0.159; p=0.017), receiving a diagnosis (Mann-Whitney U-test; Z=-2.14; p=0.032), frequent attendance (χ 2=8.74; df=3; p=0.033) and living in close proximity to the service (χ 2=9.24; df=3; p=0.026). There was a strong negative correlation between reduction in impairment and levels of satisfaction (ρ=-0.44, n=275, p<0.000). Waiting time or duration in service were not associated with CSQ and 53% (145) requested clinic opening hours outside of 09:00 a.m. to 17:00 p.m. CONCLUSION Regular user feedback, a robust and distinct measure of service quality, will ensure the development of effective, accessible, client-centered and responsive services, which can evolve in partnership with families and young people.
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