Systemic conversations across children and young people’s mental health services: a case study
| Pages | 102-111 |
| Published date | 17 June 2019 |
| Date | 17 June 2019 |
| DOI | https://doi.org/10.1108/JPMH-09-2018-0066 |
| Author | Tim Clarke,Tonia Mihill |
| Subject Matter | Health & social care |
Systemic conversations across children
and young people’s mental health
services: a case study
Tim Clarke and Tonia Mihill
Abstract
Purpose –Improving and transforming children and young people’s (CYP) mental health (MH) services is
increasing in importance. Such systems, however, are often delivered across providers and commissioned in
different ways which can lead to fragmentation and complexity, ultimately impacting negatively on how young
people access services. With increased demand, this means that services are more likely to operate in silos
when indeed they should be better integrated. Developing systemic interventions for service leaders and
commissioners may support improved integration. The paper aims to discuss this issue.
Design/methodology/approach –Systemic issues across a CYP MH system were assessed and
formulated. As a result, using systemic theory, appreciative inquiry and organisational change theories, a
“systemic conversation”intervention was developed and delivered to senior leaders and commissioners of
this system. This intervention comprised three workshop style sessions with numerous tasks.
Findings –Qualitative feedback and scores in the improvement of important elements that the conversations
targeted were collected and examined descriptively. Participants rated their perceived improvement in
relationships, transparency, integration, helpfulness and shared vision for future development.
Practical implications –In transforming CYP MH services, this paper considers how the authors can
intervene across organisations representing the system to further integrate and improve care for those
accessing services.
Originality/value –The intervention described is an original way of intervening with provider representatives
from across the system. The paper provides a blueprint of how this might be adopted by others.
Keywords Mental health, CAMHS
Paper type Case study
Purpose
It is acknowledged th at there is a need to further improve Chil dren and Young People’s(CYP)
Mental Health (MH) services in the UK in line with increasing demand being placed upon
services (Care Quality Commission, 2017, 2018). High prevalence of MH difficulties and
emotional disord ers of CYP in Great Brit ain (Green et al., 2005; NHS Digital, 2018) and an
increased preval ence of MH difficult ies in children at aged 1 4 (Patalay and Fitzs imons, 2017;
NHS Digital, 2018) support the need to transform services. Furthermore, with a majority of MH
difficulties dev eloping by the age of 24 years old (K essler et al., 2005) and the lack of resources
to meet demand (Care Quality Commission, 2017, 2018) ways to improve quality of CYP MH
services is essent ial. Positively, t he importance of im proving CYP MH serv ices has been
recognised and prio ritised by the UK Go vernment and the N HS through recent po licy
(Department of Healt h, 2015; Mental Health Taskforce, 2016 ;De partment of Health and Social
Care and Department for Education, 2017) and funding (see House of Commons Library, 2018
for summary) with ad ditional funding p ledged to NHS commis sioned CYP MH servic es.
However, as this funding was not ring-fenced in commissioning budgets it is feared that
funding pledged to meet the demand on services is not universally reaching front-line services
(British Medical Association, 2018).
Received 24 September 2018
Revised 7 December 2018
21 January 2019
Accepted 21 January 2019
Tim Clarke is based at the
Research Department, Norfolk
and Suffolk NHS Foundation
Trust, Norwich, UK.
Tonia Mihill is based at
Therapeutic Services, Mancroft
Advice Project, Norfolk, UK.
PAGE102
j
JOURNAL OF PUBLIC MENTAL HEALTH
j
VOL. 18 NO. 2 2019, pp. 102-111, © Emerald Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-09-2018-0066
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