Peer-reviewed article
Relational care in community mental health: Evaluating staff experiences in Intensive Community Care Services (ICCS) vs treatment as usual.
Atanda O, Reavey P, Wong B, Baker E, Collier J et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated staff experiences in Intensive Community Care Services (ICCS) compared to standard mental health treatment through 34 interviews with healthcare providers. Staff identified three key themes: relational barriers and enablers to engagement, the need for flexibility within systemic constraints, and the importance of trust-building in therapeutic relationships. The findings emphasize that non-clinical, personalized interactions and flexible treatment approaches are essential for engaging young people and supporting long-term recovery in mental health services.
Key points
- Trust and rapport must be developed through non-clinical engagement strategies such as informal visits and personalized interactions
- Flexibility in treatment duration and engagement methods is crucial for accommodating individual client needs
- Without trust, treatment effectiveness diminishes, necessitating tailored approaches rather than standardized models
- Relational care models in ICCS address complex needs of children and young people more effectively than treatment as usual
- Systemic barriers to implementing relational care models need to be addressed
Limitations
This is a qualitative process evaluation based on staff perspectives only, not child outcomes or effectiveness data. The study does not measure the impact of relational care on actual mental health outcomes for young people, only on provider perceptions of engagement and recovery.
Abstract
Background The quality of healthcare delivery relies heavily on building strong relationships between healthcare providers (HCPs) and clients. This study presents the results of a process evaluation for a Randomised Controlled Trial (RCT) examining the effectiveness of Intensive Community Care Service (ICCS) vs Treatment as Usual (TAU; inpatient or core community CAMHS). Methods Thirty-four semi-structured interviews were conducted with staff across various services, including 20 from ICCS and 14 other TAU services. A thematic decomposition analysis was conducted on the data, and specific themes relevant to staff experiences of young people's engagement with services and overall recovery. Results Three main themes were observed in the HCP data (1. Relational Ecologies: barriers and enablers to engagement, 2. flexibility of approach amidst systemic pressures and 3. the web of trust in the relationship-building process). HCPs highlighted the necessity of developing trust and rapport through non-clinical engagement strategies, such as informal visits and personalised interactions. HCPs emphasised that without trust, treatment effectiveness diminishes, necessitating a tailored approach rather than a one-size-fits-all model. The flexibility in duration of treatment and methods of engagement was noted as crucial in accommodating individual client needs and fostering an open, trusting environment necessary for long-term recovery. Conclusion The findings highlight the vital importance of relational care models, especially ICCS, in addressing the complex needs of Children and Young People (CYP). Flexible, family-centred approaches improve trust, engagement, and long-term recovery outcomes. Recommendations include tackling systemic barriers and expanding relational care models within CAMHS to meet increasing mental health demands effectively. Further research should investigate scalable strategies for integrating these insights into wider mental health service frameworks.