Exploring and Modifying BarrieRs to Enhance ACcess to Mental Health Support for Ethnic Minority Children and Young People in Acute Paediatric Settings. (EMBRACE)
This study will explore how, why and under what circumstances acute children's hospital settings support, or fail to support Black and Mixed-Black children and young people (CYP) to access appropriate mental health (MH) support. This matters because more CYP with MH issues are attending acute children's hospital settings. These settings include emergency departments and children's wards. Investigations have shown that they are often unsuitable for managing high-risk MH behaviour. CYP from ethnic minority groups have poorer access to, and outcomes from, MH services, but they remain under-researched. Black ethnic groups, in particular, have had persistently higher rates of serious mental health issues and detention under the Mental Health Act.
This study will use an exploratory mixed-methods multiple case study design. It will take place across up to three acute hospital trusts in England, including Nottingham University Hospitals NHS Trust and University Hospitals of Leicester NHS Trust. Data collection methods will include document reviews, observations, interviews, patient record reviews and anonymised aggregate statistics about CYP's MH presentations.
The study will use purposive sampling and aims to recruit about 90 participants: around 30 CYP, 30 parents or carers, and 30 healthcare professionals. Recruitment may take place through posters containing QR codes displayed in hospitals, community and mental health organisations, and on social media. Children, young people, and parents/carers may also be identified by clinical staff during an acute hospital presentation or through hospital databases following discharge. Healthcare professionals may additionally be recruited through email invitations, staff meetings, and direct approaches.
People who express interest, or complete a consent-to-contact form, will be contacted by the researcher to confirm whether they are eligible and to arrange an information session. Consent will usually be completed electronically. The University of Leicester is sponsoring this research as part of a PhD fellowship funded by the Wellcome Trust.
연구 개요
연구 유형
등록 (추정된)
연락처 및 위치
연구 장소
-
-
-
Leicester, 영국, LE15WW
- University Hospitals of Leicester NHS Trust
-
연락하다:
- Damian Roland, BMBS, PhD
- 전화번호: +44300 303 1573
- 이메일: dr98@leicester.ac.uk
-
수석 연구원:
- Damian Roland, BMBS, PhD
-
Leicester, 영국, LE17RH
- University of Leicester
-
연락하다:
- Joseph Manning, Registered Nurse, PhD
- 전화번호: +447812 275027
- 이메일: joseph.manning@leicester.ac.uk
-
연락하다:
- Manning
- 이메일: joseph.manning@leicester.ac.uk
-
Nottingham, 영국, NG7 2UH
- Nottingham University Hospital Trust
-
연락하다:
- Joseph Manning, Registered Nurse, PhD
- 전화번호: +447812 275027
- 이메일: joseph.manning3@nhs.net
-
수석 연구원:
- Joseph Manning, Registered Nurse, PhD
-
-
참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
샘플링 방법
연구 인구
Children and Young People, Parents and Carers, Healthcare Professionals.
설명
Inclusion Criteria:
- Black and Mixed-Black Children and Young People (CYP): Aged 11-18 years old at study enrolment (or up to 20 years if they presented before age 18 within the past 18 months) who have experienced at least one acute paediatric presentation for a mental health need within the last 18 months.
- Parents and/or carers: of CYP meeting the criteria above.
- Healthcare Professionals: who are involved in managing CYP's MH needs in acute paediatric settings.
Exclusion Criteria:
- Participants who do not understand verbal and written English and for whom it has not been possible to provide documents in an appropriately translated language or obtain an interpreter to conduct the interview.
- CYP actively sectioned under the Mental Health Act (MHA) and/or clinically unstable will not be interviewed.
- CYP aged (11-15) where assent from either the child or consent from the parent/carer is not obtained (i.e., both are required).
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 관찰 모델: OTHER
- 시간 관점: OTHER
코호트 및 개입
그룹/코호트 |
개입 / 치료 |
|---|---|
|
Children and Young People
Children and young people who: 1) Belong to a Black or Mixed-Black ethnic group, 2) Have gone to the hospital for a mental health problem within the last 18 months, AND 3) Are aged 11-18 or are now aged up to 20 but attended hospital for a mental health problem before their 18th birthday and within the last 18 months. |
How acute paediatrics settings support children and young people to access mental health support. |
|
Parents and Carers
Parents and carers of children and young people who: 1) Belong to a Black or Mixed-Black ethnic group, 2) Have gone to the hospital for a mental health problem within the last 18 months, AND 3) Are aged 11-18 or are now aged up to 20 but attended hospital for a mental health problem before their 18th birthday and within the last 18 months. |
|
|
Healthcare professionals
Healthcare professionals who are involved in managing children and young people's mental health needs in acute paediatric settings (emergency departments and acute children's hospital wards). |
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Qualitative experiences and perceptions of how acute paediatric settings support or do not support access to mental health support - interviews.
