Experiences Of Health Services Research Articles

Adolescent boys’ experiences of mental health and school health services - an interview study from Norway

BackgroundMental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys’ experiences of mental health and school health service.MethodsAn inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study.ResultsThe overall theme “barriers towards seeking help”, and three categories— navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking—described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness.ConclusionsLack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.

'I'm still su!c!dal when you're done with the paperwork': an inductive framework thematic analysis of #camhs on TikTok.

Young people are sharing their experiences of Child and Adolescent Mental Health Services (CAMHS) in the United Kingdom on TikTok. Little is known about the content of these videos and their influence on young people's attitudes towards seeking professional mental health support. This study explored how CAMHS is represented in a sample of 100 #camhs TikTok videos using participatory inductive framework thematic analysis. Four themes were developed alongside young people as co-researchers: (a) CAMHS can be frustrating and unhelpful, but sometimes life-saving, (b) Young people can feel their distress is invalidated by CAMHS, (c) CAMHS makes young people feel responsible for their distress, and (d) Young people may not feel CAMHS professionals are trustworthy. Video content described dismissive responses to expressions of suicidal ideation, professional knowledge being privileged over lived experience, and breaches of confidentiality. Some shared positive experiences of CAMHS helping to keep them safe. Together, the themes reflect a representation of CAMHS as a service where adults are powerful and young people occupy a subjugated position. This may influence young people's professional help-seeking behaviour. Recommendations for clinical practice and future research are presented.

Debate: Involuntary treatment and detention are a necessary part of mental health care for children and young people.

People of all ages are subject to involuntary psychiatric detention and treatment worldwide but there is current discussion about whether this complies with modern human rights law. The use of involuntary psychiatric hospitalisation among children and young people has largely eschewed research and policy interest to date. In this debate section, we hear from people with experience of child mental health services in the UK, USA and low- and middle-income countries about their views on the use of involuntary treatment in young people.

Prosumers' experiences of stigma dimensions within the clinical psychology field.

Lived experiences of mental illness and stigmatizing attitudes toward psychiatric diagnoses are common throughout the world. Research demonstrates that clinical psychologists are not exempt from having lived experiences of mental illness, nor experiencing, witnessing and perpetuating stigma. However, no research has examined prosumers' (providers and consumers of mental health services) experiences of witnessing discrimination within the field of clinical psychology. The purpose of this study was to explore prosumer's experiences of stigma within clinical psychology. A total of 175 doctoral level prosumers (graduated N = 39 and N = 136 in-training) completed a mixed-method online survey regarding their stigma experiences within the field. Emergent qualitative themes from grounded theory analyses included: witnessed discrimination (invalidation, over pathologizing, clinical psychologists as experts and training as a breeding ground for stigma, psychological distress, negative feelings related to field), anticipated stigma (agency and identity rejected, degree of acceptance), internalized stigma (perceived competence and social desirability), and stigma resistance (academia in action, engaging communities, comes with a risk, worthwhile). Our findings have implications for the role of clinical psychology in perpetuating stigmatizing views and attitudes toward individuals with lived experiences of mental illness, specifically in-training and academic settings. Further research should strive to evaluate how clinical psychologists, including prosumers, engage in stigma, and the associations between discrimination and other stigma dimensions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perspectives of potentially eligible Indigenous Māori on a lung cancer screening programme: a qualitative study

aims: Lung cancer causes more deaths than any other cancer, globally and in Aotearoa New Zealand, where it disproportionately affects Māori. We aimed to understand Māori perspectives on lung cancer screening in Aotearoa New Zealand to guide its equity focussed implementation, including identifying enablers and barriers. methods: We took a Kaupapa Māori based co-design approach to inform future screening, recruiting Māori current/ex-smokers and members of their whānau (family) for three focus group phases held in Auckland, Aotearoa New Zealand in August 2019. Participants responded to a proposed lung cancer screening pathway and shared their attitudes and beliefs about lung cancer and screening. Results were thematically analysed. results: The 21 Māori participants supported future lung cancer screening in Aotearoa New Zealand. Perceived benefits included being more informed about lung cancer and screening and enabling healthier future generations. Barriers to screening were previous negative health service experiences; fear; stigma; and access, including time, cost and transport. Enablers included providers’ cultural competence; clear communication; a one-stop shop; and support with transport. A range of factors could potentially influence a decision to participate in screening. conclusions: Participants favoured future lung cancer screening and identified key barriers and facilitators of screening.

