Annie Altschul Collection

Child and adolescent mental health teams have traditionally been constructed using multidisciplinary teams of different professions. Current workforce policy in mental health, however, stresses team function and the skills and competences required to fulfil that function which leads to a questioning of professional identity within those teams. This study aims therefore to define how professional identity is constructed in the policy discourse and amongst a sample of current practitioners in mental health teams.

The study highlights the need for professional groups, including mental health nurses who work in CAMHS, to maintain their professional identity by being better able to articulate the contribution they make to team functioning by virtue of their conceptual frameworks. These are shown to inform the way in which individuals use their skills and competences to care for service users and their carers.
Themes: Professional identity; CAMHS; applied linguistics; roles; mental health nursing

Background and Aim: The Theory of Planned Behaviour (TPB) and the Transtheoretical Model of Change (TTM) outline the proximal determinants of exercise. This thesis compared their predictive utility in relation to exercise among young Chinese people in Hong Kong.
Themes: Health psychology; social cognition models; exercise; Chinese high school pupils

Adolescent psychiatric intensive care units (PICU) play a significant role in child and adolescent mental health care pathways in the UK and across Europe. This thesis presents the first published primary research studies in the field of Adolescent PICU.
Situated within a transdisciplinary psycho-social research framework, psychodynamic praxis is integrated into systematic qualitative and quantitative research methods. Developmental object-relations and attachment theory are used as a lens, through which the detail of invisible or hidden relational elements of adolescent mental health inpatient work can be seen and investigated.
A new model of adolescent PICU nursing is conceptualised as an intersubjective process analogous to the good-enough carer-infant relationship, in which a rigorous and technical form of love is elaborated as the key method of intervention. Key to the implementation of ‘love as method’ are the concepts of the container-contained relationship, projective identification and reverie, alongside a willingness to continuously occupy unresolvable tensions, as demanding but productive spaces.
An evidence-based case is made for detailed, faithful and receptive observation of mental health nursing interventions that parallel, acknowledge and re-centre the place of a specific and disciplined form of love, as the method for creating the interpersonal conditions for recovery from acute and complex mental distress, especially when these manifest in young people.
Themes: Adolescent mental health; CAMHS; Psychiatric intensive care; PICU; psychoanalytic practice; psychoanalytic research methods; mental health nursing identity

In the UK, schools are gradually embracing their responsibility to cater for young people's mental wellbeing. Exploring young people's Mental Health Literacy (MHL) is an area however that is still in its infancy. Specific focus has explored young people's literacy of the condition of psychosis, considering how useful it is to provide biomedical information as a MHL intervention within schools. Such an approach reduces a more holistic understanding of mental illness and portrays young people as illiterate. My goal is instead to value young people as competent social agents with existing social and personal meaning in their understanding of mental illness. A peer research methodological approach has given young people the chance to explore their views and opinions without adult influence. Thirteen PRs (Peer Researchers) were involved in focus group sessions from two Further Education Colleges in the North East of England: 1) To explore young people's own understandings of psychosis 2) To explore what aims young people may feel psychosis literacy should address and 3) To explore what strategies young people believe would be the most useful to cater for young people's educational and health needs. AR-led (Adult Researcher) and PR-led data has been assessed for the influence of demand characteristics, adding new understanding of how young people socially constructed their responses according to an adult or non-adult audience. The need to understand young people's social, cultural, and personal meanings attached to psychosis have been an important first step to help appreciate what holistic methods and content of literacy would be most meaningful and right for young people. Nevertheless, an emphasis on academic attainment in schools and the influence of key stakeholders' views and opinions (including teachers and parents) may challenge the viability of implementing any form of psychosis literacy within the school environment. It is likely that adult concerns would remain and form a barrier towards listening to the voice of young people's views and opinions in favour of their own agenda.
Themes: Mental health literacy; participatory peer research methods; power threat meaning framework; lay understandings of mental illness; anti-stigma

Young people involved in gangs, by definition, offend and are known to have more negative outcomes than non-gang offenders. It is not clear whether there is also an increase in mental health problems for these individuals as ‘mental health’ is not discussed extensively in literature about gangs.

Aimed to determine if there was a difference between the mental health difficulties experienced by young people:
• Involved in gangs
• Non-gang offenders
• General population.

This was the first UK study to specifically investigate the mental health needs of young people involved in street gangs. It contributes to the growing evidence about UK gang members, offering a unique child and adolescent mental health perspective. The results inform the development of the preliminary conceptual model and support the need for more research, providing the first indication of what clinical services, treatment interventions and care pathways that meet the needs of this population could be developed and tested.
Themes: Children and young people; Mental health; Offending; Gangs

Involving children in decision-making and consent processes in their own healthcare has long been a challenging area of clinical practice. The reasons for this are the challenges in assessing child development capabilities in decision-making, and the lack and ambiguity of guidance and frameworks that support this area of practice. This study addresses these challenges.
Themes: Decision making; consent; clinical skills; child development; CAMHS; children; parents; case study; mental health; qualitative research; focus groups; empowerment