Central policies, wider national improvement approaches and sustained local change; An exploratory study of access to mental health treatment for children and young people in Scotland
Provision of suboptimal mental health care is widely recognised as a pressing problem in Scotland, but it traditionally remains under resourced with children and young people struggling to get timely access to high quality mental health support. To address these shortcomings, several national regulatory and improvement bodies are routinely commissioned by the Scottish Government to facilitate the implementation of its most recent mental health strategy and provide local support to ensure children and young people are receiving accessible, acceptable, and good quality treatment. This top-down approach has had some successes, but it has often led to services seeing improvement trough centrally imposed standards as something done to them, rather than by them. Even when the central direction has proved effective in achieving significant improvements in service delivery, what is less clear is how effective sustainable change takes place within a resource constrained local environment under increasing pressure to continuously redefine their work and professional boundaries in order meet nationally prescribed and centrally imposed standards.
Our Current Focus
The purpose of the study is to understand the processes of a national policy implementation, which takes account of the variation, the multiple layers and interactions which takes place between policy-makers and ‘national implementers’ as policy becomes practice. More specifically, it focuses on contextualising and exploring the extent to which a central government mental health policy (macro level) is implemented into wider national improvement approaches (meso level) and, in turn, interpreted, enacted and operationalised within local service delivery contexts (micro level). The findings are likely to contribute towards strengthening service delivery and provision, and be of benefit for academics, policy makers and healthcare professionals involved in complex mental health improvement work at local, national and central government
What’s Currently Happening
We are in the process of conducting:
a) Semi-structured interviews with policy makers and key national stakeholders to explore how the content of central mental health policy is implemented into country wide national improvement approaches; and
b) a series of focus groups with key professionals involved in leading or locally implementing improvements within CAMHS, to understand how they navigate through central and national objectives to determine how to best redesign mental health services locally.