A qualitative investigation of views on practice in early support hubs from staff working in care and support roles.

Early Support Hubs have recently become widespread in the UK and aim to provide community-based, easy access mental health support to young people aged 11-25, integrating a variety of forms of support. Evidence is needed on the role such services aim to fulfil in addressing young people's mental health needs, perceived good practice in their operations and challenges encountered in achieving this. In order to understand this, we conducted individual interviews with 24 staff members from eight Hubs across England; data was analysed using codebook thematic analysis. Several structural-, organisational- and individual-level factors were identified, including: Hubs' service model and role in care pathway; service culture; staff characteristics, and staff and young people interactions.  The Early Support Hub model was perceived to provide a valuable and distinctive contribution to mental health support for young people, including a youth-centred and holistic approach, easy accessibility (e.g. self-referrals, no minimum thresholds for access), non-clinical service settings, and a diverse and compassionate workforce. Several constraining factors were identified, including the challenge of providing early intervention support to all young people whilst also ensuring the needs of those with significant mental health difficulties are met; short-term funding affecting sustainability, and challenges in recruiting and retaining staff with the desired qualities and values. Research is needed to further understand the Hubs' role in the system as a whole, their overall impact on addressing the rising burden of young people's mental ill health, and how well-functioning local service systems that do not result in significant gaps in provision can be established.