A scoping review of the Choice and Partnership Approach in child and adolescent mental health services

Pajer, Kathleen; Pastrana, Carlos; Gardner, William; Sivakumar, Aditi; York, Ann

doi:10.1177/13674935221076215

Cited by 4 publications

(6 citation statements)

References 47 publications

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“…The importance that participants placed on rapid access to support in order to prevent the deterioration of CYP’s mental health resonates with previous studies [ 27 , 49 ]. Indeed, it has been reported that the longer CYP spend on a waiting list the more likely they are not to engage with services [ 41 ], and that rapid access is associated with increasing their motivation to engage in therapeutic work [ 50 ]. Moreover, early intervention reduces the secondary impacts on loss of education, loss of friendships and the development of co-morbid mental health issues [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…In response, there have been significant increases in government funding, however, this neither kept pace with demand nor has it been ringfenced to ensure it can only be used for children’s mental health services [ 30 , 36 , 37 ]. While multiple models of CYP mental health services have been implemented in the UK in an attempt to address service deficits (e.g., the Choice and Partnership approach (CAPA), Improving Access to Psychological Therapies Program (CYP-IAPT)), there is limited evidence of their success in ameliorating these longstanding problems [ 38 – 41 ]. Furthermore, little is known about the key factors that influence the effectiveness, acceptability and accessibility of services.…”

Section: Introductionmentioning

confidence: 99%

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Perceptions of the key components of effective, acceptable and accessible services for children and young people experiencing common mental health problems: a qualitative study

Kirk

Fraser

Evans

et al. 2023

BMC Health Serv Res

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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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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perceptions of the key components of effective, acceptable and accessible services for children and young people experiencing common mental health problems: a qualitative study

Kirk

Fraser

Evans

et al. 2023

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Modeling our urgent appointment after the Choice and Partnership Approach [ 18 ] was also unique. To date, appointments using a ‘choice approach’ have only occurred within mental health care settings [ 33 ]. Our use of this approach after the ED visit removed the burden on families to arrange care and ensured access to services.…”

Section: Discussionmentioning

confidence: 99%

Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department

et al. 2023

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Objectives We used quality improvement methods to implement a care bundle for children presenting to a pediatric emergency department (ED) with mental health concerns. A bundle novelty was that it included an option for assessment in a partnered clinic, not in the ED, to families of children assessed as having no medical or safety concerns. The primary aim of this study was to establish successful implementation of the bundle prior to studying its impact. Methods The bundle included the Ask Suicide-Screening Questions to standardize risk assessment at triage, the HEADS-ED (Home, Education, Activities/Peers, Drug/Alcohol, Suicidality, Emotions/Behavior, Discharge Resources) tool for brief, scored mental health assessments, and offering an urgent appointment within 96 h for low-risk children as an alternative to ED-based assessment or as a follow-up option for patients assessed in the ED. We developed aims, driver diagrams, and outcome measures for each bundle element. Each element was introduced with small tests of change using iterative plan-do-study-act cycles. Run charts were used to determine successful completion of aims. Results Rules for special cause were met through detection of shifts in performance 5 months after bundle implementation for the Ask Suicide-Screening Questions and HEADS-ED. These bundle elements were consistently used with ≥ 80% of eligible patients, representing aim achievement. During the 6 months of providing urgent appointments, 89.3% of 159 referred families received an appointment within 96 h. Conclusions Using quality improvement methods, we were able to successfully ensure reliable implementation of a new care bundle for pediatric patients presenting to the ED with mental health concerns and allow eligible low-risk patients to receive full assessments in a partnered clinic instead of the ED. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-023-00476-4.

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“…CAPA: Choice And Partnership Approach(Fuggle et al, 2016;Pajer et al, 2022). Also, see: https://wharaurau.…”

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confidence: 99%

Opportunities and challenges for psychotherapy in Aotearoa New Zealand’s new health system

Whisker¹

2022

ata

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The dawning of a new national public health system in Aotearoa New Zealand offers opportunities and challenges for psychotherapists. This paper discusses these against three data sets, namely, a 2022 national District Health Board psychotherapy workforce survey, a video recording of the Psychotherapy and Public Worlds panel event at the 2022 New Zealand Association of Psychotherapists’ (NZAP) conference, and psychotherapist registration statistics supplied by The Psychotherapists Board of Aotearoa New Zealand (PBANZ). The expansion of short-term, risk-based, manualised interventions during the former DHB era did not improve mental health at a community level (Mulder et al., 2022) nor promote equity and sustainability (Berg et al., 2022). Placing Te Tiriti o Waitangi, the Treaty of Waitangi (1840) (Te Tiriti) at the centre of the new health system suits psychotherapy, whose wholistic worldview of health and wellbeing aligns with te ao Māori better than most other Western psychological approaches. Kōrero about the indigenising of psychotherapy in Aotearoa has been around since at least the 1980s. The Ministry of Health (the Ministry) has recently invited psychotherapists’ advice on workforce policy development and how to promote psychotherapy in the new health system. This task will largely fall on the psychotherapy associations and some psychotherapy training organisations. A major challenge may be whether these entities can sustain the expenditure of human and other resources necessary to represent their memberships in continuing dialogue with the Ministry and its operational partners, Te Whatu Ora, Health New Zealand (Te Whatu Ora) and Te Aka Whai Ora, Māori Health Authority (Te Aka Whai Ora). Key opportunities include the recruitment of overseas psychotherapists and the greatly expanded provision of psychotherapy student placements in public health services to stimulate new psychotherapy training programmes and workforce growth.

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A scoping review of the Choice and Partnership Approach in child and adolescent mental health services

Cited by 4 publications

References 47 publications

Perceptions of the key components of effective, acceptable and accessible services for children and young people experiencing common mental health problems: a qualitative study

Perceptions of the key components of effective, acceptable and accessible services for children and young people experiencing common mental health problems: a qualitative study

Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department

Opportunities and challenges for psychotherapy in Aotearoa New Zealand’s new health system

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