Dataset Information

Efficient Sufficiency: A qualitative evaluation of a 1 year pilot study of young people and parents accessing a mental health drop-in centre in a paediatric hospital.

ABSTRACT:

Background

Children and young people with long-term physical health conditions (LTC) are known to have higher levels of co-morbid mental health problems than medically healthy children. Evidence-based treatments for mental health problems are effective in children who also have an LTC. This study aimed to explore the factors associated with participants' perceived acceptability and impact of a transdiagnostic mental health centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long term physical conditions.

Methods

One-hundred twenty-eight patients attending the drop-in centre were invited to participate. Overall, 35 participated (31 parents/carers; 4 children and young people) in semi-structured interviews (either in person or by phone) exploring their experience of the centre. Interviews were audio-recorded, transcribed and checked. Framework analysis was then conducted on all transcripts.

Results

Overall, participants found the drop-in centre highly acceptable and reported a positive experience. Reasons for this varied but broadly focused around four themes: (1) efficient sufficiency; (2) autonomy; (3) fusion of process and content factors and (4) (dis)parities of esteems and 'seeing both sides of the coin'.

Conclusions

Participants found the intervention acceptable. A mental health drop-in centre in a paediatric hospital appears to be a positive and valued adjunct to supplement existing mental health services.

SUBMITTER: Catanzano M

PROVIDER: S-EPMC10087919 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Efficient Sufficiency: A qualitative evaluation of a 1 year pilot study of young people and parents accessing a mental health drop-in centre in a paediatric hospital.

Catanzano Matteo M Bennett Sophie D SD Fifield Kate K Xu Laila L Sanderson Charlotte C Coughtrey Anna E AE Kerry Ellie E Liang Holan H Heyman Isobel I Shafran Roz R

Child: care, health and development 20220905 2

<h4>Background</h4>Children and young people with long-term physical health conditions (LTC) are known to have higher levels of co-morbid mental health problems than medically healthy children. Evidence-based treatments for mental health problems are effective in children who also have an LTC. This study aimed to explore the factors associated with participants' perceived acceptability and impact of a transdiagnostic mental health centre offering brief psychological assessment and treatment for ...[more]

PMID: 36006804

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Project description:BackgroundPaediatric patients being treated for long-term physical health conditions (LTCs) have elevated mental health needs. However, mental health services in the community are difficult to access in the usual course of care for these patients. The Lucy Project - a self-referral drop-in access point-was a program to address this gap by enrolling patients for low-intensity psychological interventions during their treatment for LTCs. In this paper, we evaluate the cost-effectiveness of the Lucy Project.MethodsUsing a pre-post design, we evaluate the cost-effectiveness of the intervention by calculating the base-case incremental cost-effectiveness ratio (ICER) using outcomes data and expenses recorded by project staff. The target population was paediatric patients enrolled in the program with an average age of 9 years, treated over a time horizon of 6 months. Outcome data were collected via the Paediatric Quality of Life Inventory, which was converted to health utility scores using an instrument found in the literature. The QALYs were estimated using these health utility scores and the length of the intervention. We calculate a second, practical-case incremental cost-effectiveness ratio using streamlined costing figures with maximum capacity patient enrolment within a one-year time horizon, and capturing lessons learned post-trial.ResultsThe base-case model showed an ICER of £21,220/Quality Adjusted Life Years (QALY) gained, while the practical model showed an ICER of £4,359/QALY gained. The practical model suggests the intervention garners significant gains in quality of life at an average cost of £309 per patient. Sensitivity analyses reveal use of staff time was the greatest determinant of the ICER, and the intervention is cost-effective 75% of the time in the base-case model, and 94% of the time in the practical-case model at a cost-effectiveness threshold of £20,000/QALY gained.ConclusionsWe find the base-case intervention improves patient outcomes and can be considered cost-effective according to the National Institute for Health and Care Excellence (NICE) threshold of £20,000-£30,000/QALY gained, and the practical-case intervention is roughly four times as cost-effective as the base-case. We recommend future studies incorporate a control group to corroborate the effect size of the intervention.

Project description:BackgroundLittle research attention has been given to understanding the lived experience of parents who access mental health services in the context of child anxiety disorders. This paper reports on findings specific to parents' lived experience of accessing services for their child living with anxiety and the recommendations they provided for improving access.MethodsWe used the qualitative research approach of hermeneutic phenomenology. The sample included 54 Canadian parents of youth living with an anxiety disorder. Parents took part in one semi-structured and one open-ended interview. We used a 4 staged data analysis process informed by van Manen's approach and Levesque and colleagues' framework of access to healthcare.ResultsThe majority of parents reported being female (85%), white (74%), and single parents (39%). Parents' ability to seek and obtain services was affected by not knowing when or where to access services, having to learn to navigate the system, limited availability of services, lack of timely services and interim supports, limited financial resources, and clinicians' dismissal of parental concerns and knowledge. Provider (ability to listen), parent (willingness to participate in therapy), child (same race/ethnicity as provider), and service characteristics (cultural sensitivity) influenced whether parents perceived services as approachable, acceptable, and appropriate. Parents' recommendations focused on: (1) improving the availability, timeliness, and coordination of services, (2) providing supports for parents and the child to facilitate obtaining care (education, interim supports), (3) improving communication with and among healthcare professionals, (4) the need to recognize parents' experience-based knowledge, and (5) encouraging parents to take care of themselves and advocate for their child.ConclusionsOur findings point to possible avenues (parents' ability, service characteristics) that can be targeted to improve service access. As experts on their situation, parents' recommendations highlight priority needs of relevance to health care professionals and policymakers.

Project description:IntroductionHealth needs are issues that face a population or specific groups, which can benefit from healthcare and wider social and environmental changes. They are inextricably linked to health inequalities, which are largely determined by non-health-related factors such as socioeconomic deprivation or belonging to ethnic minority groups. The hospital-accessing paediatric population, with higher rates of morbidity and mortality, are likely to have higher levels of met and unmet health needs related to social determinants, compared with their peers. As the gap in health inequalities widens globally, paediatric health services may now have an increasingly important role to play in identifying and acting on inequalities affecting their patient population. This scoping review aims to collate information on how children's hospitals assess the health and wider health-related social needs of patients using a health inequalities lens. On a broader level, the review may also reveal themes about healthcare and other health needs of children accessing hospitals globally.Methods and analysisThis scoping review will follow Joanna Briggs Institute guidance. A search strategy will be described to identify published articles from healthcare databases worldwide as well as healthcare-related grey literature. Literature will be examined to identify methods that aim to assess the health and related social needs of hospital-accessing paediatric patients and will exclude literature published before 2010. Two or more reviewers will independently review the results of the searches using the inclusion and exclusion criteria. Study findings will be presented in tabular form detailing the assessments identified.Ethics and disseminationThe review will synthesise information on hospital approaches to understand and assess the health and health-related social needs of children and young people worldwide. The findings will be used to inform guidelines for children's hospitals in the UK and will be disseminated through national and international professional bodies, conferences and research papers.

Dataset Information

Efficient Sufficiency: A qualitative evaluation of a 1 year pilot study of young people and parents accessing a mental health drop-in centre in a paediatric hospital.

Background

Methods

Results

Conclusions

Publications

Efficient Sufficiency: A qualitative evaluation of a 1 year pilot study of young people and parents accessing a mental health drop-in centre in a paediatric hospital.

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