National survey of inpatient mental health services for CYP in England and Wales, and latest publication on insights from stakeholder involvement

The Landscape study started in April 2025 with the aim of further developing our understanding of current clinical practice for young people, aged 12 to 18 in intensive and inpatient psychiatric care across England and Wales. To meet this aim, the research developed a bespoke national survey developed using a Delphi approach with stakeholder involvement. This blog reports on two recent key milestones of the research. Firstly, we report on the results of the Delphi study and the final iteration of the survey, and secondly on our latest publication sharing insights from stakeholder involvement.

The Delphi approach: method and results of the Landscape study

The aim of the Delphi study was to to develop a bespoke data collection instrument on current clinical practice in intensive and inpatient psychiatric care.  A Delphi study is a structured research method for gathering input from a group of participants (known as ‘panellists’) that are specially selected for their particular expertise on a topic  (Iqbal & Pipon-Young, 2009). The Delphi study is based on a consensus approach for survey development and has three main stages:

1. There was an initial ‘idea generation’ stage, in which panellists identify a range of salient issues.
2. Panellists complete one or more questionnaires known as ’rounds’, and ideas from the first round are used to construct the survey instrument distributed in subsequent rounds.
3. An evaluation phase where panellists are provided with the iteration of the survey and asked to re-evaluate their original responses.

In the Landscape study, the panelists in the Delphi were formed from volunteer participants from the Expert Advisory Panel (EAP) and Young Persons Advisory Group (YPAG). The EAP is a 26-member multidisciplinary group comprising of adults with lived experience of CYP mental health services, caregivers, representatives of service provider organisations, healthcare professionals working in CYP mental health services, commissioners, regulatory and professional bodies, charitable organisations and advocacy groups with expertise and experience in CYP mental health services across the UK. The YPAG is a panel of seven young people aged between 16 and 21 with lived experience of intensive and inpatient psychiatric care. Nineteen (65%) members of the EAP, and all seven members of the YPAG took part in the Delphi study.

The idea generation stage of the Delphi was informed by feedback and findings from the research’s policy synthesis, literature review and initial consultation with the EAP and YPAG. Data from the initial discursive round were then analyzed qualitatively through content analysis to identify key themes and ideas. Panelists were then asked to complete two rounds of quantitative ratings of these ideas via Likert scales and these ratings informed the prioritization and evaluations of questions for the final iteration of the national survey.

Clinicians from a CAMHS inpatient service pilot tested the draft survey to assess usability, clarity of expression, and practical feasibility of completion. Feedback also informed the strategy for the proposed survey distribution. Our co-researcher with lived experience of CYP inpatient services reviewed the final iteration of the survey to ensure the feedback and priority issues highlighted by YPAG members were retained.

The final iteration of the survey combines open-ended, closed, descriptive, and exploratory questions. Overall, the survey is designed to identify strengths, challenges, and variations across CAMHS inpatient units, with the intention to generate robust evidence to inform policy, service improvement, and national benchmarking. The national survey covers a broad range of domains as listed below:

1. Service Overview & Governance
2. Measuring Quality & Outcomes
3. Equality, Diversity & Inclusion
4. Voice, Rights & Participation
5. Admission and Discharge
6. Care Approach and Community
7. Treatment and Support
8. Risk, Safety & Restrictive Practices
9. Staff, Training and Wellbeing
10. Medication and Pharmacy
11. Education and Wellbeing Support
12. Variation and Standardisation
13. Open Feedback: opportunity for units to provide additional comments or insights
14. Patient Census: numbers, age ranges, diagnoses, and other population-level data

Ultimately, the development of the national survey is based on consensus from healthcare professionals, commissioners, policy makers, people with lived experience and carers. The survey has been co-produced with a range of stakeholders, including professionals from multiple disciplines and young people with lived experience of inpatient care. This approach ensures that the survey captures multiple perspectives in a single research tool, captures what is relevant and reflects the real-world complexity of services. This is particularly important given that so little evidence of such services exist.

The results of the Delphi study have been submitted as part of the NHS ethics application for the roll out of the national survey. The national survey is due to be rolled in Spring 2026. Senior health care practitioners from all CYP inpatient care  wards and units,  commissioned   as part of  NHS England’s Children and young people mental health inpatient services (CYPMHS), will be invited to take part

Latest publication: Insights from stakeholder voices

Insights and results from the research are to be shared throughout the cycle of the research to benefit the wider research community and implications for clinical practice and policy. Our latest publication focuses on describing the insights gained from stakeholder involvement. These insights link to the importance of human connection and therapeutic relationships; workforce and the inpatient environment; restrictive practices and risk culture; pathways, transitions and system fragmentation; and equity and inclusion.

We would like to thank members of the EAP and YPAG. With their consent, their names are listed below to acknowledge their input in the research.

We would also like to thank Jeni Roussounis and Molly from common room who co-chair the YPAG meetings. The external advisory group is chaired by Andy Johnston, a co-investigator on the research.