“Accessible and Acceptable” Drop-In Mental Health Services for Children With Long-Term Conditions: A Mixed-Methods Exploratory Analysis of Integrated Services From a Health Equity Perspective
Émer Kenny, Anna Roach, Nyah Patel, Sophie Bennett, Isobel Heyman, Anna Coughtrey, Roz ShafranIntroduction
Children and young people (CYP) with long-term physical health conditions (LTCs) are at increased risk of emotional and behavioural difficulties, yet barriers to psychological support remain, particularly for families from ethnic minority backgrounds. Mental health drop-in services were set up and evaluated at 6 paediatric healthcare settings, aiming to provide a more accessible route to care.
Methods
This study conducted a secondary analysis of quantitative and qualitative data collected as part of the multi-site roll-out of mental health drop-in services in paediatric healthcare settings to explore their accessibility and acceptability. The services provided short-term psychological interventions delivered by child wellbeing practitioners or equivalent, under supervision of a clinical psychologist 120 families provided quantitative data, and 104 families shared qualitative feedback. Differences in access routes and mental health symptoms were compared across White British families and those from different ethnicities. Inductive, latent content analysis of the open text feedback was conducted to understand families’ experiences of the drop-in services.
Results
CYP from ethnic minority backgrounds were over-represented in the present study (32%), when compared with nationwide CAMHs users that identify as non-white British (21%). Families from ethnic minority backgrounds reported comparable mental health outcomes and satisfaction levels to White British families. There was a significant difference in mental health change scores, with ethnic minority families showing greater improvements after accessing the service, t (46) = −3.05, p < .01, d = −1.08. Qualitative analysis found that the services were highly acceptable across ethnicities, highlighting themes of life-changing support, therapeutic relationships, and improved parent and family wellbeing.
Discussion
Drop-in services embedded in paediatric healthcare settings are both accessible and acceptable, demonstrating positive clinical outcomes, and positive family feedback across different ethnic groups. This model may help reduce inequalities by improving access to psychological support for ethnic minority families with CYP living with LTCs.