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.
研究概览
研究类型
注册 (估计的)
联系人和位置
学习地点
-
-
-
Leicester、英国、LE15WW
- University Hospitals of Leicester NHS Trust
-
接触：
- Damian Roland, BMBS, PhD
- 电话号码：+44300 303 1573
- 邮箱：dr98@leicester.ac.uk
-
首席研究员：
- Damian Roland, BMBS, PhD
-
Leicester、英国、LE17RH
- University of Leicester
-
接触：
- Joseph Manning, Registered Nurse, PhD
- 电话号码：+447812 275027
- 邮箱：joseph.manning@leicester.ac.uk
-
接触：
- Manning
- 邮箱：joseph.manning@leicester.ac.uk
-
Nottingham、英国、NG7 2UH
- Nottingham University Hospital Trust
-
接触：
- Joseph Manning, Registered Nurse, PhD
- 电话号码：+447812 275027
- 邮箱：joseph.manning3@nhs.net
-
首席研究员：
- Joseph Manning, Registered Nurse, PhD
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
Children and Young People, Parents and Carers, Healthcare Professionals.
描述
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).
学习计划
研究是如何设计的？
设计细节
- 观测模型：OTHER
- 时间观点：OTHER
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
|
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). |
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Qualitative experiences and perceptions of how acute paediatric settings support or do not support access to mental health support - interviews.
大体时间：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.
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Characteristics of the mental health support pathway - non-participant clinical observations.
大体时间：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.
大体时间：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.
大体时间：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.
|
合作者和调查者
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.