117 research outputs found
sj-pdf-1-ccp-10.1177_13591045211026048 – Supplemental Material for Transition outcomes for young people discharged from adolescent medium secure services in England: A qualitative study exploring adolescents’ and carers’ experiences
No full textSupplemental Material, sj-pdf-1-ccp-10.1177_13591045211026048 for Transition outcomes for young people discharged from adolescent medium secure services in England: A qualitative study exploring adolescents’ and carers’ experiences by Maria I Livanou, Marcus Bull, Rebecca Lane, Sophie D’Souza, Aiman El Asam and Swaran P Singh in Clinical Child Psychology and Psychiatry</p
Conceptualising the separation from an abusive partner as a multifactorial, non-linear, dynamic process: a parallel with Newton's laws of motion
No full textThe present study focused on the dynamics and factors underpinning domestic abuse (DA) survivors’ decisions to end the abusive relationship. The experiences and opinions of 12 female DA survivors and 18 support workers were examined through in-depth, one-to-one, semi-structured interviews. Hybrid thematic analysis was conducted to retrieve semantic themes and explore relationships among the themes identified and the differences in survivors’ and professionals’ narratives of the separation process. The findings highlighted that separation decisions derived from the joint action of two sets of factors, the “promoters” and the “accelerators.” Whilst the “promoters” are factors leading to the separation from the abuser over time, the “accelerators” bear a stronger and more direct connection with survivors’ decision to end the abusive relationship. Despite their differences, both these factors acted as propelling forces, leading survivors to actively pursue the separation from the perpetrator. To portray the dynamic links among these factors, we propose a conceptualisation drawn from Newton’s laws of motion. Our findings also highlighted important differences in the views of survivors and support workers, as the former conceived themselves as proactive in ending the abuse, whereas the latter described the leaving process as mainly led by authorities and services supporting survivors. This study has potential implications for research, policy and clinical practice, as it suggests that far from being a linear sequence of multiple stages, leaving an abusive relationship results from a complex interplay of factors that facilitate (“promoters”) or drastically accelerate (“accelerators”) the separation process. We argue that future research should aim at improving our current understanding of the subjective and situational factors that can act as “accelerators” or “promoters” for women’s leaving decisions. Moreover, clinicians and policymakers should invest in creating interventions that aid victims to recognise and leverage promoters and accelerators, thus increasing their readiness to end the abuse
Transition of care among young offenders with ongoing mental health problems in England : young offenders in transition
No full textBackground: previous research has shown that transitions from child and adolescent mental health services to adult services are highly problematic for young people in the UK. The needs of young people during transition periods increase and care provision resources are limited.
Objectives: this research study aimed to examine the transition processes, policies and outcomes across all six nationally commissioned medium secure adolescent units in England.
Methods: this research study included four interlinked phases within a sequential exploratory mixed methods design that examined transition of care from forensic child and adolescent mental health services (FCAMHS) among young offenders with mental health problems. The first phase looked at the prevalence of mental disorders among young offenders with the use of a meta-analysis. A mapping exercise identified young people approaching 18 years within a six-month period. Thirty-two retrospective cases notes were reviewed looking at discharged patients the preceding year. Fifty-two face-to-face semi-structured interviews were carried out to explore healthcare providers’, service users’ and their families’ transition experiences.
Results: the mapping exercise and case note review findings highlight the complexity of needs in this group. Subthemes elicited from the interviews with healthcare professionals included transitional delays and young people’s lack of readiness to move onto adult services. Majority of the young people reported that they did not know the transition date whilst families described transitions as anxiety-provoking events.
Conclusions: this research study added an original contribution to the literature based on empirical findings that inform transition policy and clinical practice. This is the first prospective study that followed up young people across England to identify transition outcomes nationally. Policy makers need to aim for flexible age criteria to facilitate service transformation that is person-centred avoiding the traditional one-size-fits-all models of care
Co-producing an inclusive-care model for young people transitioning from adolescent eating disorder services to adult care: Transition for Eating Disorder Youth intervention (TEDYi)
No full textEating disorders (EDs) present a major public health concern as well as a significant and chronic issue to child paediatric mental health services. The Royal College of Psychiatrists (2022) highlight the increasing need to prioritise ED transitions and improve discharge support aiming to reduced relapse. The need for well-planned transitions in individuals with EDs is pressing due to the high mortality rate. There is very little evidence about the feasibility of youth-specific interventions that address the complex needs of this group as they are moving to adult care. The proposed study aims to develop a newly introduced model (TEDYi) for young people aged 16-21 years with EDs transitioning from adolescent eating disorder services to adult care
Transition of care among young offenders with ongoing mental health problems in England: young offenders in transition
No full textBackground: Previous research has shown that transitions from child and adolescent mental health services to adult services are highly problematic for young people in the UK. The needs of young people during transition periods increase and care provision resources are limited.
Objectives: This research study aimed to examine the transition processes, policies and outcomes across all six nationally commissioned medium secure adolescent units in England.
Methods: This research study included four interlinked phases within a sequential exploratory mixed methods design that examined transition of care from forensic child and adolescent mental health services (FCAMHS) among young offenders with mental health problems. The first phase looked at the prevalence of mental disorders among young offenders with the use of a meta-analysis. A mapping exercise identified young people approaching 18 years within a six-month period. Thirty-two retrospective cases notes were reviewed looking at discharged patients the preceding year. Fifty-two face-to-face semi-structured interviews were carried out to explore healthcare providers’, service users’ and their families’ transition experiences.
