A third of children with epilepsy also struggle with anxiety, depression, or behavioural problems, but most never get the mental health support they need. The MICE programme—a tailored psychological intervention—already proved effective in a trial of 334 children, including those who are neurodivergent, and is now being rolled out across NHS England. This follow-on research asks whether that rollout is reaching everyone fairly. The team will analyse trial data to see if children from deprived backgrounds, ethnic minorities, or other underserved groups benefited less from MICE, or needed more sessions to improve. They will also interview families who were offered MICE through the NHS pilots but chose not to take part, to understand what stopped them. If this work identifies specific barriers—such as language, transport, or stigma—the findings could help NHS commissioners adapt how MICE is delivered, ensuring the intervention does not widen existing health inequalities. The goal is a mental health service for children with epilepsy that works equally well for all families, regardless of their circumstances.
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Background Children and young people with chronic physical illnesses, such as epilepsy, often experience mental health difficulties, yet accessing appropriate care for these mental health difficulties remains a challenge. The Mental Health Intervention for Children with Epilepsy (MICE) Programme was developed to address this gap by providing a tailored modular psychological intervention. The results of the trial (n=334) demonstrated that MICE was effective in reducing emotional and behavioural difficulties. As a result of these positive findings, MICE is now part of a funded pilot programme of implementation within the NHS England Children and Young People (CYP) Transformation Programme "Epilepsy Bundle of Care". A key advantage of MICE was inclusion of neurodivergent children and young people, in line with the NHSE national CYP Core20Plus5 agenda. Aims and objectives This research aims to add value to the NHSE implementation programme by improving the effectiveness and reach of the MICE intervention through considering health inequalities. The specific objectives are to investigate: Whether any sociodemographic inequalities were observed in participants progression through the MICE trial Whether there was preliminary evidence of differential efficacy considering demographic factors, including the inequalities defined by the CORE20-Plus Dose-responsiveness: whether some participants benefitted from fewer MICE sessions and if so, who Characteristics of treatment according to different groups Barriers and facilitators to accessing MICE Development Work Plan Objectives 1-4 will be met through secondary data analysis of the existing MICE trial data. Objective 5 will be met through a qualitative study to explore the experiences and views of patients in the NHSE implementation who did not take part in MICE. Quantitative analyses will involve assessing progression through trial stages, treatment efficacy based on demographic factors, and determining the number of sessions required for reliable improvement in symptoms. Qualitative analyses, using a framework analysis design, will explore the experiences and views of patients who did not participate in MICE in the NHSE pilots, identifying barriers and facilitators to access and implementation. Patient and Public Involvement meetings will run throughout the research, to inform development of the qualitative study materials and methods, refine research questions for the statistical analyses, outputs and dissemination plans. Timelines for Delivery Quantitative and qualitative aspects will run concurrently over an 18-month period. Ethical approvals processes for the qualitative objective will begin as soon as confirmation for the research award is received and prior to the start of the award. Research papers and the final report will be produced in the final three months of the award. Four steering group meetings and research advisory group meetings will be held over the research period to ensure that research objectives and outputs are met within the planned time frame. Anticipated impact and dissemination Findings will contribute to ongoing efforts to integrate mental and physical healthcare for children and young people with chronic health conditions, particularly epilepsy, with a focus on health inequalities and the potential avenues to mitigate the effect of this on accessing healthcare. Dissemination of findings will be facilitated through academic publications, conference presentations and stakeholder engagement.
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