“I didn’t want to leave my country” – mental health services as experienced by Bosnian refugees in Australia

PurposeDespite the substantial body of international research exploring the effects of forced migration on mental health and the obstacles faced by refugee cohorts in accessing mental health services, there is a lack of in-depth studies specifically focusing on Bosnian refugees in Australia – one of the largest ethnic groups of displaced peoples. This qualitative investigation seeks to convey the experiences of mental health services by five Bosnian refugees in Melbourne, highlighting perceived pathways and barriers to service utilisation. This study aims to address two primary research questions: firstly, what characterises the experiences of Bosnian refugees in Australia when accessing mental health services? Secondly, what are the main barriers encountered by this population when seeking mental health services?Design/methodology/approachThis study used qualitative inquiry and in-depth interviews to investigate the experiences of Bosnian refugees with mental health services in Australia. Data was collected through face-to-face interviews with five Melbourne-based Bosnian refugees who had previously accessed mental health services. Participants were recruited from community groups or associations using purposive sampling. Thematic analysis was used.FindingsKey themes were revealed, such as the crucial role of social and community services, preferences for individual vs group therapy, potential re-traumatisation from therapeutic engagement, distrust of government-run mental health services and concerns regarding psychopharmaceutical prescription practices. Addressing barriers to mental health service access necessitates a multifaceted approach, including flexible social and community service support, an increased number of co-ethnic professionals and a recognition of cultural variations for effective service provision. Implementing these strategies can enhance help-seeking behaviours, provide culturally appropriate mental health services and improve the experiences of Bosnian refugees in Australia.Originality/valueTo the best of the authors’ knowledge, this study is the first to qualitatively explore how Bosnian refugees in Melbourne perceived the adequacy and availability of mental health services upon arrival to Australia. They are a large and potentially vulnerable community, due to experiences of war trauma and dislocation from country of origin. A lack of understanding regarding how this cohort engage with mental health services can lead to persistent inequities and ineffective service provision. This study identifies unique experiences and perspectives of Bosnian refugee participants, including distrust of government-run mental health services, and concerns regarding psychopharmaceutical prescription practices. This research is expected to contribute positively to the discourse on mental health service provision for Bosnian refugees and wider refugee communities in Australia.

Health and medical experience of migrant workers: qualitative meta-synthesis

BackgroundMigrant workers in Korea are contributing to economic development by resolving labour shortages due to the increase in the ageing population, and they have become necessary and important in the Korean economy. However, long working hours, poor working conditions, and cultural differences can cause migrant workers to experience disadvantages in using health and medical services. Therefore, this study aimed to understand and analyse the health and medical service experience of migrant workers in Korea by reviewing previous studies in order to improve their health and access to medical services.MethodThe qualitative meta-synthesis method suggested by Thomas and Harden was used. The key question for searching the literature is ‘What is the status of the use of health and medical service by migrant workers in Korea and the attributes that affect them?' Five electronic databases (RISS, KCI, KISS, Science ON, and KMbase) were searched for Korean literature published in academic journals until 6 November 2022 using a combination of “migrant worker or foreign worker or foreign labourer or migrant” and “medical or health” in Korean.ResultsA total of nine studies out of 1,006 were included in the review after methodological quality assessment using the Critical Appraisal Skills Program (CASP). The results of studies were synthesised into three themes and ten sub-themes: ‘Personal factors’ of personal health beliefs and the financial burden of healthcare costs; ‘Cultural factors’ of cultural differences in the lifestyle, cultural differences in the healthcare environment, and traditional medicine in the country; and ‘Socio-institutional factors’ of poor and difficult working environment, insufficient information about medical institutions, policies with a lack of practical applicability, systems of healthcare institutions, and healthcare services usage.ConclusionsThis study identified the experiences of migrant workers in using health and medical care services. The results of this study can be used as a basis for improving the health of migrant workers and access to healthcare services. Based on the results of this study, it is necessary to improve the health management ability of migrant workers by developing a health management platform that can support Korean medical information and provide professional and accurate self-health management information.

Study protocol for a cross-sectional online survey investigating patient preferences and experiences of waiting for elective cardiac surgery

IntroductionBeing on a waiting list for elective (planned) cardiac surgery can be physically and psychologically challenging for patients. Research suggests that stress associated with waiting for surgery is dependent on...

