“The little ants that make everything else work”: Experiences of healthcare support workers in inpatient Child and Adolescent Mental Health Services (CAMHS).

Healthcare Support Workers (HCSWs) make up a large proportion of staff in in-patient Child and Adolescent Mental Health Services (CAMHS) in the UK. A good understanding of their experiences and opinions is important, especially in the context of the current retention crisis. The present study qualitatively explored HCSWs’ professional experiences, focusing on their training, support and relationships with staff and patients. In-depth semi-structured interviews were conducted with nine HCSWs and analysed thematically. Four themes were developed: lack of control, in-job support, ‘just’ a HCSW, and the therapeutic journey. The participants described how lack of control over work-related stressors, insufficient training and poor or inconsistent support, can lead to low motivation and job dissatisfaction. Relationships with patients were valued and perceived as motivational, whereas relationships with staff were more complex, suggesting lack of a clear professional identity for HCSWs and feeling undervalued on the wards. Recommendations include more consistency in the provision of peer and organisational support and improvements in the training of HCSWs. Future research should examine prospectively the associations between HCSW-retention and exposure to trauma in the ward, lack of control over work-related stressors, perceived quality of training, level of engagement with self-care and access to effective support.