Uncovering the hidden drivers of change in CAMHS: Using COM-B and systems mapping to understand staff experience

Child and Adolescent Mental Health Services (CAMHS) face mounting pressures due to increased demand, emotional complexity, and systemic strain. Improving outcomes for young people must go hand-in-hand with supporting the workforce that delivers care. This study describes a service innovation project that applied the COM-B model (Capability, Opportunity, Motivation – Behaviour) alongside behavioural systems mapping to identify barriers and enablers to change in a multidisciplinary CAMHS setting. Through the development of a systems map and structured focus group analysis, staff highlighted key feedback loops contributing to burnout, disengagement, and limited organisational responsiveness. COM-B provided a structured lens to interpret these dynamics and co-produce feasible, context-specific service improvements. This method, adapted from research culture transformation work, offers a novel and transferable approach for service development in mental health settings.