Literature Collection

Rates of poor mental health among children and young people are rising globally, with physical health professionals increasingly expected to respond to psychiatric needs. Despite this shift, limited research has explored how these professionals experience and manage mental health presentations, particularly in paediatric settings. This study examines the challenges and opportunities faced by staff supporting young people with mental health needs on paediatric hospital wards, within a system that often treats physical and mental health separately. We conducted a secondary analysis of 31 one-off semi-structured interviews, conducted with 16 mental health and 15 physical health professionals. Using reflexive thematic analysis, themes were iteratively refined in dialogue with NHS collaborators, a senior qualitative researcher, and interview participants to ensure analytic rigour and relevance. Professionals reported a widening gap between the complexity of young patients' mental health needs and the limited expertise available on physical health wards. Three themes emerged: (1) "We all feel out of our depth," reflecting feelings of being underprepared and overwhelmed; (2) "A mental health waiting room," highlighting wards being used as temporary spaces while patients await psychological care; and (3) "We're the place to keep them safe," revealing a primary focus on immediate risk management. Physical health professionals reported feeling unprepared to support young patients with mental health needs, often managing self-harm, suicidality, and eating disorders without specialist training. Both physical and mental health professionals emphasized a need for trauma-informed, non-stigmatizing communication and emotional support for staff. Barriers to integrated care within these two trusts included digital system incompatibility, understaffing, and limited psychiatric liaison. Findings highlight the urgency of cross-disciplinary training, supervision, and structural investment to support compassionate, coordinated care for young people with complex mental and physical health needs.