1
|
Meldahl LG, Krijger L, Andvik MM, Cardenas NE, Cuddeford O, Duerto S, Game JR, Ibenfeldt M, Mustafa M, Tong M, Viksveen P. Characteristics of the ideal healthcare services to meet adolescents' mental health needs: A qualitative study of adolescents' perspectives. Health Expect 2022; 25:2924-2936. [PMID: 36074720 DOI: 10.1111/hex.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Despite increased focus on development of mental health services worldwide, many adolescents still hesitate to reach out to the services when they need them. This might be linked to the lack of adolescent involvement in the development of services. This study aimed to explore adolescents' perspectives on the ideal healthcare services to meet their mental health needs. METHODS A two-stage qualitative study was carried out to explore the perspectives of adolescents on the healthcare services to support their mental health. In the first stage, data from 295 adolescents attending a mental health seminar were analysed using qualitative content analysis. In the second stage, in-depth perspectives of 10 adolescent coresearchers were gathered through self-reflection and group discussions to further explore the categories developed in the first stage. Thematic analysis was used to develop the themes answering the research question. Ten adolescent coresearchers planned the study, collected and analysed data and authored the manuscript, with the support of a senior researcher. RESULTS Five themes describe adolescents' perspectives on the ideal healthcare services to meet their mental health needs: (1) Culturally Sensitive and Responsive; (2) Communication of Information; (3) Easy Access; (4) Variety of Support; and (5) Consistency. Culturally Sensitive and Responsive services influenced all other themes. The themes describe suggestions for mental health service improvement, including how to manage the barriers that adolescents face to receive help from the mental health services. DISCUSSION This study highlights the importance of culturally sensitive and responsive services. It raises the need for an expanded definition of culture going beyond nationality and ethnic background. Adolescents need flexible services that meet their individual mental health needs. This has implications for practitioners, educators, system organizers and researchers, who should also involve adolescents in planning, implementing and assessing the services. There is a need for a self-learning system to continuously adapt to user feedback. CONCLUSION This study provides insight into adolescents' perspectives on the ideal mental health services. It offers suggestions for ways to improve services to better meet the individual mental health needs of adolescents. Additional research is needed to further develop and implement service changes, as well as to assess their acceptability, effectiveness, cost-effectiveness and safety. PATIENT OR PUBLIC CONTRIBUTION This is a study lead by adolescents. Adolescent coresearchers have, with the support of a senior researcher, planned and carried out the study, collected and analysed data and authored the manuscript.
Collapse
Affiliation(s)
- Laia G Meldahl
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Lou Krijger
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,ESCP Europe (Business Management), Ecole Supérieure de Commerce de Paris, Paris, France
| | - Maren M Andvik
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,School of Medical, Veterinary and Life Sciences (Zoology), University of Glasgow, Glasgow, Scotland
| | - Nicole E Cardenas
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,School of Psychology (Psychology), University of Aberdeen, Aberdeen, Scotland
| | - Oliver Cuddeford
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Art Design and Architecture (Architecture), University of Huddersfield, Huddersfield, UK
| | - Samuel Duerto
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Philosophy, Theology and Religious Studies (Philosophy, Politics and Societies), Radboud University, Nijmegen, The Netherlands
| | - Julia R Game
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Maya Ibenfeldt
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Biology, Medicine and Health (Pharmacology), University of Manchester, Manchester, UK
| | - Murad Mustafa
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Health Sciences (Nursing), University of Stavanger, Stavanger, Norway
| | - Mathias Tong
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Chemical Engineering and Analytical Science (Chemical Engineering), University of Manchester, Manchester, UK
| | - Petter Viksveen
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| |
Collapse
|
2
|
Bellairs-Walsh I, Perry Y, Krysinska K, Byrne SJ, Boland A, Michail M, Lamblin M, Gibson KL, Lin A, Li TY, Hetrick S, Robinson J. Best practice when working with suicidal behaviour and self-harm in primary care: a qualitative exploration of young people's perspectives. BMJ Open 2020; 10:e038855. [PMID: 33115897 PMCID: PMC7594366 DOI: 10.1136/bmjopen-2020-038855] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/09/2020] [Accepted: 09/24/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES General practitioners (GPs) have a key role in supporting young people who present with suicidal behaviour/self-harm. However, little is known about young people's opinions and experiences related to GPs' practices for such presentations, and their decisions to disclose suicidal behaviour/self-harm to GPs. Additionally, existing guidelines for the management of suicide risk and/or self-harm have not incorporated young people's perspectives. This study aimed to explore young people's views and experiences related to the identification, assessment and care of suicidal behaviour and self-harm in primary care settings with GPs. DESIGN, SETTING AND PARTICIPANTS Two qualitative focus groups were conducted in Perth, Western Australia, with 10 young people in total (Mage = 20.67 years; range: 16-24). Data were collected using a semistructured, open-ended interview schedule and analysed using thematic analysis. RESULTS Five major themes were identified from the focus groups. (1) Young people wanted a collaborative dialogue with GPs, which included being asked about suicidal behaviour/self-harm, informed of treatment processes and having autonomy in decision making; (2) young people were concerned with a loss of privacy when disclosing suicidal behaviour/self-harm; (3) young people viewed labels and assessments as problematic and reductionist-disliking the terms 'risk' and 'risk assessment', and assessment approaches that are binary and non-holistic; (4) young people highlighted the importance of GPs' attitudes, with a genuine connection, attentiveness and a non-judgemental demeanour seen as paramount; and (5) young people wanted to be provided with practical support and resources, followed-up, and for GPs to be competent when working with suicidal behaviour/self-harm presentations. CONCLUSIONS Our study identified several concerns and recommendations young people have regarding the identification, assessment and care of suicidal behaviour/self-harm in primary care settings. Taken together, these findings may inform the development of resources for GPs, and support progress in youth-oriented best practice.
Collapse
Affiliation(s)
- India Bellairs-Walsh
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Yael Perry
- Telethon Kids Institute, The University of Western Australia, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Karolina Krysinska
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Sadhbh J Byrne
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Alexandra Boland
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Maria Michail
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Michelle Lamblin
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Kerry L Gibson
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Tina Yutong Li
- Orygen, Parkville, Victoria, Australia
- Gold Coast University Hospital, Southport, Queensland, Australia
| | - Sarah Hetrick
- Orygen, Parkville, Victoria, Australia
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jo Robinson
- Orygen, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|