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Mental health
Protocol
Evaluating the implementation and impact of a new model of care for integrating children and young people’s acute mental healthcare in a paediatric setting: a protocol for a realist, mixed-methods approach
  1. Michaela Otis1,2,
  2. Susan Barber1,2,
  3. Stuart Green Hofer1,2,
  4. Jean Straus2,
  5. Michelle Kay2,
  6. Dougal S Hargreaves2,3,
  7. Benedict Hayhoe1,2,
  8. Nana Anokye2,4,
  9. Laura Lennox1,2,
  10. Dasha Nicholls2,5
  1. 1 Department of Primary Care and Public Health, Imperial College London School of Public Health, London, UK
  2. 2 NIHR ARC Northwest London, London, UK
  3. 3 Mohn Centre for Children's Health and Wellbeing, Imperial College London, London, UK
  4. 4 College of Health and Life Sciences, Brunel University London, Uxbridge, UK
  5. 5 Department of Brain Sciences, Imperial College London, London, UK
  1. Correspondence to Dr Stuart Green Hofer; stuart.green{at}imperial.ac.uk

Abstract

Introduction The mental health of children and young people in the UK has been declining and has continued to worsen throughout the pandemic, leading to an increase in mental health-related emergencies. In response, the Best for You programme was developed as a new service designed to integrate mental healthcare for children and young people between acute hospital and community services. The programme is comprised of four new services: a rapid assessment young people’s centre with dual-trained staff, a co-located day service offering family-based care,a digital hub, designed to integrate with the fourth element of the model, namely community support and mental health services. This evaluation protocol aims to assess the development, implementation and outcomes of the Best for You programme and develops a scalable model that could be implemented in other parts of the National Health Service (NHS).

Methods and analysis This mixed-methods realist evaluation aims to delineate the components of the system to assess their interdependent relationships within a wider context. Data collection will include interviews, participant observations, focus groups and the collection of local quantitative healthcare data. The research will be conducted across four phases. Phase 1—captures the development of the underlying programme theory. Phase 2—a process evaluation testing the programme theory. Phase 3— an outcome and economic evaluation. Phase 4—consolidation of learning from phases 1–3 to identify barriers, facilitators and wider contextual factors that have shaped implementation drawing on the Consolidated Framework for Implementation Research.

Ethics and dissemination Ethical approval for the evaluation was received from the NHS local ethics committee. Embedded within the evaluation is a formative review to feedback and share learning with stakeholders to scale-up the programme. Findings from this study will be disseminated in peer-reviewed journals as well as presentations to be useful to service user organisations and networks.

  • MENTAL HEALTH
  • Health policy
  • Organisation of health services
  • Paediatric A&E and ambulatory care
  • Child & adolescent psychiatry
  • Eating disorders
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2022-067074

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    Footnotes

    • Contributors MO, SB and SGH contributed equally to this paper. MO, SB and SGH led the design of the study with input and guidance from MK, JS, DSH, BH, NA, LL and DN. SGH, MO and SB produced the draft manuscript and MK, JS, DSH, BH, NA, LL and DN contributed to the manuscript. All authors read and approved the final manuscript. DN is the guarantor for this research.

    • Funding The National Institute for Health and Care Research Applied Research Collaboration Northwest London and the CW+ charity funded the evaluation.

    • Disclaimer This articlepresents independent research commissioned by the National Institute for Healthand Care Research (NIHR) under the Applied Health Research (ARC) programme forNorthwest London. The views expressed in this publication are those of theauthor(s) and not necessarily those of the NHS, the NIHR or theDepartment of Health and Social Care.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Provenance and peer review Not commissioned; externally peer reviewed.