“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

Abstract

Introduction 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. Plain Language Summary Why was the study done? Children and young people with long term illnesses are more likely than others to have poor mental health. However, these children and their families usually struggle to access mental health support. Receiving support can be even harder for families from non-White backgrounds. A drop-in service providing short-term mental health support for these children was set up at six children’s hospitals across England. This study looked at how families from non-White backgrounds accessed these services, and whether it helped their mental health. It also explored what all families, across ethnicities, thought of the service. What did the researchers do? Researchers looked at the mental health of 120 families before and after using the service. They explored if families from non-White backgrounds had the same experience as White British families who used the service. Families gave feedback about the service. This was used to understand what families thought of the service, what they liked about it and what they thought could be improved. What did the researchers find? Researchers found that many families who were not White used the service. Non-White families’ mental health symptoms improved more than White families’ after using the service. Families from all backgrounds shared very positive experiences with the service, mainly focusing on how it changed children's lives, improved parents' mental health, and how it was an easy way to get support. What do the findings mean? Families from all backgrounds shared positive experiences reaching and using the service. Providing mental healthcare this way at children's hospitals may make it easier for children with long term illnesses and families from all ethnicities to receive mental health support.