Whole-genome sequencing of some Ukrainian isolates of SARS-COV-2 virus and analysis of its genetic variability

Aim. The aim was to gain experience of the animal health services to detect and properly identify SARS-CoV-2 virus with whole-genome sequencing method and its genetic variability in Ukraine in relation to possible future spread of the virus in animals. Methods. Sixteen SARS-CoV-2 positive samples, not sequenced before, were pro- vided by the Center for Public Health of the Ministry of Health of Ukraine. These samples were obtained from hos- pitalized patients from early October to mid-November of 2021. The viral RNA was isolated from nasopharyngeal swab samples of SARS-CoV-2 qPCR positive (Ct 21-28) patients (males and females) with moderate and severe symptoms who were being hospitalized. The samples were fully anonymized. The Ion Torrent S5 instrument (Ox- ford Nanopore, the USA) was used to sequence the mentioned SARS-CoV-2 isolates, originating from Ukraine. TorrentSuite 5.16.1 was used for data processing and analysis. Nextclade 2.3.0 was used for phylogenetic analysis to locate the 6 sequenced samples on the global phylogenetic tree. It was determined phylogenetic relations be- tween tested 6 sequences and 495 verified sequences of high quality, reported in Ukraine and deposited in the GI- SAID EpiCoVTM database, (https://gisaid.org/) for the period of January 2020 – December 2022. In the compari- son of sequences obtained, the sequence of SARS-CoV-2 virus isolate Wuhan-Hu-1 (GenBank NC_045512.2) was used as a reference sequence, according to which the sequences were aligned. All studies were carried out in the laboratory of the Research Training Center for Animal Disease Diagnostics at the Institute of Veterinary Medicine of the National Academy of Sciences of Ukraine. Results. Among the 16 isolates tested, all were confirmed to con- tain SARS-CoV-2 RNA, of which only six isolates were sequenced with sufficient quality and could be classified, five of them as Delta variants (two belong to lineage AY.126 (B.1.617.2.33), two to AY.122 (B.1.617.2.122), and one to AY.4.2.3 (B.1.617.2.4.2)), and one isolate as an Omicron variant (BA.1.18). Important mutations detected in our isolates were a S:N501Y substitution and S:H69 deletion in the gene of the virus envelope spike protein. Among the examined isolates, the Omicron variant (BA.1.18) was found to exhibit greater genetic variability, with over 60 mutations compared to previous variants. In our investigation, we identified mutations in the sequenced Delta variants too, ranging from 35 mutations in AY.122 (B.1.617.2.122) to 41 mutations in AY.126 (B.1.617.2.33) in the genome compared to the reference Wuhan-Hu-1 (MN908947) variant. Important mutations found regarding infectivity were 1) for the Delta variants: T478K, L452R mutations in the RBD region, and 2) for the Omicron variant: S371L, G339D, S375F, S373P, K417N, N440K, S477N, G446S, E484A, T478K, Q493R, Q498R, G496S, N501Y, and Y505H mutations in the RBD region. Conclusions. The whole-genome sequencing of 6 isolates of SARS-CoV-2 virus was performed, and three sublines of the Delta variant were found: AY.126 (B.1.617.2.33), AY.122 (B.1.617.2.122), AY.4.2.3 (B.1.617.2.4.2) and one subline for the Omicron variant (BA.1.18), all of which were deposited in the international database GISAID as EPI_SET_230516yp. The data obtained in this study add to the existing ones delivered by the Ministry of Health in Ukraine and can be used in laboratories, (including veterinary ones), detecting the SARS-CoV-2 virus in risk animal populations, in order to prevent the spread of the disease to humans and animals, as well as to detect possible mutational changes in the pathogen genome that may affect infectivity and pathogenicity.

Collaboration With Researchers With Intellectual/Developmental Disabilities: An Illustration of Inclusive Research Attributes Across Two Projects

Abstract Researchers have implemented inclusive research for over 30 years. This article describes how two research projects collaborated with researchers with disabilities and aligns the description with four attributes of inclusive research developed by a consensus of international experts with and without disabilities. The first project, the Person Experiences Interview Survey (PEIS) Workgroup, reviewed and revised items for a self-report survey of mental health service experiences. The second project describes the peer-led implementation of the Self-Determined Career Design Model (SDCDM) intervention. Four factors facilitated or were barriers to the projects’ alignment with inclusive research attributes. First, relationships enhanced capacity to engage in meaningful ways. Second, balance between consistency and adaptability promoted engagement. Third, long-term capacity was enabled by ongoing engagement and peer mentorship. Fourth, time and funds impacted inclusive implementation. Engaging researchers with disabilities meaningfully enhanced the research process and products.

