Specialist Services Study: A mixed-method effectiveness evaluation V2
Research type
Research Study
Full title
Specialist Services Evaluation: A realistic process evaluation of the implementation and impact of Forensic Child and Adolescent Mental Health Services (F-CAMHS) and SECURE STAIRS
IRAS ID
242383
Contact name
Jessica Broni-Tabi
Contact email
Sponsor organisation
UCL Joint Research Office
Clinicaltrials.gov Identifier
Z6364106/2018/01/11 , UCL Data Protection Registration
Duration of Study in the UK
2 years, 11 months, 29 days
Research summary
Research Summary
The aim of this project is to evaluate the effectiveness of two new service models being rolled out as part of routine practice across England. This project involves collecting data from young people and parents/guardians from 33 Specialist Services provided by Forensic Child and Adolescent Mental Health Services (F-CAMHS) and the Secure Estate. F-CAMHS are new services commissioned as part of a national service model, and F-CAMHS provide two overarching types of input to mainstream services working on high complexity/risk cases: 1) advice and consultation and 2) case management and direct intervention. The Secure Estate is a collective term for three types of establishment for young people who are sentenced or detained by the State: 1) secure children’s homes, 2) secure training centres, and 3) under-18 young offender institutions. A new service model, SECURE STAIRS, is being implemented in the Secure Estate, which involves training and supporting staff to provide more psychologically informed care. The present study will evaluate the effectiveness of these new service models through a mixed-method study. Half of the sites are fully delivering the new service models and half are only partially delivering the new service models (e.g., phased start). Data collection with young people needs to begin before all sites are fully delivering the new service models. We will collect anonymised routine data and questionnaires completed by young people and parents/guardians at all sites. 8 case study sites have been selected, which cover a range of geographic locations, experience of delivering the service models and size and type of services. We will conduct interviews/focus groups with 10-15 young people and families in each of the 8 case study sites to examine their experiences of the new service models in depth. The principal aim of this study is to answer the question: Do young people in Specialist Services fully delivering the new service models have better mental health than young people in Specialist Services partially delivering the new service models?
Summary of Results
The findings indicate that input from Community Forensic CAMHS (F:CAMHS) results in an improvement in the mental health and wellbeing and the overall health and quality of life of the complex, high risk group of children and young people it is commissioned to provide. Findings also suggest F:CAMHS is effective in promoting the voices of young people and improving communication amongst other professionals working with young people to create a system of integrated care around them. It was recommended to sustain and scale up the service, as well as scale up the service model to other vulnerable groups with multiple and complex needs, such as Autism Spectrum Disorder.
The Framework for Integrated Care (SECURE STAIRS) changed culture and practices in the Children and Young People Secure Estate to be more trauma-informed, developmentally-attuned, and psychologically-based. The principles and practices of the Framework increased staff’s knowledge about children and young people and their story, thus improving their care for and relationships with the young people. Other elements such as training, supervision, reflective practice, and opportunities for multi-agency working resulted in staff feeling more valued and empowered, which increased their wellbeing. Findings suggest the scale-up and spread of the Framework should be continued and emphasised senior leadership’s role in prioritising implementation and establishing the culture of the setting.
REC name
London - South East Research Ethics Committee
REC reference
18/LO/1569
Date of REC Opinion
24 Oct 2018
REC opinion
Favourable Opinion