Delphi study to identify key features of community-based child and adolescent mental health services in the East of England

Abstract

ObjectiveTo identify priorities for the delivery of community-based Child and Adolescent Mental health Services (CAMHS).Design(1) Qualitative methods to gather public and professional opinions regarding the key principles and components of effective service delivery. (2) Two-round, two-panel adapted Delphi study. The Delphi method was adapted so professionals received additional feedback about the public panel scores. Descriptive statistics were computed. Items rated 8–10 on a scale of importance by ≥80% of both panels were identified as shared priorities.SettingEastern region of England.Participants(1) 53 members of the public; 95 professionals from the children’s workforce. (2) Two panels. Public panel: round 1,n=23; round 2,n=16. Professional panel: round 1,n=44; round 2,n=33.Results51 items met the criterion for between group consensus. Thematic grouping of these items revealed three key findings: the perceived importance of schools in mental health promotion and prevention of mental illness; an emphasis onhowspecialist mental health services are delivered rather thanwhatis delivered (ie, specific treatments/programmes), and the need to monitor and evaluate service impact against shared outcomes that reflect well-being and function, in addition to the mere absence of mental health symptoms or disorders.ConclusionsAreas of consensus represent shared priorities for service provision in the East of England. These findings help to operationalise high level plans for service transformation in line with the goals and needs of those using and working in the local system and may be particularly useful for identifying gaps in ongoing transformation efforts. More broadly, the method used here offers a blueprint that could be replicated by other areas to support the ongoing transformation of CAMHS.

Advancing methodology for scoping reviews: recommendations arising from a scoping literature review (SLR) to inform transformation of children and adolescent mental health services.

“…Although we did not undertake it in the exemplar review, we strongly recommend appraising included studies for quality. De ning coverage, breadth and inclusion/exclusion criteria The pragmatic purpose of the SLR determined coverage corresponding with key priorities for local CAMHS transformation identi ed through the three-stage Delphi study (22). The process is outlined in Fig.…”

“…After completing the last round of the Delphi study, we collated a nal list of key priorities for local CAMHS redesign (22). This list informed the nal selection of themes within each identi ed area for detailed extraction and reporting (see Table 4).…”

Advancing methodology for scoping reviews: recommendations arising from a scoping literature review (SLR) to inform transformation of Children and Adolescent Mental Health Services

“…guiding the operationalisation of key priorities for local CAMHS transformation. These priorities were identified through Delphi-method consultations [30] with stakeholders including children and young people (CYP), parents/carers, clinicians/other professionals working with CYP, and local healthcare commissioners [30]. The SLR aimed to: (i) provide a readily available repository of evidence for effectiveness, acceptability and feasibility of implementing the service improvements identified by stakeholders as key priorities; (ii) enable commissioners to make evidence-informed decisions about redesigning currently provided services and implementing new ones; (iii) guide change processes; (iv) measure outcomes.…”

“…The pragmatic purpose of the SLR determined coverage corresponding with key priorities for local CAMHS transformation identified through the three-stage Delphi study [30]. The process is outlined in Fig.…”

“…After completing the last round of the Delphi study, we collated a final list of key priorities for local CAMHS redesign [30]. This list informed the final selection of themes within each identified area for detailed extraction and reporting (see Table 5).…”