Patient journey mapping: emerging methods for understanding and improving patient experiences of health systems and services.

Patient journey mapping is an emerging field of research that uses various methods to map and report evidence relating to patient experiences and interactions with healthcare providers, services, and systems. This research often involves the development of visual, narrative, and descriptive maps or tables, which describe patient journeys and transitions into, through, and out of health services. This methods corner paper presents an overview of how patient journey mapping has been conducted within the health sector, providing cardiovascular examples. It introduces six key steps for conducting patient journey mapping and describes the opportunities and benefits of using patient journey mapping and future implications of using this approach.

The impact of racism on subsequent healthcare use and experiences for adult New Zealanders: a prospective cohort study

BackgroundRacism is an important determinant of health and driver of racial/ethnic health inequities. Experience of racism has been linked to negative healthcare use and experiences although most studies have been cross-sectional. This study examines the relationship between reported experience of racism and subsequent use and experience of health services.MethodsThis is a prospective cohort study design. The 2016/2017 adult New Zealand Health Survey (NZHS) provided the sampling frame and baseline data on exposures, health status and confounders. This stand-alone study invited all exposed individuals to participate when sampled based on their reported experience of racism (ever), stratified by broad ethnic groupings (Māori, Pacific, Asian, European/Other). Equal numbers of unexposed participants were selected for invitation using propensity score matching (propensity to experience racism, based on key available predictive factors). Follow-up was one to two years after NZHS interview. Outcome variables (last 12 months) were: unmet healthcare need (overall, for mental health, for a general practitioner); satisfaction with usual medical centre; and experiences with general practitioners (explaining care, involvement in decision-making, treated with respect/dignity, confidence and trust). Logistic regression models examining the association between experience of racism (at baseline) and health service use and experience (at follow-up) used doubly-robust estimation to weight for propensity scores used in the sampling with additional adjustment for confounders.ResultsThe study had 2010 participants. Experience of racism (ever) at baseline was associated with higher overall unmet need at follow-up (adjusted OR (aOR) = 1.71, 95% CI 1.31, 2.23), with similar patterns for other unmet need measures. Experience of racism was associated with higher dissatisfaction with a usual medical centre (aOR = 1.41, 95% CI 1.10, 1.81) and with higher reporting of negative patient experiences.ConclusionIn line with how racism structures oppression, exposure to racism is largely felt by non-European groups in Aotearoa New Zealand. Experiences of racism potentially lead to poorer healthcare and healthcare inequities through higher unmet need, lower satisfaction and more negative experiences of healthcare. The health system has a critical role to play in addressing racism within healthcare and supporting societal efforts to eliminate racism and ethnic inequities.

BRAIN HEALTH SERVICES – NOWE PODEJŚCIE DO ZAPOBIEGANIA CHOROBIE ALZHEIMERA

Since several years focus move for the prevention of Alzheimer’s disease. The primary care is the more natural setting for prevention. However, many specialised organisations want to also consider prevention in their daily work and highlight the need of further changes in organisation of preventive ways. There is 14-20 concrete prevention targets that can be modified such as hearing impairment, vascular risk factors: smoking, alkohol, hypertension, diabetes, atrial fibrillation, diet and physical activities. Ongoing project gathers different specialities that argues for the need of structure for prevention. I will present challenges and opportunities with creating a special services in form of Brain Health Clinics from geriatrics perspective. The vue of other associations will be also mentioned. Finally, two years experience of Brain Health services that exist at Karolinska Institutet in Sweden will be discussed.

Service User Perspectives of Family Involvement and Mental Health Care Outcomes in Queensland

Family‐focussed practice is an important component of mental health care. In Australia, service users’ views about their experience of service are collected using instruments such as the Your Experience of Service (YES) survey. This study examined 10,579 Queensland (Australia) service users’ experiences of mental health services during 2019–2021, with a particular focus on their perspectives of how family and carers are involved in their care. The study examined if family‐focussed practice is welcomed by service users and if it is important in terms of predicting recovery‐related outcomes (e.g., hopefulness, managing day‐to‐day life, well‐being, and experience of care) and which demographics (e.g., age, gender, and Indigenous status) and service characteristics (e.g., time in service, duration, year of service, and setting type) are associated with these outcomes and with family member involvement. A substantial majority of service users reported a positive experience of care (very good or excellent), feeling they had opportunities for family involvement and that their opinions about family involvement were respected (usually or always). Chi‐square tests and nonlinear regression models showed that family involvement predicts care outcomes. Specifically, where individuals felt that their perspectives were recognised, their outcomes were consistently rated as more positive. The results also revealed that setting, age group, time in service, and admission status were significantly correlated with all user experience outcome variables and family‐oriented variables. Future research has the potential to further strengthen this understanding of service users’ preferred opportunities and opinions about family involvement and how to improve family engagement and better meet the needs of service users and their families.

