Developing and evaluating digitally-mediated service provision for children with social, emotional, and mental health needs
: (Alternative Format Thesis)

  • Lauren Jones

Student thesis: Doctoral ThesisPhD


The mental health of children and young people (CYP) is a growing concern nationally. With high unmet community need and significant pressures on mental health services, there are increasing calls for innovative and efficient approaches to deliver timely and accessible mental health guidance and support. The remote delivery of services via digital communication technologies such as videoconferencing (digitally-mediated service provision) may offer a solution.

There became an immediate need for digitally-mediated service provision during the COVID-19 pandemic and constraints on face-to-face service provision, and digitally-mediated service delivery may be integrated in a post-COVID-19 world. However, there is little research about the service user experience of digitally-mediated service provision for this population. Review of the literature highlights a need to better understand the acceptability of digitally-mediated service provision from the perspective of all those involved in services for CYP, including young people and parents/carers, education staff (i.e. referring providers), and professionals working across health and education (i.e. specialists), as well as the clinical/health outcomes for CYP. The COVID-19 pandemic has made this even more important in the development and transformation of services. The overall aim of the present thesis was to develop and evaluate digitally-mediated service provision for CYP in educational settings and mental health settings, by using comprehensive outcome measurement including assessment of outcomes for CYP and by exploring service user experience through survey and qualitative methods.

Chapter One describes the key issues relating to research and practice in the area of mental health service provision for CYP that have influenced study design and write-up in the present thesis. In Chapter Two, a systematic review was conducted to identify the outcomes obtained in the literature of team communication via digital communication technologies. Chapter Three is a commentary about implementing digitally-mediated team communication in pandemic times and beyond, with further reflections on the opportunities and challenges of conducting research during the global pandemic in the chapter summary. In Chapter Four, focus group and survey methods were used to explore views and expectations of digitally-mediated service provision from the perspective of young people and parents/carers to inform service development and evaluation. Chapters Five and Six were a pilot evaluation of digitally-mediated team communication for responding to emerging SEMH support needs in primary school settings, using a pre/post study design to understand the perceived value, feasibility, and acceptability of digitally-mediated team communication (Chapter Five), and an in-depth qualitative study to understand progress towards systems changes (i.e. increased capacity for early intervention and improved coordination between services) from the perspective of education staff and a multidisciplinary team over time (Chapter Six). Chapter Seven used survey and interview-based methods to explore young people’s views of and satisfaction with accessing digitally-mediated mental health services during the period of restrictions related to the COVID-19 pandemic, and their experience of the therapeutic alliance during therapeutic consultations via videoconferencing. Chapter Eight is a general discussion of the findings.

Overall, the findings of this thesis indicate that digitally-mediated service provision is feasible and it is valued, and it can be transformative with respect to greater transparency and empowerment for service users, parents/carers, and frontline staff. It is also an enabling tool, facilitating multi-professional collaborative working for the benefit of all stakeholders. However, despite these advantages, it is not the preferred option for young service users accessing mental health services. As such, there is support for the partial adoption of digitally-mediated service provision in the longer term from the service user perspective. Remote contacts may be valuable for MDT formulation meetings and for later, activity-focused/change-oriented sessions as part of a blended therapeutic process for young service users.
Date of Award28 Jun 2023
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorMark Brosnan (Supervisor) & Ailsa Russell (Supervisor)

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