Children and Young People’s Experiences of Mental Health Services in Healthcare Settings: An Integrated Review

Figures & data

Table 1. Inclusion criteria.

Inclusion Criteria
Qualitative and Quantitative Primary Research
Primary Research
Peer-reviewed empirical research articles
Full Text Available
English Language
All geographical locations (Global)
Male and Female participants
All time frames (no year/ time limits)
Children and Young People’s experiences only (0–17 years old)
All Mental Health Services within healthcare settings

Figure 1. Prisma flow diagram.

Table 2. Characteristics of included studies.

Title of research article and Purpose	Author, Year and Geographic Location	Sample studied	Study Design	Strengths and Limitations Quality Assessment Score (QA)
Paper 1 Adolescents’ perceptions of outpatient mental health services Purpose: To explore adolescent perceptions of the purpose, goals, expectations, frustrations and benefits of their mental health experiences.	Garland, A. and Besigner, B. 1996 United States of America	33 adolescents from three MH service settings 17 Male and 16 Female participants Aged 13–17 years old 36% Caucasian; 39% Hispanic; 21% African American; and 3% Asian	Qualitative Phenomenological approach Semi – Structured Interviews with Open-ended questions Taped, transcribed and coded	Strengths Representative of a diverse population within various settings Limitations Relatively small sample size – limited power to detect group differences QA Score: 20 (High)
Paper 2 Adolescents with mental health problems: what do they say about health services? Purpose: To explore health-related views and experiences of adolescent users of MH services.	Buston, K. 2002 Greater Glasgow, Forth Valley and Lanarkshire (UK)	32 young people ages 14–17 years old 21 females and 11 males All White British participants 1+ years of MH diagnosis 24 participants are attending child and adolescent services, 12 had been inpatients	Qualitative Phenomenological approach Semi-structured interviews In depth interviews that were taped, transcribed and coded following a grounded theory approach. Mean interview time = 1 hour and 30 minutes	Strengths Interview schedule piloted – increases reliability and validity Informal manner-promoting openness Various mental health illnesses Limitations One ethnic background (White). Small group and limited ages QA Score: 18 (High)
Paper 3 Children’s Key Concerns: Piloting a Qualitative Approach to Understanding Their Experience of Mental Health Care. Purpose: To systematically explore the service concerns of children who had received MH care in the community.	Day, C., Carey, M. and Surgeoner, T. 2006 Southwark, UK.	11 CAMHS service users 9–14 years old 5 males and 6 females. All white British participants	Qualitative Explorative descriptive study Stage 1: 3 semi-structured focus groups – taped and transcribed verbatim and coded Focus Group Mean Time: 52 minutes Stage 2: Validation Group – 4 participants from Stage 1 group for accuracy	Strengths Focus Group: Informal manner and icebreakers – increase honesty. Participants had various mental health illnesses Validation Group: Increases accuracy and validity of themes. Trained researchers Limitations One ethnic background (White). Small group and limited ages QA Score: 20 (High)
Paper 4 Children’s Views on Their Own Hospitalization at a Child Psychiatric Ward. Purpose: To allow children to explore and describe their own views of hospitalization at a child psychiatric ward.	Sorsa, M., Ranta, T., Hartikainen, A. and Paavilainen, E. 2006 Norway	29 participants 4–12 years old 25 males and 4 females participated. Ethnicity not specified.	Qualitative Phenomenological Approach Interviews using a structured questionnaire, including open-ended questions which were taped, recorded and transcribed verbatim	Strengths Questionnaire: Not very invasive to the children, and they felt safe when stating their point of view, improves accuracy Various mental health illnesses Limitations Small group and limited ages Ethnicities unknown QA Score: 20 (High)
Paper 5 Children’s Views Matter Too! A Pilot Project Assessing Children’s and Adolescent’s’ Experiences of Clinical Psychology Services Purpose: To explore the experiences and understanding of clinical psychology practices and services of children and adolescents attending clinical psychology outpatient appointments.	Gordon, M. and Russo, K. 2009 Northern Ireland	15 participants (Aged 7–17 years old). 9 Children, 4 Males and 5 Females (7–11 years old) 6 Adolescents, 3 Males and 3 Females (12–17 years old) Ethnicity not specified	Qualitative Explorative Interpretive Study Semi- structured interviews. 9 open-ended interview questions. Interviews taped, transcribed verbatim and coded.	Strengths Participants had various mental health illnesses Interview Style provides flexible agenda. Limitations Ethnicities unknown Small sample size QA Score: 18 (High)