Caregiving and receiving experiences in UK community mental health services during COVID-19 pandemic restrictions: A qualitative, co-produced study.

WHAT IS KNOWN ON THE SUBJECT?: At the outset of the COVID-19 pandemic, little was known about ways of delivering registered nurse practice within CMHTs under restrictions associated with a global pandemic. Emerging research focused on broad healthcare staff wellbeing during the pandemic. Qualitative research explored the overall response of COVID-19 on people with existing health needs or remote working more specifically. Over the past 2 years studies have emerged detailing experiences but no studies have used qualitative research to understand community mental health nurses and service users experience of services. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This co-produced qualitative study is the first to explore the changes to CMHT care from the experience of service users and nurses later in the COVID-19 pandemic. The study questions whether recovery-based approaches are possible in a hybrid way of working. The findings identify challenges for nurses' well-being and work-life boundaries when working from home. The study adds to historical professional narratives of mental health nursing. WHAT ARE THE IMPLICATIONS FOR PRACTICE: While hybrid approaches developed in response to COVID-19 restrictions may offer more choice these approaches need further co-produced evaluation on the impact of recovery-focused care and therapeutic relationships. Mental health nurses need to review how future hybrid working continues to impact nurses' mental health and emotional safety. Nurses and service users need to raise awareness within society and policy on the impact that COVID-19 had on people with existing mental health conditions. ABSTRACT: Introduction Community Mental Health Team responses to COVID-19 included fundamental service delivery adaptations. Aim/Question Our co-produced study sought to understand which service delivery changes experienced by service users and registered nurses were helpful or unhelpful to caregiving and receiving. Method Qualitative semi-structured interviews were undertaken with 10 service users and 13 registered nurses from 3 NHS England sites. Co-produced throughout, people with lived experience of mental health services and nurses wishing to improve their research experience undertook interviews following training. Data were analysed thematically. Findings Care radically changed from in-person to large phone or video contact. This reportedly altered therapeutic relationship building and raised questions about whether recovery-focused care was possible. Hybrid working was viewed as helpful but raised challenges for nurse wellbeing. Discussion Changes to care delivery challenged the fundamentals of recovery-focused interventions and therapeutic relationships. Service users and nurses well-being consequently suffered. The impact of the pandemic on people with existing mental health conditions was poorly acknowledged in the media. Implications for Practice Recovery-focused interventions and relationship building need evaluating in the light of ongoing hybrid working. Teams need to consider the well-being of nurses engaged in complex service-user interactions from home.

EE756 Real World Evidence (RWE) Evaluation of Cost Savings through Continuous Vital Sign Monitoring in the Medical-Surgical Ward: A National Health Service (NHS) Experience

EE756 Real World Evidence (RWE) Evaluation of Cost Savings through Continuous Vital Sign Monitoring in the Medical-Surgical Ward: A National Health Service (NHS) Experience

Development and content validity of the Person Experiences Interview Survey (PEIS): a measure of the mental health services experiences of people with developmental disabilities.

