Due to unprecedented and increasing demand, child and adolescent mental health services face significant challenges, including long waiting times, fragmented service provision, and a lack of involvement of children and young people in decisions about their care.
These issues contribute to inefficiency, poor outcomes, and a negative experience for children, young people, and their families. The system is under strain, with up to 70% of children not being seen within a year of referral.
In response to these challenges, the THRIVE Framework was published as an integrated, person-centred, and needs-led approach to mental health services for children and young people. It was designed to improve access to services, enhance efficiency, and raise the overall quality of care.
A comprehensive evaluation of the THRIVE Framework revealed increased activity, and reductions in triage, assessment, and treatment waiting times. Sites also demonstrated improved efficiency, reducing the duration of patient episodes by 4% and increasing patient contacts by 30%. Face-to-face interactions saw a 37% rise.
These results highlight the THRIVE Framework's potential to enhance services and presents a scalable model for future improvements in mental health services.
Within just a few years of its inception, more than half of children and young people in England were living in areas where the THRIVE Framework was being used as the foundation for local transformation in children and young people’s mental health services.
NIHR ARC North Thames did an evaluation collecting data from NHS accelerator sites, they gathered site-level outcomes data from ten comparable non-i-THRIVE sites, matched for demographics, resources, and clinical variables.
Alongside site-level data collection, over 400 semi-structured interviews were conducted using the THRIVE Assessment Tool with both accelerator and comparison sites. They could therefore assess how effective the implementation programme was in supporting sites to adopt THRIVE principles by evaluating how ‘THRIVE-like’ their systems were at various stages.
Their evaluation revealed that i-THRIVE sites experienced:
- A 46% increase in community triage and signposting
- A 29% reduction in triage waiting times
- A 20% reduction in assessment waiting times
- An 8% reduction in treatment waiting times.
NIHR ARC North Thames Mental Health Lead, Professor Peter Fonagy, says:
“The ARC-funded team accomplished an extraordinary feat in implementing a service transformation programme that enabled participating services to better manage the unprecedented surge in referrals to children and young people’s mental health services.
"This achievement highlights the power of science-driven service redesign, demonstrating what is possible even in the most challenging circumstances.”
More detail on this topic is available in the original article published by NIHR Applied Research Collaboration (ARC) North Thames: Improving child and adolescent mental health services: Evaluating the impact of the iTHRIVE
Image: RDNE Stock project