Evidence map›Paper›PMID 41947929›Full record

ArticleLearning health systems2026

Inishowen Child and Adolescent Mental Health Service: Developing a Learning Health Microsystem.

Tom Foley, Bennie Steyn, Eoin Fitzgerald, Liesl Roos, Areej Gazzaz, Mohamed Mohamed, Jumanah Al Ibrahim, Amr Abu Shehab, Gavin McBridge, Aoife Robb and 8 more

Abstract read
In one paragraph

Article in Learning health systems, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Tom FoleyCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Bennie SteynCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Eoin FitzgeraldChildren's Health Ireland Dublin Ireland.
Liesl RoosDonegal Mental Health Service Donegal Ireland.
Areej GazzazDonegal Mental Health Service Donegal Ireland.
Mohamed MohamedDonegal Mental Health Service Donegal Ireland.
Jumanah Al IbrahimUniversity of Galway Galway Ireland.
Amr Abu ShehabUniversity of Galway Galway Ireland.
Gavin McBridgeCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Aoife RobbCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Sheila GillCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Caoimhe McDaidCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Breidge McGarveyCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Jessica Du PreezCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Tom SharpeCAMHS, Buncrana Primary Care Centre Buncrana Donegal Ireland.
Paige Leigh McDonaldGeorge Washington University Washington USA.ORCID https://orcid.org/0000-0001-8741-6276
Sue Lacey BryantManchester Metropolitan University Manchester UK.
Fiona McNicholasUniversity College Dublin Dublin Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Learning health systems (LHSs) offer a model for continuous improvement in complex, real-world clinical environments. While widely described internationally, little evidence exists regarding their implementation within Irish mental health services. Inishowen child and adolescent mental health service (CAMHS), a small rural microsystem with limited digital maturity, sought to apply a LHS framework through the creation of a learning community, manual data collection and a living standard operating policies and procedures (SOPP) manual. Aim: This study examines the development and early outcomes of this locally driven learning health microsystem, taking wait times as an exemplar. It explores the organizational complexity using the non-adoption, abandonment, scale-up, spread and sustainability (NASSS) framework. Methods: A descriptive case-study design was used. Data were drawn from routine audits, caseload analysis, patient experience measures, referral metrics, and outputs from the learning community. The NASSS framework was applied to analyze complexity across conditions, technology, adopters, organization, wider system influences, and the capacity for embedding and adaptation over time. Results: Implementation of LHS processes was feasible despite paper-based records and minimal infrastructure. Between 2020 and 2024, the caseload reduced by half; from 2023, 100% of young people were seen within 3 months, and maximum waiting times fell from 743 days in 2020 to 49 days in 2025. Patient and family experience remained highly positive. Several elements, including the SOPP and youth engagement, became embedded, whereas continuous data collection remained vulnerable to staff turnover and workload pressures. Conclusion: A learning health microsystem can emerge in digitally immature, resource-constrained CAMHS settings. Inishowen CAMHS demonstrates measurable service improvements and offers a replicable early model for LHS development in Irish mental health care. Future work should focus on scaling this microsystem approach and spreading nationally, strengthening digital infrastructure to support faster, more reliable learning cycles and to sustain improvements over time.

Indexed as

access to carecomplexitylearning communitieslearning health systemsmental health

Identifiers

PMID41947929
PMCPMC13052015

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.