Evaluating integrated mental health care with and for young adults
Research type
Research Study
Full title
Evaluating a new model of integrated primary and community mental health care for adults with significant mental health needs: A co-production study focused on young adults (18-25 years).
IRAS ID
321710
Contact name
Elizabeth Barley
Contact email
Sponsor organisation
Research Integrity and Governance, University of Surrey
Duration of Study in the UK
1 years, 6 months, days
Research summary
This study will evaluate a new integrated model of adult primary and community mental health care being implemented in Surrey Heartlands Integrated Care Partnership, which aims to improve access, experience, and outcomes for adults with significant mental health needs. The research will look specifically at how it is meeting the needs of young adults (18-25 years). Young adults are a vulnerable group; they often find it difficult to engage with mental health services due to the differences between child and adult care service provision, and the lack of experience of staff in working with young adults. The evaluation will be co-produced with young adults throughout to report on how the new model is working, and propose changes and/or enhancements to ensure it addresses their needs.
One or more young adults with personal experience of using mental health services will be employed, supervised, and mentored as peer researcher(s) and core member(s) of the research team. With support, they will interview six health care professionals who deliver and support the new model, and 15 young adult mental health service users, on three occasions each, to explore their journey and experiences of the new model. Data collection will focus on Spelthorne and Epsom areas, to ensure the inclusion of young adults typically underrepresented in research (care leavers and those living in areas with high levels of socio-economic deprivation). Findings will be presented at a stakeholder event to develop solutions and recommendations for improving the new model of care in preparation for full implementation through Surrey Heartlands Integrated Care Partnership in 2024.
The study is funded by the National Institute of Health Research, Applied Research Collaboration Kent, Surrey, and Sussex, and is being conducted through a collaboration between the University of Surrey, Surrey and Borders Partnership NHS Trust, and the McPin Foundation.
Lay summary of study results: Young adults with mental health problems report that services are difficult to access and engage with, and young adulthood has long been identified as a risky period for disengagement from healthcare. Surrey Heartlands Integrated Care System introduced a new model of integrated primary and community mental health care aimed at meeting the needs of adults and older adults. This project explored how young adults (aged 18-25 years) experienced involvement with this provision. The project was funded by the National Institute for Health Research, Applied Research Collaboration Kent, Surrey and Sussex. It was sponsored and led by the University of Surrey in collaboration with Surrey and Borders Partnership NHS Foundation Trust and the McPin Foundation.A co-production methodology was employed supported in the first instance by a peer researcher who themselves had experience of mental health services. The peer researcher interviewed ten young adults at two to three time points during their service journey. Participants were drawn from two discreet areas in Surrey Heartlands (Epsom and Spelthorne). Across all boroughs or districts in Surrey, Spelthorne has a higher percentage of care leavers and young adults in the population who are not in education, employment or training. The results highlighted that the provision met the needs for some, for others they were partially met, and for some needs were unmet. These were framed respectively as ‘On Track’, ‘Mind the Gap’ and ‘Off Track’. Those whose needs were met found it easy to access the service and were supported to remain engaged. For those whose needs were partially met, there were concerns about communication and unclear processes, in particular how they would be supported in the service and helped to transition to another service or leave. For a few, there appeared to have been organisational problems that prevented access. The young adults recognised that the best practitioners were those who were relatable, transparent about the intervention process, and able to validate their experiences.
The project findings were disseminated at a subsequent stakeholder event where they were discussed and developed further among a group of professionals, researchers and young adults who had taken part in the interviews. The completed project was presented at a Surrey-wide Transformational Conference, and two videos were developed, one about the project for the Transformation Board and a second on how to undertake peer research. A slide deck of the research project was disseminated to support the other healthcare systems that provide the service. The project findings will be presented in a peer reviewed scientific journal.
A number of young adults from the Surrey advocacy networks contributed to the development of the project to support its co-production ethos. These young adults were involved from the inception of the project through all processes to data analysis and dissemination. They provided helpful insights to support the peer researcher in thinking about the data and how best to synthesise and present it to the stakeholder group. They attended key monthly project meetings and the stakeholder event, helped inform the recommendations, and were invited to the dissemination event. Owing to their own personal development and life choices the individuals joining the project team changed across the lifetime of the project. The peer researcher and team members provided updates on the project and their role in the project. The peer researcher helped shape and influence every stage of the project delivery.
The findings from this project highlighted the benefits and successes of the new service for young adults and identified the barriers to user engagement and successful outcomes that need to be addressed. The learning generated aligned with evaluations of the service among other user groups and the need to address key areas of the service.
REC name
South Central - Oxford B Research Ethics Committee
REC reference
23/SC/0189
Date of REC Opinion
3 Aug 2023
REC opinion
Further Information Favourable Opinion