기간: Up to 11 months.
|
Up to two qualitative semi-structured interviews per participant, each lasting up to 90 minutes, with Black and Mixed-Black children and young people who have presented to an acute paediatric setting at a participating a site with a mental health need, their parents/carers and healthcare professionals with direct experience of the mental health pathway at the site. The interviews will explore the experiences and perceptions of these participants and cover the following components of access to mental health support for Black and Mixed-Black Children and Young People attending acute paediatric settings with a mental health need: 1) disclosure of mental health needs, (2) assessment and referral for mental health support, (3) availability of mental health support, and (4) engagement with mental health support. Access is a composite outcome. |
Up to 11 months.
|
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Characteristics of the mental health support pathway - non-participant clinical observations.
기간: Within 1 month of each participating site opening.
|
Care processes and service delivery for children and young people presenting to acute paediatric settings at participating sites with mental health needs, assessed through approximately four, 2-3 hour non-participant clinical observations at each participating site. Field notes will contain non-identifiable, anonymised, contextual information only. |
Within 1 month of each participating site opening.
|
|
Characteristics of the recommended mental health support pathway - document review.
기간: Up to 11 months.
|
Recommended processes at participating sites for the assessment, management, escalation and referral of children and young people presenting to acute paediatric settings with mental health needs, assessed through review of relevant documents from participating NHS trusts. |
Up to 11 months.
|
|
Characteristics of the mental health support pathway - medical record review.
기간: Up to 11 months.
|
Medical records of participating Black and Mixed-Black children and young people who previously presented to an acute paediatric setting at a participating site with a mental health need will be reviewed retrospectively to identify the characteristics of their mental health support pathway, including any documented assessment, management, escalation and referral. |
Up to 11 months.
|
공동 작업자 및 조사자
간행물 및 유용한 링크
일반 간행물
- GOV.UK (2024) Detentions under the Mental Health Act. Ethnicity Facts and Figures. [online]. Available from: https://www.ethnicity-facts-figures.service.gov.uk/health/mental-health/detentions-under-the-mental-health-act/latest/.
- National Health Service (NHS) Race & Health Observatory (2025) THE COST OF RACISM How ethnic health inequalities are standing in the way of growth. NHS Race & Health Observatory.
- Mathews F, Ford TJ, White S, Ukoumunne OC, Newlove-Delgado T. Children and young people's reported contact with professional services for mental health concerns: a secondary data analysis. Eur Child Adolesc Psychiatry. 2024 Aug;33(8):2647-2655. doi: 10.1007/s00787-023-02328-z. Epub 2024 Jan 4.
- Bansal N, Karlsen S, Sashidharan SP, Cohen R, Chew-Graham CA, Malpass A. Understanding ethnic inequalities in mental healthcare in the UK: A meta-ethnography. PLoS Med. 2022 Dec 13;19(12):e1004139. doi: 10.1371/journal.pmed.1004139. eCollection 2022 Dec.
- 36512523
- Health Services Safety Investigations Body, Hughs, M. (2024) Keeping children and young people with mental health needs safe: the design of the paediatric ward.
- Healthcare Safety Investigation Branch (2023) Interim report: Keeping children and young people with mental health needs safe: the design of the paediatric ward.
- NHS England (2022) Supporting children and young people (CYP) with mental health needs in acute paediatric settings: A framework for systems. NHS England. [online]. Available from: https://www.england.nhs.uk/long-read/supporting-children-and-young-people-with-mental-health-needs-in-acute-paediatric-settings-framework-for-systems/.
- Ward JL, Vazquez-Vazquez A, Phillips K, Settle K, Pilvar H, Cornaglia F, Gibson F, Nicholls D, Roland D, Mathews G, Roberts H, Viner RM, Hudson LD. Admission to acute medical wards for mental health concerns among children and young people in England from 2012 to 2022: a cohort study. Lancet Child Adolesc Health. 2025 Feb;9(2):112-120. doi: 10.1016/S2352-4642(24)00333-X.
연구 기록 날짜
연구 주요 날짜
연구 시작 (추정된)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .