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.
Studie Overzicht
Toestand
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studie Locaties
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Leicester, Verenigd Koninkrijk, LE15WW
- University Hospitals of Leicester NHS Trust
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Contact:
- Damian Roland, BMBS, PhD
- Telefoonnummer: +44300 303 1573
- E-mail: dr98@leicester.ac.uk
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Hoofdonderzoeker:
- Damian Roland, BMBS, PhD
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Leicester, Verenigd Koninkrijk, LE17RH
- University of Leicester
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Contact:
- Joseph Manning, Registered Nurse, PhD
- Telefoonnummer: +447812 275027
- E-mail: joseph.manning@leicester.ac.uk
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Contact:
- Manning
- E-mail: joseph.manning@leicester.ac.uk
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Nottingham, Verenigd Koninkrijk, NG7 2UH
- Nottingham University Hospital Trust
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Contact:
- Joseph Manning, Registered Nurse, PhD
- Telefoonnummer: +447812 275027
- E-mail: joseph.manning3@nhs.net
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Hoofdonderzoeker:
- Joseph Manning, Registered Nurse, PhD
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Children and Young People, Parents and Carers, Healthcare Professionals.
Beschrijving
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).
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Observatiemodellen: OTHER
- Tijdsperspectieven: OTHER
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
|---|---|
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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. |
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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. |
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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). |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Qualitative experiences and perceptions of how acute paediatric settings support or do not support access to mental health support - interviews.
Tijdsspanne: Up to 11 months.
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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.
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Characteristics of the mental health support pathway - non-participant clinical observations.
Tijdsspanne: Within 1 month of each participating site opening.
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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.
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Characteristics of the recommended mental health support pathway - document review.
Tijdsspanne: Up to 11 months.
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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.
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Characteristics of the mental health support pathway - medical record review.
Tijdsspanne: Up to 11 months.
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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.
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Medewerkers en onderzoekers
Sponsor
Publicaties en nuttige links
Algemene publicaties
- 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.
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Studieregistratiedata
Eerst ingediend
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 1077
- 323578/Z/24/Z (Ander subsidie-/financieringsnummer: Wellcome Trust)
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
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