Integration of physical and mental health services for children and young people with eating disorders and functional symptoms: a qualitative study of staff and parents’ perspectives

<ns3:p>Background There has been increased focus on the importance of integration between physical (PH) and mental health (MH) services in the care of children and young people (CYP). Despite this, there are few studies describing the implementation of integrated working and their impact on CYP with eating disorders and functional symptoms. This study provides an overview of the perspectives of health care professionals and parents of children with these disorders on the ongoing service re-development of children’s services in one region in England. Methods In-depth interviews with parents (n=10) and professionals (n=15) affected by or working in redesigned services. Interviews were analyzed using the Consolidated Framework for Implementation Research (CFIR) to assess the impact in five domains: innovation, outer setting, inner setting, individuals, and implementation process. Results The integration between PH and MH services was broadly seen positively by staff and parents. Key issues for staff centered on how integration of services would be achieved in practice, the impact on professional roles and identities, how leadership would be divided between acute and mental health service providers, and the impact of co-location on CYP with functional symptoms and eating disorders. Parents of CYP with functional symptoms thought that earlier intervention with MH services could reduce stigma and improve the efficiency of diagnosis and treatment. Parents of CYP with eating disorders believed integrated services would provide a more seamless experience with all services provided in the same place, but expressed concerns about potential loss of existing services and the appropriateness of mixed PH and MH wards. Conclusions The implementation of integrated PH and MH services must address concerns regarding roles, responsibilities, and leadership under the new model of working. Parental concerns about how services for CYP with eating disorders might be affected also need to be taken into consideration.</ns3:p>