Community Mental Health Treatment and Subsequent Outcomes in Children and Young People: What Works, For Whom, and Why?

Why is the research needed?

Population studies suggest that Children and Young People’s (CYP) mental health has deteriorated since the start of the COVID-19 pandemic, with a 53% increase in contacts with CYP Mental Health Services (MHS) in England compared to pre-pandemic levels. Those who access treatment want mental health services to be as effective as possible. While treatment guidelines are based on scientific evidence, this does not necessarily mean that services are equally effective in the “real world” as they are in controlled study settings. There remains limited understanding of whether, and how, the services received support young people with different types of mental health difficulties, and whether some individuals benefit more than others. It is therefore important to assess the effectiveness of community MHS for children and young people’s mental health.

What are we doing?

Our project aims to understand how effective community Mental Health Services (MHS) are for Children and Young People (CYP), compared to those who do not access services. Using data, we will explore which types of support work best, for whom, and why, including whether prior service use protected young people during the COVID-19 pandemic.

Focusing on ages 11 - 24, we are combining interviews with young people and their parents or carers with analysis of large UK datasets. This will help us understand how services impact different mental health difficulties over time, why some young people benefit more than others, and how outcomes differ for those who did and did not access support.

In the next phase, we will analyse data from large, representative UK youth samples, guided by insights from patient and public involvement (PPI) and interviews. We will track young people’s mental health over time by using reports from them, parents, and teachers, and examine how this relates to their use of MHS, including comparisons with those who needed but did not access support.

We will assess a range of outcomes, including anxiety, depression, self-harm, behaviour, wellbeing, relationships, education, and health records. We will also examine how service use changed before and during the COVID-19 pandemic, compare outcomes for those who did and did not receive treatment, and explore which approaches work best, for whom, and why.

How are we working with communities, services and organisations?

We are working closely with communities, services, and organisations through Patient and Public Involvement (PPI) groups. Young people with experience of community mental health services, their carers, and professionals involved in delivering care are contributing to all stages of the research. This includes a national sample across England, recruited via GP records, alongside extensive consultation with national organisations and participants to ensure the research focuses on the questions that matter most to them.

What will the impact and benefits of this research be?

The project will provide direct input to policy by generating valuable evidence for service providers and commissioners. Knowledge mobilisation will be key to this impact, although detailed plans are still in development.

What do we have planned for knowledge mobilisation and implementation?

The patient, caregiver, and professional advisory groups will work with us to co-produce recommendations for clinicians, service planners, and policymakers. These will focus on how services can be personalised and improved for young people at risk of poorer outcomes, which impairments are likely to persist after treatment and may require further support, and how to identify those at risk of ongoing mental health difficulties following the pandemic.

Alongside academic papers and reports, we will co-produce a short animated video to share findings more widely, including through mental health charities and schools.