Experiences of clinicians working in the inpatient and community mental health care pathway for young people in the UK

Shah, Ashika; Holland, Josephine; Briley, Paul M.; Majumder, Pallab

Abstract

Background/Aims
Increases in the complexity, severity and risk level of patients referred to child and adolescent mental health services has put considerable pressure on bed availability in adolescent psychiatric hospitals, resulting in lengthy admission processes. This study aimed to explore clinicians' experiences of the admission process and transition between community and inpatient care for adolescents, with a view to informing improvement, allowing appropriate, timely admission and discharge and achieving better outcomes.

Methods
Two questionnaires were developed by the authors to collect data on their experiences of the admissions and discharge process to and from psychiatric inpatient wards. One questionnaire was designed for community clinicians (14 items) and one for inpatient teams (nine items), all working under child and adolescent mental health services. The questionnaires were distributed, completed and returned by eligible staff across six NHS trusts. A combination of multiple-choice and open-ended questions were used. Descriptive statistics were used to analyse quantitative data from the multiple-choice questions, while thematic analysis was used to analyse qualitative data from the open-ended questions and generate themes.

Results
Quantitative analysis showed that over half (54.0%) of community clinicians who had been involved in requesting an admission for a young person had received no, minimal or sporadic updates about the progress of the referral. Delays to the bed finding process meant that over a third (35.5%) of these clinicians had felt forced to call for a Mental Health Act assessment for a young person. Five themes were generated from the qualitative data: communication; issues with the admissions process (particularly with Form 1); benefits and drawbacks of technology; bed finding processes; and the importance of Form 1 for inpatient teams.

Conclusions
There is scope for improvement in the admissions process. Measures may include modifications to Form 1, holding regular meetings between community and inpatient teams, creating clearer bed finding and management processes and developing strategies for

Citation

Shah, A., Holland, J., Briley, P. M., & Majumder, P. (2024). Experiences of clinicians working in the inpatient and community mental health care pathway for young people in the UK. British Journal of Healthcare Management, 30(12), 1-13. https://doi.org/10.12968/bjhc.2024.0020

• Journal Article Type: Article
• Acceptance Date: Mar 14, 2024
• Online Publication Date: Dec 13, 2024
• Publication Date: Dec 2, 2024
• Deposit Date: Mar 28, 2024
• Publicly Available Date: Jun 3, 2025
• Journal: British Journal of Healthcare Management
• Print ISSN: 1358-0574
• Electronic ISSN: 1759-7382
• Publisher: Mark Allen Healthcare
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Issue: 12
• Pages: 1-13
• DOI: https://doi.org/10.12968/bjhc.2024.0020
• Public URL: https://nottingham-repository.worktribe.com/output/33023376
• Publisher URL: https://www.magonlinelibrary.com/doi/abs/10.12968/bjhc.2024.0020
• Additional Information: This document is the Accepted Manuscript version of a Published Work that appeared in final form in British Journal of Healthcare Management after peer review and technical editing by the publisher. To access the final edited and published work see https://www.magonlinelibrary.com/doi/abs/10.12968/bjhc.2024.0020