Table 1 Themes and subthemes

1. Acknowledging the heterogeneity of needs: the need for a person-centred care approach and flexibility when working with CEN

1.1. Working with the person not the diagnosis

1.2. Keeping relationships at the core of care

1.3. Staff characteristics needed to deliver this care

1.4. Addressing underlying trauma

2. ‘Still a diagnosis of exclusion’: Exploring the healthcare provider level barriers to providing care

2.1. Provider fear of the risks associated with complex emotional needs

2.2. Staff feelings of hopelessness to help and create change

2.3. The challenge of working in a culture of stigma and labelling

2.4. The need to mitigate these barriers through supporting staff.

3. Understanding the exclusionary culture: exploring the system-based barriers to providing care for CEN

3.1. The inaccessible and limited availability of services

3.2. The lack of specialist training to help staff support service users with CEN

3.3. Poor resourcing and lack of funding