Adolescents' and parents' views of Child and Adolescent Mental Health Services (CAMHS) in Ireland

Abstract

Accessible summary Despite increasing focus on researching users' experiences of mental health provision, there are few studies which report adolescents and parents' experiences of attending child and adolescent mental health clinics in Ireland. We found that a lack of information and availability of services made it difficult for participants to access help. They want to be included in information sharing and decision making, but adolescents in particular felt that their voices were not heard in the decision‐making process. Frequent staff changes were particularly difficult for adolescents as they need consistent relationship with a key professional to build trust and disclose thoughts and feelings. Provision of flexible consultations (both single and shared), with sensitivity to the differing perspective of adolescents and parents, coupled with inclusion in information sharing and decision making would significantly improve the experience for adolescents and parents. Abstract Service user involvement is essential for quality care in the Child and Adolescent Mental Health Services (CAMHS). This study was conducted to explore adolescents' and parents' experiences of CAMHS in relation to accessibility, approachability and appropriateness. This study used a descriptive qualitative design, and focus groups and single interviews were conducted with adolescents (n = 15) and parents (n = 32) from three mental health clinics. Data were analysed using thematic analysis. Accessing mental health services was a challenging experience for many parents and adolescents due to knowledge deficit, lack of information and limited availability of specialist services. Some parents and adolescents reported positive experiences while others reported negative experiences. They expressed a need for more information, involvement in decision making, flexible scheduling of appointments, school support and parent support groups. The nature and quality of the relationship with staff was critical to positive experience with the service; therefore, frequent changes of medical staff was disruptive. Mental health nurses can play a vital role in ensuring continuity, assessing adolescents' participation preferences and advocating for their information needs with other members of the interdisciplinary team.

Parental Experiences of Supporting Children with Clinically Significant Post-Traumatic Distress: a Qualitative Study of Families Accessing Psychological Services

“…The reported difficulty in accessing formal psychological services is consistent with the limited literature on the subject (Coyne et al 2015). It is notable that a number of parents did not receive a referral to psychological treatment to address their own post-trauma distress, despite contact with several health professionals to arrange treatment for their child.…”

Facilitators and Barriers to Person‐centred Care in Child and Young People Mental Health Services: A Systematic Review

“…Nonetheless, several studies did not provide sufficient detail on issues such as justification of the research design ( n = 3; Iachini, Hock, Thomas, & Clone, ; Molesworth & Crome, ; Street, ), recruitment strategy ( n = 6; Lee et al, ; LeFrançois, ; Ma & Lai, ; Molesworth & Crome, ; Offord, Turner, & Cooper, ; Street, ), data collection ( n = 3; LeFrançois, ; Molesworth & Crome, ; Street, ), the relationship between researcher and participants ( n = 14; Buckley et al, ; Harper, Dickson, & Bramwell, ; Hart, Saunders, & Thomas, ; Iachini et al, ; Kovshoff et al, ; Lee et al, ; LeFrançois, ; Molesworth & Crome, ; Offord et al, ; Oruche, Downs, Holloway, Draucker, & Aalsma, ; Pelto‐Piri, Engstrom, K., & Engstrom, ; Street, ; Tam‐Seto & Versnel, ; Wisdom, Clarke, & Green, ), ethical issues ( n = 4; Abrines‐Jaume et al, ; LeFrançois, ; Molesworth & Crome, ; Wisdom et al, ) and rigour of data analysis ( n = 4; Hart et al, ; LeFrançois, ; Molesworth & Crome, ; Street, ). Finally, contribution to research, knowledge or policy was not discussed in two studies (Molesworth & Crome, ; Street, ), new areas of research were not identified in six studies (Buckley et al, ; Hart et al, ; Lee et al, ; Molesworth & Crome, ; Pycroft, Wallis, Bigg, & Webster, ; Street, ) and generalizability of findings was not taken into account in nine studies (Buckley et al, ; Bury, Raval, & Lyon, ; Coyne et al, ; Kovshoff et al, ; LeFrançois, ; Molesworth & Crome, ; Offord et al, ; Pelto‐Piri et al, ; Street, ).…”

“…One of the most prominent factors coded at the professional level that was reported by professionals, service users and carers was a lack of sharing information regarding treatment. This was predominantly described as being a barrier to PCC (Buckley et al, ; Coyne et al, ; Hart, Saunders, & Thomas, ; Iachini, Hock, Thomas, & Clone, ; Ma & Lai, ; Simmons, Hetrick, & Jorm, , ; Street, ; Wisdom, Clarke, & Green, ); however, it was reported to be a facilitator when it did occur (Buckley et al, ; Bury, Raval, & Lyon, ; Iachini et al, ; Ma & Lai, ; Simmons et al, ). Equally valued as a factor influencing PCC was when service users and carers were listened to and their opinions respected and validated.…”

“…Service users felt that parents were seen as the primary ‘service user’, reducing the young person's role in PCC. Presence of parents during the session also contributed to self‐censorship, where both service users and carers felt ‘inhibited to speak in front of each other’ (Coyne et al, ; p. 565). When service users had a choice of seeing professionals without carers, in services for 16–18 year‐olds, this mitigated the potential barrier of parental over‐involvement (Harper et al, ).…”

Exploring social identity change during mental healthcare transition

“…This could be considered something of a positive change, particularly for young people involved with mental health services. Previous research has found that young people feel their voices are not heard in the decision‐making process in CAMHS and desire greater input into their care (Coyne et al, ). While a move to AMHS might be seen as a negative life change, the fact that it occurs in the context of a positive life change may in some way buffer adverse effects on well‐being.…”