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There is an international drive to improve mental health services for young people. This study aims to investigate service user experience of a youth mental health service in Norfolk, UK. In addition to suggesting improvements to this service, recommendations are made for the development of youth mental health services in general.

A mixed-methods approach was used. Quantitative data from satisfaction questionnaires were analysed using descriptive statistics and compared between two time points. A semi-structured interview was used to generate qualitative data. Thematic analysis was used to identify themes in the interview transcripts and triangulation was used to synthesise quantitative and qualitative data.

Service users appeared satisfied with the service. Significant improvements in satisfaction were found between two time points. Qualitative analysis identified three main themes that were important to service users, including support, information and personhood.

Recommendations for the development of youth mental health services are provided. Although these are based on findings from the Norfolk youth service, they are likely to apply to other mental health services for young people.

Mental health care for young people requires significant improvement. The Norfolk youth service is one of the first services of its kind in the UK. The findings from this study might be helpful to consider in the development of youth mental health services across the world.

Young people can often “fall through the gaps” between Child and Adolescent Mental Health services (CAMHS) and Adult Mental Health services (AMHS). This discursive viewpoint study aims to reflect a conversation among the authors on how CAMHS and AMHS psychiatry came together to develop and embed a UK community “Youth Mental Health Service”.

This reflective viewpoint study explores the perspectives of three of the lead CAMHS and AMHS psychiatrists from the implementation phase of a community youth mental health service. It explores, in a discursive way, these individuals’ views on some of the key facilitators and barriers in the development of the service that aimed to “bridge the gap” for young people.

These clinicians’ reflections recognise the importance of strong clinical leadership in enabling a youth/young adult model of mental health to be implemented. They also recognise how culture internal and external to a service has a key role to play in the success and sustainment of implementing an innovative model. This study describes a merging of CAMHS and AMHS psychiatry to meet the needs of young people in the most developmentally appropriate way.

This reflective study highlights the need for services and systems to think creatively about how they can allow flexibility for CAMHS and AMHS psychiatrists to learn and plan together, as well as gain experiences across the age ranges, to facilitate collaborative working that is developmentally appropriate and meets the needs of young people in a way that is accessible to them.

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.

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.

Whilst there are pockets of excellence in the provision of Child and Adolescent Mental Health Services (CAMHS), many services fail to meet young people’s needs. Considering this, the purpose of this paper is to ascertain perceptions of CAMHS provision in a rural county of the UK to inform re-design of youth mental health services.

The study comprised of two phases: phase one involved analysis of questionnaire data of youth views of CAMHS. Phase two involved analysis of the “Have Your Say” event data which explored perceptions of CAMHS and future service re-design. Data were thematically analysed.

Knowledge of the existence and purpose of CAMHS was variable. Participants wanted accessible information about services, rights, confidentiality and for this to be provided in multiple media. Young people wanted staff who were easy to talk to, genuine, understanding and who valued their insights. Participants wanted to be offered choice about appointments, location and timing. An ideal mental health service was described as a “one-stop-shop” of co-locality and multi-agency collaboration. Young people clearly expressed a desire to influence the design and delivery of the radical service re-design and to be embedded in its development.

The results highlighted multiple problems with CAMHS provision and provided a clear justification for the re-design of services.

This was a novel approach demonstrating the importance, utility and power of effective participatory practices for informing the re-design of services.

In response to elevated local self-harm and suicide rates, and the lack of a dedicated pathway for children and young people (CYP) who self-harm, a rapid response pathway united to reduce self-harm (RUSH) was developed and implemented within Norwich (Norfolk, England). This public health case study aims to describe the pathway model and share its outcomes, learnings, and reflections over the pilot year.

RUSH was a community-based pilot pathway aiming to support CYP, 11–18 years old, engaging in or at risk of engaging in repeated self-harm and subsequently at risk of repeated attendance at local emergency departments. From May 2020 to April 2021, RUSH supported 61 CYP using funding from NHS England and Improvement.

This case study shares the pathway’s outcomes, through a mixed-method evaluation. Results indicate statistically significant reductions in self-harm frequency (p = 0.01) and anxiety and depression symptomatology (p < 0.001); a statistically significant increase in progress towards goals (p < 0.001); and a general downward trend in re-attendance at local emergency departments following RUSH. Findings also illustrate high service user satisfaction. Framework analysis of focus group data highlights positive experiences with hope for recommissioning from a staff perspective.

This study will be valuable for services looking to develop and implement a similar service provision, in response to the need to tackle self-harm rates as a broader approach to suicide prevention. In light of the NHS long-term plan (2019), it also serves as an example of how to develop and use a strategic co-production group, and work collaboratively with the voluntary, community and social enterprise sectors.

This paper aims to examine the barriers and facilitators of conducting and implementing research in frontline child and youth mental health settings in the UK.

Researchers, clinicians and commissioners who attended a workshop at the Big Emerging Minds Summit in October 2022 provided their expert views on the structural barriers and possible solutions to integrating research in clinical practice based on their experiences of child and young people mental health research.

The identified barriers encompass resource constraints, administrative burdens and misalignment of research priorities, necessitating concerted efforts to foster a research-supportive culture. This paper proposes the potential actionable solutions aimed at overcoming challenges, which are likely applicable across various other health-care systems and frontline NHS services. Solutions include ways to bridge the gap between research and practice, changing perceptions of research, inclusive engagement and collaboration, streamlining ethics processes, empowering observational research and tailored communication strategies. Case examples are outlined to substantiate the themes presented and highlight successful research initiatives within NHS Trusts.

