Listening to the voices in four Scottish adolescent mental health units : young people, their carers and the unit cultures

Serious mental health problems among young people are on the increase in Western countries. Involving young people in their mental health care, and working in partnership with them during the treatment process, is a primary concern of all mental health services; their parents have also been promised a place in the health care team. Research into the process and outcomes of hospitalisation of young people in specialist mental health units is complex and therefore limited. Qualitative investigations into the experience of young people as users of these services are few. Making use of ethnographic methods, this study explored young people and their carers' (both parents and staft) experience regarding treatment and participation in decision-making in four Scottish adolescent inpatient or day-care mental health units. The findings suggest that the young people (n = 18) valued the personalised relationships they developed with the staff and their peers and that if these relationships were empowering, they facilitated both treatment and participation in treatment. However, the findings also show that the parents (n = 16) and staff members (n = 21) were sometimes disempowered and that this impaired the overall participative nature of the units. The unit culture was an important contributor to the effectiveness of young people and parent involvement. Making use of concepts from the neighbouring academic field of pastoral theology to interpret the findings, the study concludes with a conceptual framework of what is required for a unit to be more participative. This theoretical framework adds significant elements to the existing knowledge regarding participation in adolescent mental health units. It places relationships of justice and care between all stakeholders at the core of successful participation, hereby drawing attention to the importance of humanistic and ethical considerations in user and carer involvement.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Listening to the voices in four Scottish adolescentmental health units: young people, their carersand the unit cultures.

Serious mental health problems among young people are on the increase in Westerncountries. Involving young people in their mental health care, and working in partnershipwith them during the treatment process, is a primary concern of all mental health services;their parents have also been promised a place in the health care team.Research into the process and outcomes of hospitalisation of young people in specialistmental health units is complex and therefore limited. Qualitative investigations into theexperience of young people as users of these services are few. Making use of ethnographicmethods, this study explored young people and their carers' (both parents and staft)experience regarding treatment and participation in decision-making in four Scottishadolescent inpatient or day-care mental health units.The findings suggest that the young people (n = 18) valued the personalised relationshipsthey developed with the staff and their peers and that if these relationships wereempowering, they facilitated both treatment and participation in treatment. However, thefindings also show that the parents (n = 16) and staff members (n = 21) were sometimesdisempowered and that this impaired the overall participative nature of the units. The unitculture was an important contributor to the effectiveness of young people and parent involvement.Making use of concepts from the neighbouring academic field of pastoral theology tointerpret the findings, the study concludes with a conceptual framework of what is requiredfor a unit to be more participative. This theoretical framework adds significant elements tothe existing knowledge regarding participation in adolescent mental health units. It placesrelationships of justice and care between all stakeholders at the core of successfulparticipation, hereby drawing attention to the importance of humanistic and ethicalconsiderations in user and carer involvement

Partnership working and improved service delivery: views of staff providing sexual health services

Objectives Successful partnership working has theoretically been linked to improvements in service delivery and is dependent on the strength of the partnership, trust, communication, professional roles and resource sharing. Empirical evidence to confirm the relationships between these factors and improved service provision, however, is lacking. Our aim was to assess the views of staff as to the conditions required for partnership working. Methods This study was a cross-sectional survey of 687 staff offering sexual health education, information or support to young people in the Healthy Respect intervention area in Scotland. Views of each variable were scored and structural equation modelling was used to assess the theoretical model. Results Responses were received from 284 (41%) staff. Greater strength of partnership was directly associated with increasing the number of referrals. Establishing professional roles between organizations was also associated with increasing the number of referrals. Strength of partnership was indirectly associated with working more effectively with young people and this relationship depended on clear communication, trust, established professional roles and shared resources. Effective partnership working depends on a number of interdependent relationships between organizations, which act synergistically to improve organizational outcomes. Conclusions Effective partnership working leads to improved service delivery though there is a need for better controlled studies which demonstrate the effect on health outcomes

The limits, challenges and opportunities of safeguarding children in the context of primary care

The sexual health of young people is a concern for policy makers and practitioners alike in Scotland. Some young people are particularly vulnerable to the adverse consequences of early sexual behaviour and as such are widely recognized to be one of the most important groups for reproductive health interventions (Cowen 2002). In 2005, there were seven births for every 1000 women under 16 years (ISO Scotland Publications 2007) while in 2003, 25 per cent of young Scottish women aged under 20 years reported having had a pregnancy terminated (Scottish Executive 2006a). Moreover, abortion rates in all teenage age groups are rising. especially in the under 16s (ISO Scotland Publications 2007). Approximately one in seven attendances to Genito-urinary Medicine Clinics (GUM) are by young people aged under 20 years and between 2002 and 2003 there was a 40 per cent increase in Chlamydia diagnoses in females under 15 years (Scottish Executive 2006a). Over the last two decades, the sexual health ofyoung people has seen virtually no improvements (ISO Scotland Publications 2007; Viner and Barker 2005), although the availability of information, education and services is improving throughout Scotland and there is no sign of further worsening ofthe situation (Scottish Executive 2006a)

Evaluation of Healthy Respect phase two: final report

The Healthy Respect National Health Demonstration Project represented the Scottish Government’s response to the poor sexual health of young people It consisted of two phases and was implemented across Lothian including Edinburgh City. Healthy Respect One began in 2001 and ended in 2004, andHealthy Respect Two began in 2005 and ended in March 2008. This report contains the findings from the evaluation of Healthy Respect Two. aimed to integrate education, sexual health services and information for young people aged 10 to 18 years (although sexual health services were aimed at 13 to 18 year olds) across Lothian and was supported by an overarching communications strategy that included branding and media campaigns

Evaluation of Healthy Respect phase two: final report

The Healthy Respect National Health Demonstration Project represented the Scottish Government’s response to the poor sexual health of young people It consisted of two phases and was implemented across Lothian including Edinburgh City. Healthy Respect One began in 2001 and ended in 2004, andHealthy Respect Two began in 2005 and ended in March 2008. This report contains the findings from the evaluation of Healthy Respect Two. aimed to integrate education, sexual health services and information for young people aged 10 to 18 years (although sexual health services were aimed at 13 to 18 year olds) across Lothian and was supported by an overarching communications strategy that included branding and media campaigns