The CAMHbulance* Study: How does the largest out-of-hospital emergency health service in Wales receive, respond and resolve mental health crises in young people? *CAMH = Child and Adolescent Mental Health’

In the context of rising levels of urgent and emergency mental health needs of CYP, this PhD aims to examine crisis responses provided through the Welsh Ambulance Services NHS Trust (WAST). Underpinned by the idea that crisis care is a complex intervention introduced into a complex system, the project will adopt an implementation science focus, an embedded case study design and a mixed methods approach to explore the organisation, delivery and impact of how WAST receives, responds to and resolves mental health crisis of CYP, which necessitates exploring the care experiences of CYP family members and staff.

The project has three specific objectives:

1. To systematically review the national and international evidence relating to the implementation and impact of ambulance service-led responses to children and young people in mental health crisis, and the evidence relating to the experiences of people using and working in services of this type.
2. o examine, via a mixed methods approach, the implementation and impact of crisis responses for CYP provided by WAST and to explore how these responses are experienced as episodes of care by service users and providers. This examination will generate quantitative data using a standardised survey and secondary data on episodes of care accessed through WAST. Using a case study design, it will also generate extensive qualitative data via interviews with key individuals at relevant macro (policy), meso (provider) and micro (patient and carer) levels pertinent to mental health care provision by WAST. This part of the project is theoretically grounded in, and informed by, normalisation process theory (NPT), a strand of implementation science designed specifically to yield understanding of the implementation and evaluation of complex interventions in complex systems.
3. To synthesise and share findings, draw clear implications for future policy, services and practice and make recommendations for further research aimed at improving mental health care for CYP.