Understanding the nature of mental health nursing within CAMHS PICU: 1. Identifying nursing interventions that contribute to the recovery journey of young people

Abstract

Child and adolescent mental health services psychiatric intensive care units(CAMHS PICU) are a small, specialised, but important component of the portfolio of child and adolescent mental health service delivery in the UK. There has been no published research in relation to nursing care provision within CAMHS PICU and little or nothing is known about nursing identity and intervention within these settings. This research study investigated the nature of mental health nursing in a CAMHS PICU setting, to propose a conceptual model of CAMHS PICU mental health nursing. A qualitative conceptual text analysis from an externally facilitated psychodynamic work discussion group over a period of six months was undertaken using a theoretically informed inductive content analysis method. This, the first of a two part paper, investigates the context of CAMHS PICU and the nursing interventions developed within it. Findings indicate that CAMHS PICU nursing contains elements that are unique from either general adolescent mental health inpatient settings and adult PICU settings. The primary nursing task of enabling developmental growth and reparation, for young people who are experiencing acute psychiatric disturbance during a critical phase of their maturation against a back drop of chronic adversity, complex trauma and learning difficulties, manifests as a series of irresolvable tensions within the clinical environment. Interventions are required that explicitly engage with young people’s dependency and the inherently dialectic nature of adolescent development. Part 2 of this research explores nursing staff experience of their work and of the clinical environment, and their support needs.