This paper provides an insight into the views of stakeholders in child and youth mental health. The themes will hopefully support and influence clinicians and academics to come together to improve the integration of research into clinical practice with the hope of improving service provision and outcomes for our children and young people.

This paper aims to determine whether a single session of a motivational interview (MI) reduces smoking relapse amongst people released from smoke-free prisons.

This study sought to recruit 824 ex-smokers from 2 smoke-free prisons in the Northern Territory, Australia. Participants were randomised to receive either one session (45–60 min) face-to-face MI intervention 4–6 weeks prior to release or usual care (UC) without smoking advice. The primary outcome was continuous smoking abstinence verified by exhaled carbon monoxide test (<5 ppm) at three months post-release. Secondary outcomes included seven-day point-prevalence, time to the first cigarette and the daily number of cigarettes smoked after release.

From April 2017 to March 2018, a total of 557 participants were randomised to receive the MI (n = 266) or UC (n = 291), with 75% and 77% being followed up, respectively. There was no significant between-group difference in continuous abstinence (MI 8.6% vs UC 7.4%, risk ratio = 1.16, 95%CI 0.67∼2.03). Of all participants, 66.9% relapsed on the day of release and 90.2% relapsed within three months. On average, participants in the MI group smoked one less cigarette daily than those in the UC within the three months after release (p < 0.01).

A single-session of MI is insufficient to reduce relapse after release from a smoke-free prison. However, prison release remains an appealing time window to build on the public health benefit of smoke-free prisons. Further research is needed to develop both pre- and post-release interventions that provide continuity of care for relapse prevention.

This study is the first Australian randomised controlled trial to evaluate a pre-release MI intervention on smoking relapse prevention amongst people released from smoke-free prisons.

The global shift in the traditional skills required of real estate graduates has led to an increased demand for employees who have the required skills and competencies. The purpose of this study is to evaluate employment considerations of real estate firms and analyse employers’ skill expectations and the observed skills possessed by the graduate employees. This study also analysed the self-assessed soft skill levels of the graduate employees, thereby establishing the skill gap.

Data were sought from real estate employers in the two dominant real estate markets of Nigeria: Lagos and Abuja, and real estate graduate employees who have had a minimum of six months working experience in real estate firms. Data collected were analysed using statistical techniques such as frequency, percentages, mean, correlation, multivariate analysis of variance, paired-samples t-test and independent samples t-test.

The findings of this study revealed that employers’ soft skills expectations were high with skills such as responsibility, administrative, listening, communication, business negotiation and work ethics. Based on employers' observed skills, there were significant skill gaps with respect to soft skills such as responsibility, business negotiation, logical thinking, marketing and dispute resolution. An analysis of the core skills reveals employers' preference for technical competencies in valuation, agency, property management, marketing, report writing and landlord and tenant laws. However, graduate employees possessed significant skill gaps with regards to technical skills such as valuation, property investment analysis, feasibility and viability appraisal, market research methods and facility management.

An understanding of the skill gaps will provide useful feedback to professional bodies, regulatory boards, institutions of higher learning, faculty members and other stakeholders regarding deficient skill areas, especially for curriculum review, development and training in the real estate sector.

There is a paucity of information about employers' skill preferences and the skill gaps in the real estate sector.

Tourism has become a sustainable and viable tool in place making or community revitalization process. Residents’ perceptions of tourism impacts are critical to the sustainability of the tourism industry. This study follows a quantitative research approach to examine how variation in patronage pattern impact its host community using Olumo Rock in Abeokuta, Nigeria, as a case study.

Primary data from 324 residents are analysed using mean scores, chi-square and one-way ANOVA analysis. Secondary data such as the number of monthly patronage and precipitation and temperature were also analysed.

The findings revealed that the majority of residents do not patronize the tourism destination and that patronage patterns were seasonal and varied within and between seasons in Olumo. The perception of the residents living adjacent to the tourism destination established that they experienced positive and sometimes negative regardless of the season of the year or the proximity residential neighbourhood to tourism destination.

The findings of this study are sufficiently valuable to merit further investigation. It also provides an important spatial–temporal platform for future tourism impacts variability research in Nigeria and other countries in the tropic region. Furthermore, it is apparent from this study that temporal analyses in a given tourism destination may not translate effectively into another. In this respect, tourism managers in Olumo Rock should be aware of fluctuation in patronage pattern so as to introduction other attraction components at the right season.

Government reforms have seen shifts from rules-based to principles-based risk regulatory governance. This paper examines the effects of principles-based risk regulatory reforms on public sector risk management (RM) and management control practices in public sector organizations (PSOs).

The principles-based regulation focuses on providing autonomy to PSOs while maintaining control over their actions without direct intervention. This resonates with Foucault's notion of how modern forms of governments operate. The research is informed by Foucault's concept of governmentality. The authors conducted a qualitative field study of an Australian PSO, gathering and analysing data from interviews, focus groups, and archival documents.

The findings show the capillary modes by which principles-based risk regulatory regime penetrates and works with management control practices in pursuit of regulatory goals within the PSO the authors studied. In addition, the authors find that the principles-based approach (focusing on autonomy) and rules-based approach (focusing on control) are not opposites in kind and effect but rather, autonomy should be understood as a central pillar of control. Furthermore, the findings show how cultural controls and formal controls are not in conflict but are interconnected in RM practices, with cultural controls providing control architecture for RM and formal control translating the control architecture into routines. Finally, the study provides insights into how enterprise risk management (ERM) provides capabilities for and routinizes RM practices in a PSO and the management control systems (MCS) that enabled this to occur.

The paper provides novel insights into how MCS are infiltrated, mobilized and deployed to enact principles-based risk regulatory reforms. These insights are useful for regulators, practitioners and researchers.