A Qualitative Study Exploring the Lived Experience of Caregivers’ Attending Child and Adolescent Mental Health Services (CAMHS)

Abstract

Child and Adolescent Mental Health Services (CAMHS) are specialist, publicly funded services that play a vital role in supporting young people with moderate to severe mental health needs. In Ireland, and internationally, CAMHS face enduring systemic pressures, including underinvestment, workforce shortages, and long waits for assessment and intervention. Caregivers are central to service engagement, acting as advocates and coordinators of care, yet their perspectives remain underrepresented in the literature. Understanding caregiver experiences is essential to improving quality, strengthening therapeutic relationships, and shaping meaningful reform. To explore the lived experiences of caregivers engaging with CAMHS in Ireland and to examine the relational, systemic, and structural factors shaping these experiences. Reflexive thematic analysis (RTA) was used to analyse semi-structured interviews and focus groups. A qualitative study design was employed, with participants purposively sampled following a national caregiver survey. Data collection and analysis were iterative and reflexive across all stages. Twenty-two caregivers participated, generating six interrelated themes: (1) When CAMHS Works: Feeling Seen, Heard, and Supported, (2) Barriers to Communication and Trust: Caregiver–Clinician Disconnects, (3) Fragmented and Standardised Care: Impacts on Continuity and Engagement, (4) Limited Access and Inadequate Crisis Response, (5) Workforce and Infrastructure Deficits, and (6) Neuroinclusion Gaps: Barriers for Autistic and Neurodivergent Young People. These findings illustrate how structural and relational challenges shape caregiver experiences and inform priorities for CAMHS reform. Caregivers described fragmented care, poor communication, and limited neuroinclusion, exacerbated by staff shortages, service fragmentation, and inconsistent support. Positive examples were rare but highlighted the value of relational, family-centred practice. The findings underscore the need for structural reform alongside a cultural shift toward more inclusive, family-centred and neurodiversity-informed CAMHS, in line with international calls for accessible, high-quality youth mental health services.