Paper 6 ‘They’re not witches…’ Young children and their parents’ perceptions and experiences of Child and Adolescent Mental Health Services. Purpose: To explore children’s experiences of CAMHS with the objective of providing guidance for those wishing to improve inclusivity and empowerment.	Bone, C., O’Reilly, M., Karim, K. and Vostanis, P. 2014 England (Rural, Urban, Inner City all included)	Study included 4 CAMHS services, teams 11 participants 8–12 years old 9 Male and 2 Female Ethnicity not specified	Qualitative Explorative interpretive study Semi-structured interviews were taped and coded	Strengths Children were given the option to have an adult or present or not: makes them more comfortable and in turn, more open. Various mental health illnesses and social backgrounds Limitations Ethnicities unknown Small sample size QA Score: 20 (High)
Paper 7 Adolescents’ and parents’ views of Child and Adolescent Mental Health Services (CAMHS) in Ireland. Purpose: To explore adolescents’ experiences of CAMHS in relation to accessibility, approachability and appropriateness.	Coyne, I., McNamara, N., Gower, C. and McNicholas, F. 2015 Republic of Ireland	3 CAMHS Clinics were involved from 3 geographically distinct urban regions 15 Adolescents participated 12–17 years old 6 Male and 9 Female Ethnicity not specified	Qualitative Descriptive Qualitative Design Focus Groups (n = 9) and Semi-structured Interviews with open-ended questions (n = 10) Interviews were audio recorded, transcribed verbatim and coded	Strengths Various mental illnesses and social backgrounds Trained researchers Option of focus group or interview Limitations Unknown ethnicities Small sample size QA Score: 20 (High
Paper 8 ‘I don’t want to be here, but I feel safe’: Referral and admission to a child and adolescent psychiatric inpatient unit: The young person’s perspective. Purpose: To identify and understand the experiences of the admission process for young people referred to psychiatric inpatient units.	Salamone-Violi, G., Chur-Hansen, A. and Winefield, H. 2015 Australia	Purposeful sampling 11 Inpatients from a state psychiatric ward participated 15–17 years old 6 Males and 5 Females	Qualitative Explorative, Interpretive study Semi-structured interviews with open-ended questions – audiotaped, transcribed and thematically analyzed	Strengths Various mental illnesses and social backgrounds Purposeful sampling enabled a consideration of a range of variables. Limitations Small sample size Limited age range Ethnicities unknown QA Score: 20 (High)
Paper 9 Young offenders’ and their families’ experiences of mental health interventions. Purpose: To explore the relevance of young people’s experiences of MH interventions with CAMHS before and during their time with youth offending services.	Jack, A., Lanskey, C. and Harvey, J. 2015 UK	14 participants that were involved with Young Offender Services (YOS) and CAMHS – 19% of population in this area. All aged 14–17 years old 1 White European, 1 Chinese and 12 White British participants 5 Females and 9 Males	Qualitative Exploratory interpretative study Semi-structured interviews with open-ended questions – taped, transcribed and coded	Strengths Various mental illnesses and ethnicities Interview Style provides flexible agenda (Semi-structured interviews with open-ended questions). Limitations Small sample size and small age range QA Score: 18 (High)
Paper 10 Young voices in mental health care: Exploring children’s and adolescents’ service experiences and preferences. Purpose: To explore young service users’ views of outpatient and community health clinics.	Persson, S., Hagquist, C. and Michelson, D. 2017 Sweden	7 participants (5 Females and 2 Males). All aged between 10 and17 years old All from community and CAMHS outpatient settings	Qualitative Phenomenological approach Semi-structured focus group interviews were conducted, taped, transcribed and coded. These two sources were then combined. 4 main themes identified. Validation group to confirm themes.	Strengths Various mental illnesses The combination of data from surveys and focus groups. Informal manner of focus group-participants may be more open. Limitations Ethnicities unknown QA Score: 20 (High)
Paper 11 Vulnerable young people’s experiences of Child and Adolescent Mental Health Services. Purpose: To explore the experiences of vulnerable young people in using a local child and adolescent mental health service (CAMHS)	Davison, J., Zamperoni, V. and Stain, H. 2017 North – East England, UK.	51 CAMHS service users aged 12–17 years old (Mean age: 15 years old) 74% Female participants and 26% Male participants All White – British ethnic origin. All participants attend a multi-site Foundation Special School	Qualitative Phenomenological approach Semi-structured interviews with open -ended questions which were taped, transcribed and coded	Strengths Good validity and reliability Large sample size Limitations Comparison or involvement of children in mainstream education was not possible due to time and resource constraints: may lack generalizability QA Score: 20 (High)

Figure 2. Themes and sub-themes.