"I think everybody's finding it a challenge to be honest" The experience of mental health professionals working in Child and Adolescent Mental Health Services in Ireland

Abstract

This qualitative research study explored the experience of mental health professionals working in Child and Adolescent Mental Health Services (CAMHS) in Ireland. Mental health services, including CAMHS, have undergone significant development over the past decade. This development has largely occurred within the context of the publication of the national policy document A Vision for Change (Department of Health and Children, 2006) which set out a framework for mental health services across the lifespan. While there has been a considerable focus on the number of referrals and waiting-lists in CAMHS, the experience of the professionals working within the services has been neglected. Little is known about how professionals make sense of their work in CAMHS and the nature of their experiences within these services.

Semi-structured interviews were carried out with six multidisciplinary professionals working in CAMHS and the data was analysed using interpretative phenomenological analysis. Three superordinate themes emerged from the data which indicate the challenging nature of working in CAMHS: negotiating identity, power and the changing nature of CAMHS. Participants described their unexpected journey to establishing a professional identity and being part of a multidisciplinary team. They also spoke about the hierarchical nature of the team and how their experience of the elevated status of psychiatry leads to participants having to battle for their voices to be heard. While participants acknowledged advantages and disadvantages of recent changes in CAMHS, the over-arching feelings were those of frustration, in addition to pessimism about the future of the services, despite their motivation to engage in best practice with the clients and families they serve.

The findings of this study highlight concerns about current practice in CAMHS and the complex nature of multidisciplinary team-working. Although efficiency and accountability are necessary, greater attention needs to be paid to the experiences of professionals working within services, as well as the quality of the services being provided. This study has number of implications for current service provision and it also informs future developments in CAMHS.