# Investigating the Applicability of the SAFER‐YCL Care Bundle for Transitions From CAMHS Crisis and Liaison Services: The Barriers and Enablers

## TL;DR

Researchers adapted a care bundle to improve transitions from youth mental health crisis services, seeking feedback from stakeholders to make it practical and effective.

## Contribution

The study adapts the SAFER-YMH care bundle for CAMHS Crisis and Liaison teams using stakeholder feedback to identify barriers and enablers for implementation.

## Key findings

- Stakeholders suggested integrating the SAFER-YCL care bundle into electronic records to reduce documentation burden.
- The care bundle could replace current discharge documents with a standardized template for safety plans and discharge letters.
- Feasibility testing is needed to validate the effectiveness of SAFER-YCL in clinical practice.

## Abstract

Crisis and Liaison teams in Child and Adolescent Mental Health Services (CAMHS) offer intensive, short‐term support to young people experiencing mental health crisis in the community (Crisis) or admitted to acute hospitals (Liaison). There is no evidence‐based model for how these teams operate. The SAFER care bundle, designed to improve discharges from acute hospitals, has been adapted for use in mental health inpatient discharges for adults (SAFER‐MH) and young people (SAFER‐YMH). This study took a care bundle designed to improve discharges from CAMHS inpatient care (SAFER‐YMH) and used stakeholder feedback to adapt it for use in CAMHS Crisis and Liaison teams.

Focus groups were carried out with healthcare professionals (HCPs), young people and parents/carers to present the SAFER care bundle and discuss necessary adaptations for use in CAMHS Crisis and Liaison teams. Analysis of transcripts followed a Normalisation Process Theory (NPT) framework to identify barriers and facilitators to implementation and necessary adaptations.

Participants expressed that integrating the SAFER‐YCL care bundle into the electronic patient record, automatically pulling information from other forms, and providing a template for discharge letters and safety plans could serve as an aide‐memoire and potentially replace current discharge documents. It would need to avoid increasing documentation burden for staff and have flexibility to be administered by different staff members and at an appropriate time.

The SAFER‐YCL care bundle has been successfully developed for implementation in CAMHS Crisis and Liaison services, demonstrating potential to enhance transition experiences. Feasibility testing will be crucial to validate its effectiveness and facilitate successful integration into clinical practice.

This study was initially presented at the Nottinghamshire Healthcare NHS Foundation Trust's Involvement group of young people to gather their thoughts on it. They were supportive of the study design and gave constructive feedback on the study. A PPI representative with lived experience was part of the study team who was involved in developing and reviewing all study materials, was part of monthly reviews of the study's progress and supported data collection, analysis and write‐up of the study results.