Knowledge and confidence of clinicians in Irish CAMHS when working with transgender youth; and the factors clinicians report will assist them in this work

Abstract

Objectives: The Health Service Executive (HSE) Quality Improvement Division (2016) report states that young people who identify as transgender are one of the highest risk groups for suicidal ideation, self-harm, and completed suicides and may require significant input in Irish Child and Adolescent Mental Health Services (CAMHS). This research represents the first exploration of CAMHS staff’s capacity within an Irish mental health service to support transgender youth by considering their knowledge about and confidence in working with these youth. Method: A multi-method design was used to evaluate the knowledge and confidence levels of CAMHS clinicians in supporting transgender youth and to identify what factors would enable them to conduct this work. A questionnaire and a survey about supporting transgender youth were distributed to all clinicians in five Irish-based CAMHS services (N = 71), using an online platform. Additionally, semi-structured interviews were conducted with six clinicians. Quantitative, content, and thematic analyses were performed. Results: CAMHS staff reported limited knowledge and experience about supporting transgender youth. Findings indicated that both of these factors undermined their confidence in supporting these youths. Clinicians expressed a need for additional clinical education delivered through expert consultation, presentations, and learning from ‘experts by experience’. Conclusion: CAMHS clinicians need and want further clinical education about supporting transgender youth and their families. Recommendations are made for enhancing the knowledge, confidence, and competence of CAMHS clinicians using methods identified as acceptable by clinicians, in order to best support these youths.

Irish transgender voices on mental health and mental health care

“…The findings of the study confirm the issues reported by transgender people internationally (Aylagas-Crespillo et al , 2018; Pinna et al , 2022) and in other Irish studies (Collins and Sheehan, 2004; Higgins et al , 2011; Mullen and Moane, 2013; McCann, 2015; TENI, 2017; Hodgins et al , 2020). Irish society is becoming more inclusive and more accepting of diversity, but the transgender people in our study identified limitations to this.…”

“…Whether this is available in the RoI is questioned. A review of research in RoI highlights that mental health professionals often lack specific training, are hard to access and costly and are not well prepared to work in partnership with transgender people (Collins and Sheehan, 2004; Higgins et al , 2011; Mullen and Moane, 2013; McCann, 2015; TENI, 2017; Hodgins et al , 2020). Recent developments, notably the introduction of same-sex marriage, overwhelmingly supported by a referendum, and legislation around gender diversity, are indicative of progress in Irish society.…”

Staff competence in caring for LGBTQ+ patients in the paediatric emergency department

“…Paediatric nurse practitioners in the USA report low levels of formal education in caring for transgender youths, despite frequently encountering them in practice 32. In Ireland, staff working within Child and Adolescent Mental Health Services report limited knowledge or experience in supporting transgender youth 33. There is an identified need for postgraduate educational interventions across healthcare disciplines 34 35…”

“… 32 In Ireland, staff working within Child and Adolescent Mental Health Services report limited knowledge or experience in supporting transgender youth. 33 There is an identified need for postgraduate educational interventions across healthcare disciplines. 34 35 …”