Blueprint

ALT •154 services identified, provided by 123 unique service providers •74% operated in England, 19.5% in Wales and 6.5% pan-UK •Mostly urban/metro services •Equally run by the statutory and third sectors with some private sector provision •Self-referral routes more common in third sector than NHS (though more than half of NHS services offered self-referral) •Community outreach models (Group D: schools outreach, outreach to home, community outreach and liaison services) most common •Map sufficient for Work stream 3 sampling

ALT Strongest effectiveness evidence was for collaborative care Brief intervention approaches may be especially good at managing waiting lists No one model seemed to be more acceptable than others Effective and acceptable services seem to be underpinned by: few barriers to access some degree of interagency working the use of consultation/liaison a consideration of a service’s wider culture

ALT Specialist CAMHS: outpatient (generic and condition-specific), day care, inpatient Community embedded CAMHS: collaborative care, school MH service, community psychiatry hub In/outreach: to home, to schools, community and liaison, paediatric liaison Ecological models: wraparound approachies, multi-systemic therapy Demand management: organisation-level, patient-level

ALT There are four workstreams: 1.Scoping and integrative literature reviews 2.Service map across England and Wales 3.Case study of services across England and Wales drawn from service map (primary research) 4.Collaborative development of a model for high quality service design for children and young people (CYP) with common mental health problems (CMHPs)

ALT Service design for children and young people with common mental health problems (‘Blueprint’) Steven Pryjmachuk, Susan Kirk, Claire Fraser, Nicola Evans, Rhiannon Lane, Liz Neill, Elizabeth Camacho, Peter Bower, Penny Bee and Tim McDougall. Funded by the NIHR HS&DR Programme (ref: 17/09/08). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care

ALT Valuing lived experience – central to the project throughout Rare opportunity to get first hand research experience Flexible and manageable project workload Individual and tailored approach to co-interviewing Impact of involvement: personal and professional benefits All 6 Co-R → new roles/further study in research and/or healthcare Challenges: Restricted hours; remote working & delays due to C-19

ALT Co-designing a video to improve accessibility Advisory group and team meetings Reflective summaries Dissemination

ALT Bespoke training in research methods Co-interviewing service users and providers Assisting with data analysis Informing interpretation

ALT PPI is widely acknowledged as an essential component of research Guidance largely theoretical / aspirational & lacked practical guidance on the ‘how’ rather than the ‘why’ Lack of guidance in relation to involving young people as active members of the research team Challenges in relation to employment status & governance

ALT Blueprint aim: To develop a model of effective service design for children and young people experiencing common mental health problems Project aspiration → to move beyond PPI as an advisory role Data generation rooted in lived experience - working with young person co-researchers as active members of the research team The Blueprint journey…to the guidelines to involvement

ALT 1.CYP and families do not always know how to access services, and may then find themselves not eligible 2.Text, phone and online crisis provision are welcomed 3.CYP would like access to peers or age-appropriate out-of-hours services 4.Attendance at an emergency department was experienced as stressful but… 5.care in emergency departments is effective

ALT Effectiveness Emergency departments are effective Community services facilitate ongoing care and avoid hospitalisation No suicide attempts with models in educational setting Goals Stabilise situation Keep CYP home Train/support other services

ALT Organisation triage/assessment-only (EDs, schools, via telephone triage and out of hours services); digitally mediated support approaches (via telephone, text or online); intervention approaches and models Experiences knowing where to go, access, having support, transport, costs, and transitions, lack of support before crisis is reached.