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Systemic conversations across children and young people’s mental health services: a case study

Tim Clarke (Research Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK)
Tonia Mihill (Therapeutic Services, Mancroft Advice Project, Norfolk, UK)

Journal of Public Mental Health

ISSN: 1746-5729

Article publication date: 14 June 2019

Issue publication date: 18 June 2019




Improving and transforming children and young people’s (CYP) mental health (MH) services is increasing in importance. Such systems, however, are often delivered across providers and commissioned in different ways which can lead to fragmentation and complexity, ultimately impacting negatively on how young people access services. With increased demand, this means that services are more likely to operate in silos when indeed they should be better integrated. Developing systemic interventions for service leaders and commissioners may support improved integration. The paper aims to discuss this issue.


Systemic issues across a CYP MH system were assessed and formulated. As a result, using systemic theory, appreciative inquiry and organisational change theories, a “systemic conversation” intervention was developed and delivered to senior leaders and commissioners of this system. This intervention comprised three workshop style sessions with numerous tasks.


Qualitative feedback and scores in the improvement of important elements that the conversations targeted were collected and examined descriptively. Participants rated their perceived improvement in relationships, transparency, integration, helpfulness and shared vision for future development.

Practical implications

In transforming CYP MH services, this paper considers how the authors can intervene across organisations representing the system to further integrate and improve care for those accessing services.


The intervention described is an original way of intervening with provider representatives from across the system. The paper provides a blueprint of how this might be adopted by others.



Clarke, T. and Mihill, T. (2019), "Systemic conversations across children and young people’s mental health services: a case study", Journal of Public Mental Health, Vol. 18 No. 2, pp. 102-111.



Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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