Search

Digital technology offers opportunities for child mental health capacity building, which is a priority for Majority World Countries (MWC). The aim of this study was to explore the experiences and perspectives of professionals from different disciplines in Turkey (n =12) and Pakistan (n =15), who had completed a two-module digital trauma-informed programme on enhancing practice skills and instigating systemic changes. Interview data were analysed through a coding thematic approach. Participants especially valued the interdisciplinary and holistic approach of the training, and its proposed scaled service model. Digital training, particularly in blended format, can enhance reach and capacity in MWC low-resource settings. [ABSTRACT FROM AUTHOR]

The implementation of child protection training programmes can be influenced by a range of societal, policy, service and practice-related factors. The aim of this study was to establish the experiences of implementation barriers among 26 professionals from different disciplines in Saudi Arabia, 18 months after they had completed such training. The three identified themes related to customs and traditions; organizational, administrative and staff-related barriers; and challenges in contact with families. It is important that these inter-linked levels of barriers are tackled in co-ordination through policy, legislation, awareness campaigns and service development, and that they are anticipated holistically by educational programmes. [ABSTRACT FROM AUTHOR]

Background: Unaccompanied refugee minors present with disproportionately high prevalence of emotional and psychological morbidities. However, their utilization of mental health services has been shown to be significantly poorer than the indigenous population of the country they seek asylum in. Despite this, there is limited research exploring their perspectives on the barriers they face. Aims: This research aims to understand unaccompanied refugee minors' and their carers' perceptions of the barriers to utilize mental health services and to explore issues perceived to be related to poor engagement with services. Methods: Semi-structured interviews with 15 unaccompanied refugee minors and their carers were conducted. This was to elicit their views, perceptions and beliefs based on their experience of receiving treatment from a specialist mental health service in the UK. Results: Thematic analysis was used and the findings were categorised into two broad themes; the participants' perceptions of the intervention and perceptions of the professionals. Salient aspects of these are discussed. Conclusions: The findings have potential to stimulate further research into gaining a better understanding of the barriers these young people face in accessing help, and may contribute to developing services that are more efficient in engaging this vulnerable group and meeting their specific needs. [ABSTRACT FROM AUTHOR]

Children exposed to multiple adversities are at high risk of developing complex mental health and related problems, which are more likely to be met through integrated interprofessional working. Combining the expertise of different practitioners for interprofessional care is especially pertinent in low- and middle-income countries (LMIC) in the absence of specialist resources. The aim of this study was to work with practitioners who deliver care to vulnerable children in six LMIC (Turkey, Pakistan, Indonesia, Kenya, Rwanda, and Brazil) to understand their perspectives on the content of an interprofessional training programme in building resilience for these children. Seventeen participants from different professional backgrounds, who were in contact with vulnerable children were interviewed. A thematic analytic framework was used. Four themes were identified, which were the benefits of a tiered approach to training, challenges and limitations, perceived impact, and recommendations for future training. The findings indicate the importance of co-ordinated policy, service, and training development in an interprofessional context to maximize resources; the need for cultural adaptation of skilled-based training and interventions; and the usefulness of new technologies to enhance accessibility and reduce costs in LMIC. [ABSTRACT FROM AUTHOR]

Low‐ and middle‐income countries (LMIC) are faced with disproportionately high levels of unmet child mental health needs. This study explored through interviews the perspectives of 17 inter‐agency service stakeholders from Brazil, Indonesia, Kenya, Pakistan, Rwanda and Turkey on existing supports and challenges. Four themes emerged on the holistic nature of children's mental health needs linked with disadvantage; limited resources and skilled workforce; stigma; and strategies for future implementation, including awareness, parental engagement, skills‐based programmes and cultural adaptation. Stakeholder input is essential in conceptualising, developing and evaluating culturally appropriate interventions for vulnerable children in LMIC. [ABSTRACT FROM AUTHOR]

Rationale Self-harm in young people is of significant clinical concern. Multiple psychological, social and clinical factors contribute to self-harm, but it remains a poorly understood phenomenon with limited effective treatment options. Objective To explore young women's experience of self-harm in the context of interpersonal stressors and supports. Method Fourteen adolescent females (13–18 years) who had self-harmed in the last six months completed semi-structured interviews about self-harm and supports. Interpretative phenomenological analysis was undertaken. Results Themes identified were: 1) Arguments and worries about family breakdown; 2) Unhelpful parental response when self-harm discovered and impact on seeking support; 3) Ongoing parental support; 4) Long-term peer victimization/bullying as a backdrop to self-harm; 5) Mutual support and reactive support from friends (and instances of a lack of support); 6) Emotions shaped by others (shame, regret and feeling ‘stupid to self-harm’); and 7) ‘Empty promises’ - feeling personally let down by clinical services. These themes were organised under two broad meta-themes (psychosocial stressors, psychosocial supports). Two additional interconnected meta-themes were identified: Difficulties talking about self-harm and distress; and Impact on help-seeking. Conclusion Parents and peers play a key role in both precipitating self-harm and in supporting young people who self-harm. The identified themes, and the apparent inter-relationships between them, illustrate the complexity of self-harm experienced in the context of interpersonal difficulties, supports, and emotions. These results have implications for improving support from both informal and clinical sources. [ABSTRACT FROM AUTHOR]

