As part of a pioneering new study, Great Ormond Street Hospital (GOSH) today launched a drop-in centre providing accessible, low-intensity early intervention services for patients and families concerned about their mental health.
It is hoped that this new research, which received funding from GOSH Children’s Charity with support from the Beryl Alexander Charity, could pave the way for effective treatment of mental health conditions for children with complex physical conditions that is effective and delivers positive outcomes, whilst being less resource intensive.
For the study, researchers from GOSH and UCL Great Ormond Street Institute of Child Health (ICH) set up a drop-in centre, named “the Lucy Booth” after the beloved Peanuts’ characters' stand, in the hospital’s reception area. Resembling a large photo booth, the centre is painted a vibrant purple and features words of encouragement and useful information scattered across its facade to increase visibility. Although the research project is led by the ICH Psychological Medicine Research Team, the centre is run by a multidisciplinary team of volunteers and staff from research, clinical psychology and psychiatry who are available to patients and families, throughout the day.
Already seeing benefit
Children have already benefitted from their involvement in the first phase of the study, including 11-year-old Luella who started her journey at GOSH when she was just three months old when she was diagnosed with sagittal craniosynostosis. Surgery to correct the condition, which resulted in the fusing of bone in her head, was successful, but side-effects from the procedure have meant that she is still monitored by clinicians at the hospital. It was a routine visit to GOSH that led Luella and her mum, Fleur, to discover the Lucy Booth back in February 2018.
At the time, Luella was experiencing lots of changes at home and in school. Around the same time, Luella also developed psoriasis on her skin which became increasingly worse when she was anxious.
Fleur said: “It was such a stressful time for her, and rather than talking about it openly, we began to notice that Luella was keeping to herself more and more. Then, as we were leaving a dermatology appointment at GOSH, the Lucy Booth caught our eye. The staff sitting next to it looked so approachable and we were both curious, but it was Luella who was really keen to check it out. What we thought would be 10 minutes getting a bit more information about the service turned into a 40-minute session with Marc Tibber, one of the clinical psychologists. The most amazing thing is that whilst Luella chatted with Marc, I chatted with another one of the volunteers there too. I just remember feeling such a relief to simply talk to someone about what was going on.”
Luella went on to use the service regularly throughout the year. She said: “Marc was so easy to approach and talk to. On that first day, when I stopped by the Lucy Booth, I was having trouble sleeping and my emotions felt like they were all over the place. I had always been a bubbly and joyful person, but with all the changes going on – starting a new school and then my skin – I think I lost my voice a bit and found it hard to talk to the people closest to me. In September, when I went for my last session, I realised I was in such a different place. A better place. I’m so grateful to Marc and his team for not only letting me talk, but really listening.”
The Lucy Booth team provided Luella with access to one to one support where she could discuss what was on her mind, as well as being taught coping mechanisms for what to do when she felt anxious or had trouble sleeping. Through the service she learned how to identify different types of anxiety, when something was worth worrying about, and how to calm her thoughts before they could escalate. Since it opened in January 2018, the project has seen over 130 patients and parents or carers consent into the project as either self-referrals or referrals from clinicians, demonstrating a need within the hospital’s patient population for a service that fit around their pre-existing treatment schedules and offered tangible and immediate results.
How the booth has helped
The majority of referrals to the Lucy Booth were seeking support for anxiety (37%), behavioural issues (32%) and low mood (16%) which are the most common mental health problems for children without chronic conditions as well. With one of the one of the largest breadth of specialties under one roof and pioneering research programmes, GOSH is exceptionally placed to provide children with complex medical conditions with access to treatments that are fully integrated to meet their physical and psychological needs.
Professor Isobel Heyman who is a consultant child and adolescent psychiatrist at GOSH and a principal investigator for the research project said: “Our preliminary findings are very promising. We’re only half way through the project but have already had positive feedback from patients and parents using the service. At GOSH, we’ve already seen a steady number of referrals for the Lucy Booth, which indicates a real need for a flexible and readily accessible service. The best part is that it integrates efficiently with existing services in the hospital and doesn’t replicate other sources of support.”
Roz Shafran, professor of translational psychology at ICH and also a principal investigator in the study added: “The drop-in centre also has the capacity to provide assessment and onwards referral where greater need is identified, which makes the experience unique to each beneficiary and this is particularly important within our specialist clinical environment. We have a bit more work ahead before we start to analyse the impact of the Lucy Booth, but hope that the successful application of the service inspires similar models in other hospitals.”
Support currently provided to participants includes assessments, one to one and group therapy sessions, as well as the provision of interventions through a psychological wellbeing practitioner who can deliver cognitive behavioural therapy, guided self-help and onwards referrals both to the hospital’s own psychological services and external agencies such as CAHMS.
Although still in its preliminary stage, the research could lead to a new standard of care for patients with complex physical conditions who are also struggling with their mental health and wellbeing.