University students' access to mental health services: A qualitative study of the experiences of health service professionals through the lens of candidacy in England.

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES Journal of Health Services Research & Policy Pub Date : 2024-10-01 Epub Date: 2024-02-27 DOI:10.1177/13558196241235877
Tom G Osborn, Rosa Town, Majeed Bawendi, Emily Stapley, Rob Saunders, Peter Fonagy
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Abstract

Objectives: In order to develop a better understanding of students' access to mental health services, we explored the experiences of health care professionals interacting with university students with mental health problems.

Methods: We interviewed 23 professionals working across university advice and counselling services, NHS general practice, crisis, and psychological services in North and East London between June 2022 and January 2023. Our approach drew on reflexive thematic analysis and the principles of abductive analysis. The notion of candidacy - that is, how different needs are deemed deserving of health service attention - was particularly helpful to our understanding of the ongoing phenomenon of interest in the data.

Results: Each student's access to mental health support was highly contingent on the student's dynamic social context and the pressures and organisation of the local health system. Professionals described how different students viewed different needs as deserving of health service attention. Which students reached the professional's service depended on the resources and relationships a student could draw upon, and the service's relative permeability. Once there, what action professionals took was strongly influenced by the professional's service expertise, resource constraints, the relationships the professional's service had with other organisations, the students' wishes, and whether students regarded treatment offers as acceptable.

Conclusions: Candidacy offers a useful lens to view university students' access to mental health support. Access appears to be an increasingly intricate task for students, given the fragmented service landscape, surging demand for mental health care and challenges of emerging adulthood. Our findings suggest that policy goals to increase use of mental health services are unlikely to improve outcomes for students without policy makers and health systems giving holistic consideration of inter-service relationships and available resources.

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大学生获得心理健康服务的情况:通过英国候选资格的视角对医疗服务专业人员的经验进行定性研究。
目的为了更好地了解学生获得心理健康服务的情况,我们探讨了医护人员与有心理健康问题的大学生互动的经验:我们在 2022 年 6 月至 2023 年 1 月期间采访了 23 位专业人士,他们分别在伦敦北部和东部的大学咨询和辅导服务机构、国家医疗服务体系全科诊所、危机处理和心理服务机构工作。我们的方法借鉴了反思性主题分析和归纳分析的原则。候选资格的概念--即不同的需求如何被认为值得医疗服务机构关注--特别有助于我们理解数据中的持续关注现象:结果:每个学生能否获得心理健康支持在很大程度上取决于学生所处的动态社会环境以及当地医疗系统的压力和组织结构。专业人员描述了不同的学生是如何将不同的需求视为值得医疗服务关注的。哪些学生可以得到专业人员的服务,取决于学生可以利用的资源和关系,以及服务的相对渗透性。一旦到达那里,专业人员所采取的行动受到以下因素的强烈影响:专业人员的服务专长、资源限制、专业人员的服务与其他组织的关系、学生的意愿以及学生是否认为治疗方案是可以接受的:候选资格为大学生获得心理健康支持提供了一个有用的视角。对学生来说,获取心理健康支持似乎是一项越来越复杂的任务,因为他们面临的服务环境支离破碎,对心理健康护理的需求激增,以及成年后所面临的挑战。我们的研究结果表明,如果政策制定者和卫生系统不全面考虑服务间的关系和可用资源,那么提高心理健康服务使用率的政策目标就不可能改善学生的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.40
自引率
4.20%
发文量
39
期刊介绍: Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.
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