Six young adults (aged 19–21 years) with repeat self-harm for over 5 years were interviewed about their self-harm, why they continued and what factors might help them to stop. Interpretative phenomenological analysis identified six themes: keeping self-harm private and hidden; self-harm as self-punishment; self-harm provides relief and comfort; habituation and escalation of self-harm; emotional gains and practical costs of cutting, and not believing they will stop completely. Young adults presented self-harm as an ingrained and purposeful behaviour which they could not stop, despite the costs and risks in early adulthood. Support strategies focused on coping skills, not just eradicating self-harm, are required. [ABSTRACT FROM AUTHOR]

Background Children in the UK care system often face multiple disadvantages in terms of health, education and future employment. This is especially true of mental health where they present with greater mental health needs than other children. Although transition from care - the process of leaving the local authority as a child-in-care to independence - is a key juncture for young people, it is often experienced negatively with inconsistency in care and exacerbation of existing mental illness. Those receiving support from child and adolescent mental health services ( CAMHS), often experience an additional, concurrent transfer to adult services ( AMHS), which are guided by different service models which can create a care gap between services. Method This qualitative study explored care-leavers' experiences of mental illness, and transition in social care and mental health services. Twelve care-leavers with mental health needs were interviewed and data analysed using framework analysis. Results Sixteen individual themes were grouped into four superordinate themes: overarching attitudes towards the care journey, experience of social care, experience of mental health services and recommendations. Conclusions Existing social care and mental health teams can improve the care of care-leavers navigating multiple personal, practical and service transitions. Recommendations include effective Pathway Planning, multiagency coordination, and stating who is responsible for mental health care and its coordination. Participants asked that youth mental health services span the social care transition; and provide continuity of mental health provision when care-leavers are at risk of feeling abandoned and isolated, suffering deteriorating mental health and struggling to establish new relationships with professionals. Young people say that the key to successful transition and achieving independence is maintaining trust and support from services. [ABSTRACT FROM AUTHOR]

Adopted children tend to have high levels of emotional, behavioural and developmental need and are more likely to present to a range of services, including Child and Adolescent Mental Health Services (CAMHS). Although research exploring adopted children's perspectives is growing, it remains limited. Furthermore, there has been little work to engage adopted children in research. Our project aimed to examine adopted children's viewpoints of mental health and services alongside those of their adoptive carers. Results indicated that although there were some similarities between carer and child perspectives, they also frequently differed. They provided different constructions of the problem but agreed that family relationships were strained. Some acknowledgement of the role of the school was offered and other external sources of support cited. Coping was considered to be complex and while some issues were analogous to ‘normal’ family life, much was inherent to the adoption status. [ABSTRACT FROM AUTHOR]

Background: Unaccompanied refugee adolescents are a small but clinically significant group. This group is vulnerable with physical and psychiatric needs which are often not met. There are several barriers to providing care for this group, originating with the refugees but also due to service provision. Aims: The aim of this research is to appreciate the views and perceptions that unaccompanied minors hold about mental health and services. Method: Fifteen unaccompanied adolescents engaged with mental health services were interviewed, and thematic analysis was employed to explore relevant issues. Discussion: Their views reflected a range of opinions on mental health and the treatments they received, but many held negative attitudes toward mental health and had a lack of trust in services. This could be explained by their descriptions of their experiences within their home country of psychiatric care, their experiences of being a refugee/asylum-seeker or cultural differences. Conclusion: We argue it is important to engage this group in the development of policy and practice in child mental health, and in developing services. [ABSTRACT FROM AUTHOR]

Background Recent policies recommend effective joint working between health and education; however, the views of service users are underrepresented, particularly opinions of young children. Method The project was operational from 2005-2008 when interviews were conducted with parents and children. The children were attending CAMHS for mental health and educational difficulties. Results Results indicated that they had a positive view of multiagency working. They consider that joint working is limited by a number of problems and make recommendations for improvement. Conclusions Findings indicate that more effective communication between agencies is needed and this should be provided for parents in an accessible language. This has implications for training professionals together. [ABSTRACT FROM AUTHOR]

The importance of joint working between educational and child mental health professionals is well documented but there are numerous challenges and only limited training models. While the evidence base and training programmes for educationalists regarding child mental health is growing, training mental health professionals about education is more limited. This study presents the views of 36 child mental health and education professionals from four service localities in England regarding their experiences of joint working and perceptions of training, including a preliminary evaluation of a training programme designed to bridge this gap. The findings indicate that participants perceived that a degree of knowledge in education matters is important, and reported that this could be acquired through the development of relationships with educational professionals, setting up link posts and joint training; they also described challenges related to building experience and to resource constraints. Participants were generally positive about the training package and reported that there was a clear training need in this area. [ABSTRACT FROM AUTHOR]

This paper explores non-legal spaces in which the right to health is invoked. Consideration is given to the potential for creating spaces in which people who are mobile can access health care services, as well as engage with services and activities related to the underlying determinants of health in order to overcome inequities in health. The aims of the research were to explore: service user and provider perceptions of the right to health; the role of individual and collective agency in a partnership approach to health; and the development of a framework of sites for health rights. Interviews and participatory diagramming and visualization were conducted with service users and providers and participant observation was undertaken at two hostels. It was found that there needs to be greater clarity of entitlements for service users as well as responsibilities for those with a duty to protect, respect, and fulfil the right to health. As public space becomes more regulated, hostels are becoming one of the few places which homeless people can transform to use as sites for addressing violations of health rights, for self-advocating for health rights, and for engaging with services advocating on their behalf. It is necessary to ensure that spaces in which the right to health can be invoked are acceptable and appropriate to those who seek to claim the right to health in these spaces. Where the spaces are unacceptable or inappropriate, the spaces can become sites against rights, rather than sites for rights. [ABSTRACT FROM AUTHOR]