“You absorb trauma, without noticing it”: A qualitative exploration of staff experiences and subjective well-being working in CAMHS inpatient services.

Background Child and Adolescent Mental Health Service (CAMHS) inpatient staff are lacking representation in the literature, particularly their subjective experiences in the context of well-being. Previous research has tended to be quantitative, with a focus upon an absence of distress or symptomology as indicative of well-being, rather than holistically exploring the felt sense of well-being. The current research aimed to gain a greater understanding of the subjective experiences of CAMHS inpatient staff, the impact of their well-being, and what can be done to support staff in meaningful ways. Method A qualitative research methodology was employed. Recruitment took place across two CAMHS inpatient units and a total of 11 frontline staff from various disciplines participated in the study. Semi-structured interviews were utilised for data collection, data was analysed using thematic analysis. The study was underpinned by a critical-realist position. Findings A total of 10 themes and 16 subthemes were developed from participants’ data. Participants described CAMHS to be both rewarding and stressful, and placed emphasis on the collaborative atmosphere within the wards. Participants felt an enhanced sense of responsibility compared to other settings. The findings also indicated possible Secondary Traumatic Stress within the staff. Participants expressed a need to be held in mind, as well as trying to find ways to overcome barriers to accessing the support offered to them. Discussion Findings are discussed in relation to existing literature and relevant psychological theory. The strengths and limitations of the study are outlined. Consideration is given to the clinical implications, including recommendations for Trauma Risk Management training for staff, revisions to local policies, and meaningful staff consultation during CAMHS inpatient design. Recommendations for future research are presented such as exploring the impact of staff values on subjective well-being, and well-being comparisons between psychiatric intensive care and acute CAMHS settings.