Results: The mapping exercise and case note review findings highlight the complexity of needs in this group. Subthemes elicited from the interviews with healthcare professionals included transitional delays and young people’s lack of readiness to move onto adult services. Majority of the young people reported that they did not know the transition date whilst families described transitions as anxiety-provoking events.
Conclusions: This research study added an original contribution to the literature based on empirical findings that inform transition policy and clinical practice. This is the first prospective study that followed up young people across England to identify transition outcomes nationally. Policy makers need to aim for flexible age criteria to facilitate service transformation that is person-centred avoiding the traditional one-size-fits-all models of care
Brief Report:Exploring Perceived Stigma from Healthcare Professionals in an Adult Sample with Eating Disorders. Mental Health Science
No full textThis study aimed to develop and test a novel Perceived Stigma from Healthcare Professional's self-report questionnaire in a sample of female and male young adults with eating disorders (EDs). An online cross-sectional self-report study was conducted, recruiting a community and clinical sample of 18 to 35-year-olds diagnosed with or self-identifying with an ED (N = 140). The questionnaire utilised the Eating Disorder Inventory-3 to measure ED severity. Those who sought professional help for their ED proceeded to answer the novel Perceived Stigma from Healthcare Professionals questionnaire (N = 42). There was a large range of total perceived stigma scores but, volitional stigma and weight discrimination were the most frequently perceived stigmatising views. A Pearson's correlation illustrated that greater perceived stigma from healthcare professionals was moderately associated with greater ED severity, r(4) = 0.49. p = 0.001. The results indicate heterogeneity of experiences of stigma but, provide preliminary evidence that volitional stigma and weight discrimination may reflect common experiences. Greater stigma from healthcare professionals might be linked to worse outcomes for those with EDs. The findings underscore the importance of further exploration into perceived stigma from healthcare professionals and ED outcomes, using validated questionnaires and larger samples
Assessing the feasibility of a multicenter transition intervention model across adolescent secure services in England (MOVING FORWARD) : protocol for a feasibility cluster randomized controlled trial
No full textBackgroundYoung people moving from adolescent secure inpatient units to adult care in the United Kingdom have multiple and complex needs and are more likely to experience poor transition outcomes. Poorly managed transitions can lead to enduring use and dependency on mental health services. However, there is a lack of knowledge about the feasibility of transitional care models.
ObjectiveThis paper presents the protocol for a study that aims to test a feasibility cluster randomized controlled trial for young people transitioning from adolescent secure services to adult-oriented settings. The overarching aim of the MOVING FORWARD study is to provide a preliminary estimate of the effectiveness and cost-effectiveness of a new transition intervention model and to inform a future full-scale cluster randomized controlled trial.
MethodsThe design of the study is a 3-arm feasibility cluster randomized controlled trial comparing the MOVING FORWARD intervention against standard transition preparation conducted at 6 adolescent secure services, of which 4 units will receive the intervention and 2 will serve as controls. Eligible young people between 17-19 years, their parents/carers, and key workers will be invited to participate. Young people and parents/carers will be allocated to two conditions (young people alone and young people with a parent/carer) and will receive 4 transition preparation workshops across 6 months. Six adolescent secure hospitals will be randomly allocated, stratified by area and service type. Data will be collected at 3 time points: baseline (T0), 6-12 months postintervention (T1), and 18-24 months postbaseline (T2). Primary and secondary outcomes will be based on assessment measures and interviews conducted at T1 and T2.
ResultsA total of 13 young people and 17 staff members have contributed to the intervention design through online advisory groups on the design of the study and important themes for transition. We have also consulted members of the public (a steering group) including 2 young people who have transitioned to the community and 2 parents/carers. Common identified themes included appropriateness of module content and support during delayed transitions. The content of the intervention will be finalized during the first 6 months of the study. Participants will be recruited over the course of 6 months. An intraclass correlation coefficient will be calculated to inform the power of the sample size for a further large-scale trial. With a sample size of 50, we will be able to estimate a dropout rate of 80% (95% CI –11% to 11%).
ConclusionsThis research will provide practitioners and policy makers with an evidence-based framework of how training and familiarization with the prospective transitions can yield positive outcomes. This study will test whether a psychosocial intervention can be implemented in adolescent secure hospitals. The results will identify barriers and facilitators to the proposed intervention and will enable services to reflect on the quality of transitional care delivery.
International Registered Report Identifier (IRRID)PRR1-10.2196/2927
Care-Planning Co-Production Legislation, Policy and Guidance Implications for People Affected by Dementia in England::A Scoping Review
No full textThis article reports on a scoping review of legislation, policy, and guidance for England on care-planning co-production within dementia care. Systematic searching of online repositories uncovered nineteen documents, and synthesis revealed seven key categories representing practice requirements and recommendations: ‘person-centred care plan’, ‘accessibility and support’, ‘involvement of person with dementia’, ‘involvement of partners-in-care’, ‘decision-making’, ‘treatment goals and outcomes’, and ‘care plan review’. Findings validate the premise that care-planning should always be co-produced with people affected by dementia as experts-by-experience, and support practice principles previously identified by this group within the empirical literature. Health and social care professionals can use this learning to improve care-planning practice. However, a disconnect persists between national expectations for service providers to co-produce care-planning and users’ reported experiences, with many expressing dissatisfaction at being treated as passive recipients. Consequently care-planning co-production stills needs a stronger evidence base and more practical support to achieve statutory guidance ambitions
The problematic nature of transitions amongst adolescents with multiple and complex needs in secure care: An overview of institutional transitions:Diversity and Marginalisation in Forensic Mental Health Care
No full textThe problematic nature of transitions amongst adolescents with multiple and complex needs in secure care. An overview of institutional transitions
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