Mental health training to improve communication with children and adolescents: A process evaluation

Abstract

Aims and objective: To characterise the intervention components, mechanisms of change and barriers to implementation of an intervention to improve communication behaviour of hospital staff surrounding mental health with children and adolescents.

Background: Healthcare professionals consistently report a lack of confidence and knowledge to care for young people experiencing mental health difficulties. We Can Talk is a one-day training, delivered to hospital staff, which provides tools to improve their communication with children and adolescents about mental health. Initial evaluation suggests the training improved confidence and skills regarding communication; however, the effective intervention components and mechanisms of change are not yet understood.

Design: A process evaluation was conducted using a qualitative research design.

Methods: Document analysis of the training manual, using the Behaviour Change Technique Taxonomy, characterised intervention components. Ten interviews with paediatric staff from an east London hospital were conducted post-intervention. Using the Theoretical Domains Framework, the mechanisms of change and remaining barriers to communication were coded thematically. COREQ checklist was used in the reporting of the study.

Results: Twenty behaviour change techniques were identified. Communication about mental health was mainly facilitated through improving the knowledge, cognitive and interpersonal skills, and beliefs about capabilities of healthcare professionals. A small number of staff continued to experience barriers to communication including a lack of opportunity for communication, beliefs that their professional role is not suited to supporting mental health and nervousness. Behaviour change techniques are highlighted to address remaining barriers reported post-intervention.

Conclusions: Using validated and systematic behaviour change tools, this process evaluation contributes to the translation of evidence to clinical practice for more effective, sustainable and transparent mental health care, reducing the research-practice gap in this area.

Relevance to clinical practice: These findings can facilitate implementation of evidence-based practice and inform interventions, improving clinical practice and outcomes for children and adolescents.

Keywords: adolescent; children; communication barriers; continuing nursing education; health services; mental health; programme evaluation; qualitative research; social skills.