People with developmental disabilities and mental health service experiences have a right to be included in healthcare decisions, including the evaluation of their mental health services and providers. However, few self-report measures address this need. This study aimed to fill this gap by developing and evaluating the content validity, including comprehension, relevance, and comprehensiveness, of the Person Experiences Interview Survey (PEIS) with people with developmental disabilities and mental health experiences. The research team established a measurement framework based on the Family Experiences Interview Survey (FEIS), resulting in 21 PEIS items that were written in collaboration with young adults with developmental disabilities and mental health service experiences. Comprehension, relevance, and comprehensiveness were evaluated through cognitive interviews with people with developmental disabilities and mental health service experiences (respondents; n = 9) ages 23-49 years. Comprehensiveness and relevance were also evaluated in focus groups with family caregivers (n = 9) and mental health providers (n = 10) who serve this population. Two researchers independently coded open-ended responses to the PEIS for comprehension. A content validity index (CVI), indicating relevance, was calculated for each participant group for each item, and comprehensiveness was rated for item sets. Fifteen of the 21 items met the criteria of ≥80% comprehension, with 89-100% of responses containing all or some intended information. All items met the CVI ≥80% criterion in at least two of the three groups. In all item sets, between 1 and 4 family members or providers felt one question was missing. Respondents used the response scale in a manner that corresponded with their open-ended descriptions, and family caregivers and providers had positive feedback about the response scale's visual cues and number of choices. Using these findings, four items were removed and six items were revised, resulting in a 17-item measure. This study presents a novel and promising measure, the Person Experiences Interview Survey (PEIS). It also demonstrates that the employment of accessible methods allows people with developmental disabilities to meaningfully evaluate mental health services and providers. The PEIS shows great promise for application in the field by engaging those directly involved in the evaluation of mental health services and providers.

Breast Cancer Patients’ Experience of Current Health Services as A Holistic Care: A Qualitative Study

Introduction: Breast cancer is now one of the leading causes of death and morbidity worldwide, including in Indonesia. Every health care professional and community member should pay close attention to these issues. Women diagnosed with breast cancer will experience physical, psychological, and social issues. Methods: This study looked into breast cancer patients’ experiences with holistic nursing care. The complexity of the difficulties confronting breast cancer patients will influence their experiences and perceptions, necessitating a holistic approach to nursing services. A qualitative exploratory, descriptive method was adopted in the investigation. During data collection, fifteen participants were recruited and interviewed. Focus Group Discussion (FGD) was utilized to collect data. Result: The study’s findings provide five significant themes: (1) knowledge and understanding of breast cancer; (2) experiences felt at the beginning of breast cancer complaints; (3) non-health breast cancer treatment; (4) perception of nursing services received by breast cancer patients; (5) facts and holistic needs during and beyond treatment; and (6) patients’ expectations of nursing services to help their needs. Conclusion: The findings provide information on how breast cancer patients understand the examination procedure, accept a diagnosis, and proceed to treatments.

Parent perspectives of engaging with a community paediatric clinic with linked child development supports in a disadvantaged area of Ireland.

Parent experiences of child health services can be used to understand their value and optimise the support provision to families during critical developmental periods. A gap in the literature exists regarding parental perspectives of linked child development supports, particularly in disadvantaged areas. This study examined parent experiences of the impact and value of a community paediatric clinic (Kidscope) with linked, multi-agency supports in a disadvantaged area of Ireland. Using a qualitative analysis design, 10 parents participated in one-to-one interviews. A Community Advisory Group consulted on interview schedules. Data was thematically analysed in line with Braun & Clarke's Framework. Five themes and twenty-two sub-themes emerged. Kidscope's linked, multi-agency approach was valuable for engaging families, addressing developmental delay, supporting readiness for education, and developing parent-child relationships. Relational working and a child and family centred model of care empowered parents to become active agents in children's health. Coronavirus disease 2019, national deficits in healthcare, and staff turnover impeded service delivery. Kidscope and linked supports work in partnership to disrupt the impact exclusion from healthcare has on vulnerable children and families. This study provides evidence of an effective integrated paediatric service delivery model designed around vulnerable children and families and highlights areas for improvement.

University Student Perspectives Negotiating Positive and Negative Mental Health on Campus

This study explored university students’ perspectives on negotiating and navigating their fluctuating mental health on one specific campus, with particular interest in their experiences of campus-based mental health services. Given the dearth of evidence across paradigms that establishes a concerning prevalence of poor mental health among post-secondary students, this study sought to give voice to students with respect to what changes they felt were most pressing. Seven semi-structured interviews were completed with undergraduate students (second through fourth year) at a mid-sized Canadian institution. Data were analyzed thematically, integrating critical and recovery-oriented social theories. Findings, from the perspective of the students themselves, generated through this process included barriers to help seeking behaviours related to formal services included perceived and actual stigma, lack of confidence in the effectiveness of services, roundabout intake processes, and the perceived need for formal diagnosis as a prerequisite to access. Facilitators to help seeking behaviour related to formal services included quickly developing a positive relationship with a counsellor and access to knowledgeable gatekeepers of mental health services. And finally, informal supports included social support, being meaningfully included and involved in the university environment, recreation, and some forms of substance use.