Background Young people in secure services present with multiple vulnerabilities; therefore, transition periods are especially challenging for this group. In this study, we followed up young people discharged from adolescent medium secure services to adult and community settings with the aim to explore transition experiences and outcomes. Methods Participants were recruited from 15 child and adult mental health services in England. We conducted qualitative semi-structured interviews with 13 young people, aged 18–19 years, moving from adolescent medium secure units 2–6 months post-transition, and five carers 1–3 months pre-transition. Thematic analysis was performed to identify predetermined or data-driven themes elicited from face-to-face interviews. Results The findings indicated poor transition outcomes for young people with the most severe mental health symptoms and those who committed serious offences. Three overarching themes were identified: (1) unsettling environmental factors within adult services; (2) experiences of transition management and preparation and (3) parental experiences of transition process and engagement with adult services. Conclusion The findings of this study indicate that young people and carers value ongoing involvement in the transition process by well-informed parallel care. They also highlight the need for a national integrative care model that diverges from the traditional ‘one-size-fits-all’ approach.

BackgroundYoung people moving from adolescent secure hospitals to adult care present with multiple and complex needs which often remain unmet during transition periods. This paper delineates the process of developing and co‐producing the moving forward intervention (MFi), which aims to address the psychosocial needs of transitioning youth who have limited access to well‐researched and tailored service provisions.MethodAn extensive search of the relevant literature was conducted to generate themes and guide the co‐production phase. Fourteen Advisory Group Meetings were held virtually during COVID‐19 to design the MFi module content with 17 keyworkers, 2 parents and 13 young people aged 17–18 years across six adolescent secure hospitals in England. Thematic analysis was used to reflect on the field notes discussed in the Advisory Groups.ResultsCo‐produced themes from the literature and the Advisory Groups informed the development of the proposed intervention. Three overarching themes pertinent to expectations in adult services, improving communication gaps between services and facilitating the letting go period emerged from the co‐production phase. It was suggested the MFi is co‐delivered by a peer with lived experience to build trust and create hopefulness among young people. The importance of promoting graded transitions through standardised procedures was highlighted.ConclusionsThe current findings promote evidence‐based initiatives and build robust practice frameworks that inform treatment and policy guidelines. The young people, parents and keyworkers found the MFi supportive and valued the co‐production experience. As such, co‐production has been a vital tool in promoting patient engagement and empowerment, and reducing service inequalities, especially in adolescent secure hospitals.

Young people with conduct problems (CPs) have been detrimentally impacted by Covid-19 restrictions, with increased behaviour problems and internalising symptoms. Parents experienced increased strain, managing their child’s behaviours through lockdowns, while support services have been reduced. The present qualitative study aims to explore the deeper parental experience of caring for an adolescent child with CPs during the Covid-19 period. Participants were purposively recruited through a social media support forum. Semi-structured online interviews were conducted with 14 parents of children with CPs (13 mothers and one father) between June-December 2021. Interviews were analysed through reflexive thematic analysis. Analysis revealed four main themes; Experiencing Positive Changes in Children, Navigating Practicalities of Home Confinement, Parents at “Breaking Point”, and Methods of Survival. Parents observed increased behavioural problems in their children, and expressed great strain and fatigue in relation to their child’s expression. Overall, parents felt isolated, confused, and burnt out, feeling they have no support to turn to. These issues appear to expand beyond the pandemic, highlighting an imperative need to provide more social, practical, and psychoeducational support for these parents whose voices are currently going unheard. These should be more robust and tailored to this unique population, with suggested services including peer social networks or parental hubs, more proficient and targeted psychoeducation, crisis interventions, and a greater capacity for parental respite.

Introduction The Covid-19 pandemic has significantly changed family dynamics and parents experience greater psychological distress. Conduct problems in young people have increased by 35%. However, it is not known how Covid-19 associated stresses have affected parenting practice, conduct problems, and comorbidities and what additional support is needed for families at risk. Objectives This study uses self-report measures and semi-structured interviews to examine and explore the impact of Covid-19 on the families of young people with conduct problems and comorbid mental health conditions. Methods This is a sequential mixed-methods study. Eligible families with children aged between 11-18 years have participated. One-hundred-and-eighty-two families have completed eight online questionnaires and 12 have participated in semi-structured follow-up interviews. Results Analyses indicate that parental harshness, warmth, educational background, and employment have a significant impact on Covid-19 exposure and worries, as well as significantly higher scores of conduct disorder symptoms. Interview codes reveal that young peoples’ behaviour became more severe during the pandemic, and this was associated with reduced in-person support services, reduced personal space at home, and parents taking on the additional role of educator. Conclusions The findings suggest that Covid-19 is a significant risk factor to young people with conduct problems and their families. For example, reduced parental warmth and increased parental harshness increased conduct problems for young people during the lockdown. This study highlights that policies and services should work to better support such families. Future online psychosocial interventions are needed to empower families and improve parenting practice at home during the lockdown period and in general. Disclosure No significant relationships.