Relational care in community mental health: Evaluating staff experiences in Intensive Community Care Services (ICCS) vs treatment as usual
11 affiliations
- 1London South Bank University, London, United Kingdom
- 2East London NHS Foundation Trust, London, United Kingdom
- 3Queen Mary University of London, London, United Kingdom
- 4Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- 5South London and Maudsley NHS Foundation Trust, London, United Kingdom
- 6Oxford University Hospitals NHS Trust, Oxford, United Kingdom
- 7Central and Northwest London NHS Foundation Trust, London, United Kingdom
- 8Kings College London, London, United Kingdom
- 9Northeast London NHS Foundation Trust, London, United Kingdom
- 10Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
- 11Cwm Taf Morgannwg University Health Board, Abercynon, United Kingdom
Abstract
Background: The quality of healthcare delivery relies heavily on building strong relationships between healthcare providers (HCPs) and clients. This study presents the results of a process evaluation for a Randomised Controlled Trial (RCT) examining the effectiveness of Intensive Community Care Service (ICCS) vs Treatment as Usual (TAU; inpatient or core community CAMHS). Methods: Thirty-four semi-structured interviews were conducted with staff across various services, including 20 from ICCS and 14 other TAU services. A thematic decomposition analysis was conducted on the data, and specific themes relevant to staff experiences of young people’s engagement with services and overall recovery. Results: Three main themes were observed in the HCP data (1. Relational Ecologies: barriers and enablers to engagement, 2. flexibility of approach amidst systemic pressures and 3. the web of trust in the relationship-building process). HCPs highlighted the necessity of developing trust and rapport through non-clinical engagement strategies, such as informal visits and personalised interactions. HCPs emphasised that without trust, treatment effectiveness diminishes, necessitating a tailored approach rather than a one-size-fits-all model. The flexibility in duration of treatment and methods of engagement was noted as crucial in accommodating individual client needs and fostering an open, trusting environment necessary for long-term recovery. Conclusion: The findings highlight the vital importance of relational care models, especially ICCS, in addressing the complex needs of Children and Young People (CYP). Flexible, family-centred approaches improve trust, engagement, and long-term recovery outcomes. Recommendations include tackling systemic barriers and expanding relational care models within CAMHS to meet increasing mental health demands effectively. Further research should investigate scalable strategies for integrating these insights into wider mental health service frameworks.
Related
- Experiences and satisfaction with intensive community care services for children and adolescents with severe mental health disorders: a mixed-methods systematic review
- Tai Chi practice and community belonging in active aging: embodied, relational, and place-based embedding in a Beijing community
- Voices from the City’s Youth: A Qualitative Study of Perceptions and Experiences of Urban Outpatient Adolescents Exposed to Community Violence
- Evaluating a shared decision engagement system in the National Cancer Institute Community Oncology Research Program: a multi-level randomized controlled trial
- A qualitative exploration of community health workers' roles and motivations in delivering care during and after the COVID-19 pandemic: experiences and community perceptions in rural and urban Delhi, India.
BibTeX
@article{atanda2026relational,
title = {{Relational care in community mental health: Evaluating staff experiences in Intensive Community Care Services (ICCS) vs treatment as usual}},
author = {Opeyemi Atanda and Paula Reavey and Ben Wong and Ebony Baker and Jessica Collier and Thilipan Thaventhiran and Veronika Dobler and Ruth Woolhouse and Toby Zundel and Joe Clacey and Jovanka Tolmac and Izabela Pilecka and Leon Wehncke and Tauseef Mehdi and Rhys Bevan-Jones and Dennis Ougrin},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0356608},
url = {https://doi.org/10.1371/journal.pone.0356608},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Relational care in community mental health: Evaluating staff experiences in Intensive Community Care Services (ICCS) vs treatment as usual
AU - Opeyemi Atanda
AU - Paula Reavey
AU - Ben Wong
AU - Ebony Baker
AU - Jessica Collier
AU - Thilipan Thaventhiran
AU - Veronika Dobler
AU - Ruth Woolhouse
AU - Toby Zundel
AU - Joe Clacey
AU - Jovanka Tolmac
AU - Izabela Pilecka
AU - Leon Wehncke
AU - Tauseef Mehdi
AU - Rhys Bevan-Jones
AU - Dennis Ougrin
PY - 2026
DA - 2026/09/09
JO - PLOS One
DO - 10.1371/journal.pone.0356608
UR - https://doi.org/10.1371/journal.pone.0356608
AB - Background: The quality of healthcare delivery relies heavily on building strong relationships between healthcare providers (HCPs) and clients. This study presents the results of a process evaluation for a Randomised Controlled Trial (RCT) examining the effectiveness of Intensive Community Care Service (ICCS) vs Treatment as Usual (TAU; inpatient or core community CAMHS). Methods: Thirty-four semi-structured interviews were conducted with staff across various services, including 20 from ICCS and 14 other TAU services. A thematic decomposition analysis was conducted on the data, and specific themes relevant to staff experiences of young people’s engagement with services and overall recovery. Results: Three main themes were observed in the HCP data (1. Relational Ecologies: barriers and enablers to engagement, 2. flexibility of approach amidst systemic pressures and 3. the web of trust in the relationship-building process). HCPs highlighted the necessity of developing trust and rapport through non-clinical engagement strategies, such as informal visits and personalised interactions. HCPs emphasised that without trust, treatment effectiveness diminishes, necessitating a tailored approach rather than a one-size-fits-all model. The flexibility in duration of treatment and methods of engagement was noted as crucial in accommodating individual client needs and fostering an open, trusting environment necessary for long-term recovery. Conclusion: The findings highlight the vital importance of relational care models, especially ICCS, in addressing the complex needs of Children and Young People (CYP). Flexible, family-centred approaches improve trust, engagement, and long-term recovery outcomes. Recommendations include tackling systemic barriers and expanding relational care models within CAMHS to meet increasing mental health demands effectively. Further research should investigate scalable strategies for integrating these insights into wider mental health service frameworks.
SN - 1932-6203
ER -