O24 Implementing an insomnia intervention into adolescent mental health services: a mixed-methods feasibility and process evaluation

Tools

Mccrory, Stephanie and Crawford, Megan and MacMahon, Kenneth and Fleming, Leanne (2026) O24 Implementing an insomnia intervention into adolescent mental health services: a mixed-methods feasibility and process evaluation. BMJ Open Respiratory Research, 13 (Suppl ). A17.1-A17. (https://doi.org/10.1136/bmjresp-2026-bss.24)

[thumbnail of McCrory-etal-2026-O24-Implementing-an-insomnia-intervention-into-adolescent-mental-health]
Preview
 Text. Filename: McCrory-etal-2026-O24-Implementing-an-insomnia-intervention-into-adolescent-mental-health.pdf
Final Published Version
License: Creative Commons Attribution-NonCommercial 4.0 logo
Download (134kB)| Preview

Abstract

Introduction Insomnia is highly prevalent amongst adolescents with mental health complaints. Research shows insomnia exacerbates mental health symptoms, limits treatment effectiveness, and predicts relapse. However, it is typically under assessed or treated in practice, largely due to a lack of training for practitioners. Cognitive Behavioural Therapy for insomnia (CBTi) is effective for improving sleep, depression and anxiety. Using Delphi methodology, we developed training and a CBTi intervention suitable for adolescents. The aim of this study was to evaluate the feasibility and acceptability of the intervention. Methods We aimed to recruit practitioners and >40 adolescents from 2 mental health services. Adolescents were not eligible to participate if they had diagnoses of a neurodevelopmental disorder (NDD), contraindicators for sleep restriction, or at risk of harm. Data collection included sleep diaries and questionnaires at baseline, post-intervention, and 3-month follow-up. Qualitative interviews were analysed using thematic analysis. Results Ten practitioners were trained to deliver the intervention. Between October 2024 – 2025, only 9 referrals were received, and 3 adolescents provided consent. All adolescent participants completed the baseline assessment, but none completed the follow-up assessments. A qualitative process evaluation was conducted, and 13 practitioners attended semi-structured interviews to explore barriers and facilitators. The findings highlighted 1) sleep problems are common, but are poorly assessed and treated, 2) the training workshops and intervention was acceptable for practitioners, 3) the intervention may not be suitable for most adolescents attending mental health services, 4) CBTi must be delivered flexibly, balancing patient need and available resource, 5) ‘Red tape’ restrictions make conducting research in mental health services challenging. Key barriers and facilitators were identified. Discussion The findings indicate it is not currently feasible to implement CBTi via adolescent mental health services in Scotland. However, it does provide key insights and avenues for future research.

ORCID iDs

Mccrory, Stephanie ORCID logoORCID: https://orcid.org/0000-0002-8072-7482, Crawford, Megan ORCID logoORCID: https://orcid.org/0000-0002-3167-1398, MacMahon, Kenneth and Fleming, Leanne ORCID logoORCID: https://orcid.org/0000-0001-6197-9214;
CORE (COnnecting REpositories)