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Mental health service delivery for adolescents and young people: a comparative study between Australia and the UK

Fenton, Sarah-Jane Hannah (2016)
Ph.D. thesis, University of Birmingham and The University of Melbourne.

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This thesis explores policy and service delivery for adolescent and young adult or ‘transition age’ mental health service users aged 16-25 across different jurisdictions in the UK and Australia. The study explores the implications that policy formulation and implementation have for service delivery in these different contextual settings; and examines how young people (who are at a vulnerable stage developmentally in terms of mental health), have their access to services affected by the existing policy framework.

A policy analysis was conducted along with qualitative interviews in six case sites (three in the UK and three in Australia). The thesis adopted a critical realist approach using a laminated cross-sectional interview strategy that was developed to include interviews with national policy makers; local policy makers and service managers; staff working within services; and the young people whom were accessing services as the recipients of policy.

Findings from this thesis explore how young people use risk escalation as a way of managing delays to treatment and how practitioners identify particular difficulties for young people transitioning in services when they are due to ‘step up’ into more acute services, or ‘step down’ to a less intensive service. The thesis explores the implications and unintended consequences for young people of policy including processes of ‘cost-shunting’ and ‘resource envy’ at local and national levels. Finally, the thesis offers some learning for systems working to support 16-25 year olds through demonstrating the importance of the dual role of ‘curing’ and ‘caring’ in mental health services.

Type of Work:Ph.D. thesis.
Supervisor(s):Glasby, Jon and Tew, Jerry and Pirkis, Jane and Killackey, Eóin
School/Faculty:Colleges (2008 onwards) > College of Social Sciences
Department:School of Social Policy, Health Services Management Centre
Additional Information:

Please note: This thesis was completed under a Cotutelle arrangement between the University of Birmingham and the University of Melbourne. This thesis can also be found at the University of Melbourne's Institutional Repository:

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Keywords:Mental Health, Health Policy, Youth, Adolescence, Social Policy, Qualitative research, Comparative research, Critical realism.
Subjects:DA Great Britain
DU Oceania (South Seas)
HV Social pathology. Social and public welfare
RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
RJ101 Child Health. Child health services
Institution:University of Birmingham and The University of Melbourne
ID Code:7111
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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