A systems relations model for Tier 2 early intervention child mental health services with schools: An exploratory study

Abstract

Over the last 15 years, policy initiatives have aimed at the provision of more comprehensive Child and Adolescent Mental Health care. These presented a series of new challenges in organising and delivering Tier 2 child mental health services, particularly in schools. This exploratory study aimed to examine and clarify the service model underpinning a Tier 2 child mental health service offering school-based mental health work. Using semi-structured interviews, clinician descriptions of operational experiences were gathered. These were analysed using grounded theory methods. Analysis was validated by respondents at two stages. A pathway for casework emerged that included a systemic consultative function, as part of an overall three-function service model, which required: (1) activity as a member of the multi-agency system; (2) activity to improve the system working around a particular child; and (3) activity to universally develop a Tier 1 workforce confident in supporting children at risk of or experiencing mental health problems. The study challenged the perception of such a service serving solely a Tier 2 function, the requisite workforce to deliver the service model, and could give service providers a rationale for negotiating service models that include an explicit focus on improving the children's environments.

Clarifying an approach to consultation: The impact of a systemic consultation training for schools-based child and adolescent mental health services clinicians

“…Recent research found that consultation fulfilled the need to move skilled mental health providers and therapeutic interventions into community resources, rather than reserving them for specialist services (Draper et al, 2022). The findings of the study align a model of consultation within the development of a broader relationship focused way of working with children, families, schools and other partners to improve children’s mental health as part of a broader community partnership approach (explained in van Roosmalen, 2018). Participants found that they began to develop a shared understanding of, and responsibility for, mental health together with the school and family; this is a key feature of the model whereby agencies reconceptualise mental health as relational and ‘everyone’s responsibility’.…”

“…The aim of this paper was to examine the usefulness of a systemic consultation training for practitioners working with schools. This study is part of the development of a community partnership approach for children and families (van Roosmalen, 2018) and national push towards early intervention and partnership working (Future in Mind, 2015).…”

“…van Roosmalen (2018) proposed a community partnership approach to child mental health teams working with schools, families and relevant wider stakeholders to address the health of children and the systems they live in. In this model, children’s mental health is viewed and understood within the context that they live in.…”