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Highlights in child mental health research: December 2022

Prepared by AIFS, Australia, December 2022

Related to Adverse Childhood Experiences (ACEs), Child and family, Child mental health, Complex trauma, Mental health services, Post-traumatic stress disorder, Prevention and early intervention, Responding to traumatic events, Trauma

Resource Summary

The monthly research summary provides a selection of recently released papers, systematic reviews, and meta-analyses related to infant and child mental health. Each summary includes an introductory overview of the content for the month, followed by a list of selected articles. Each article is accompanied by a brief synopsis which presents the key messages and highlights. Links to abstracts, full-text articles, and related resources, where available, are provided.

What's new this month in child mental health research?

This month’s highlights include:

This research mapped the geographical distribution of children with a high risk of mental disorders at age five based on signs of early child developmental vulnerability in New South Wales. A higher proportion of children at risk were located in regional and socioeconomically disadvantages areas. A few metropolitan areas also had relatively high populations of children at risk.

This study identified the impact of the Child and Family Traumatic Stress Intervention (CFTSI) on children’s post-traumatic stress symptoms in the United States. The findings revealed a significant reduction in child-reported post-traumatic stress scores compared to pre-CFTSI. The authors highlight that CFTSI was impactful, regardless of demographic and event-related characteristics of the child or caregiver.

This study developed a consensus from a panel of experts about the barriers and facilitators to the organisational implementation of Father-Inclusive Practice in child and family services. The findings suggested that more attention should be given to top-down organisational processes and practices to improve service-level provision.

This systematic review identified barriers and facilitators for implementing youth peer support workers (YPSWs) in mental health services that provide support to young people. The authors outlined key organisational factors to improve implementation. These factors were predominantly focused on balancing support for YPSWs in their new roles with fostering the authenticity and utility of YPSWs’ personal strengths.

Early childhood risk for mental health disorders based on local government area

Regional mapping of early childhood risk for mental disorders in an Australian population sample

Authors: Harris, F., Dean, K., Laurens, K, R., Tzoumakis, S., Carr, V, J., & Green, M, J.

Journal: Early Intervention in Psychiatry

Highlights

  • This study aimed to understand the geographical distribution of children showing risk for mental disorders in early childhood to help inform the planning of place-sensitive early intervention services that are cost-effective and account for specific need.

Key findings

  • Using data from the NSW Child Development Study, multi-agency records, and child development assessments, this research mapped to local government areas of New South Wales (NSW), the proportion of children, age five, who were at risk of developing a mental disorder later in life.
  • Two risk profiles for future mental disorder were used – ‘misconduct’ risk (hyperactivity, inattention, aggression) and a general ‘pervasive’ risk profile A previous study using these risk profiles showed children classified as ‘high risk’ had a threefold risk of hospital or ambulatory treatment for mental disorder between ages of 6-13 years.
  • 3% of the 82,891 children included in this study were classified as ‘high risk’ (4.2% ‘pervasive’ risk profile and 7.0% ‘misconduct’ risk profile).
  • A higher proportion of children at risk of later mental disorders were located in regional areas and in socioeconomically disadvantaged areas. Several metropolitan areas in Sydney (in outer western suburbs) also had relatively high populations of children at risk.
  • The paper provides a visual representation of the proportion of children with risk profiles in each local government area.

Implications

  • These findings are consistent with other literature detailing the greater prevalence of mental ill-health in socioeconomically disadvantaged and regional areas of Australia.
  • Authors suggest that targeted interventions in high-risk areas could mitigate against the development of mental health problems in middle childhood and adolescence.
  • Possible interventions may include school-based mental health promotion programs or the provision of suitable support services.

 

Read the free full text

Effectiveness of a traumatic stress intervention program

The child and family traumatic stress intervention: Factors associated with symptom reduction for children receiving treatment

Authors: Strover, C, S., Hahn, H., Maciejewski, K, R., Epstein, C., & Marans, S.

Journal: Child Abuse and Neglect

Highlight

  • This study aimed to identify the impact of the Child and Family Traumatic Stress Intervention (CFTSI) on children’s post-traumatic stress symptoms (PTSS) in the United States.
  • CFTSI is a brief trauma focused mental health treatment designed to reduce trauma symptoms, in the aftermath of a traumatic experience, in children aged seven years and older. It engages children together with their caregivers to teach and guide practice in effective communication, coping strategies, and behavioural interventions to use at home.

Key findings

  • 1,190 child-caregiver pairs were included in the study. 76.8% of participating children were younger than 12 years of age and 81.8% were female. For 87.4%, the primary nature of the traumatic event was sexual abuse, and for 10.9% it was physical abuse.
  • Significantly higher PTSS scores were found pre-CFTSI for girls, children older than 12 years (compared to ages 6-11), children with a history of experiencing multiple trauma types, and children whose caregivers reported higher levels of PTSS at the start of treatment.
  • The findings revealed a significant reduction in pre- to post- CFTSI post-traumatic stress scores for children. The intervention was equally as effective for children with high or low PTSS scores pre-CFTSI.
  • Children’s post-traumatic recovery was not impeded by demographic or event-related characteristics such as the child’s age, gender, ethnicity, number of prior trauma experiences or nature of abuse, caregiver posttraumatic stress symptoms, or length of time between the event and receiving treatment.

Implications

  • This study showed evidence of a brief early intervention program, CFTSI, in reducing post-traumatic symptoms, which may have beneficial impacts on children’s development and later psychiatric, physical, and behavioural health.
  • The authors suggested that PTSS may decrease for caregivers as they feel more effective in supporting their child’s recovery and/or can achieve greater control over their own recovery.
  • The study suggests that CFTSI is impactful, regardless of the demographic or event-related characteristics of the child or caregiver. This suggests that this type of program may be helpful to a wide range of children.

 

Read the full abstract

Implementing father-inclusive practice in child and family mental health services

Strategic priorities for implementation of father-inclusive practice in mental health services for children and families: A Delphi expert consensus study

Authors: Baran, M.B. & Sawrikar, V.

Journal: Administration and Policy in Mental Health and Mental Health Services Research

Highlights

  • This study aimed to develop consensus from a panel of experts about the barriers and facilitators to the organisational implementation of father-inclusive practice (FIP) in child and family services.
  • FIP encompasses an organisational commitment to supporting fathers in their role, actively encouraging fathers’ participation in programs, and ensuring fathers are appropriately and equally considered in service delivery.
  • Greater father involvement and active engagement with their children has been found to significantly benefit child outcomes including cognitive development, social competence, academic achievement, levels of happiness and psychological well-being.

Key findings

  • A panel of 56 of experts in child and family service provision and father inclusion from Australia, the UK, the US, Canada, and Belgium were surveyed using the Delphi technique. Participants included research and academic professionals (28.6%), managers and leadership professionals (19.6%), practitioner psychologists (19.6%), and family support workers and coordinators (14.3%).
  • The panel were asked about potential barriers and facilitators to FIP implementation, the extent to which they agree/disagree with the views of other experts and to re-rate their answers following group feedback.
  • Key facilitators for FIP implementation were:
    • Organisational encouragement, staff training, systems and processes that foster discussion and reflection on FIP
    • Service targets and key performance indicators for the inclusion of fathers and monitoring and auditing implementation
    • Systems-level support from external bodies (e.g., government and commissioners).
  • Key barriers to implementation were:
    • Lack of prioritisation and provision of support from organisations
    • Lack of leadership, centralised guidance, and performance monitoring
    • Lack of organisational awareness of father’s needs and practitioner perspectives of FIP being an extra burden for staff.
  • Practitioner-level issues (such as staff assumptions about, or confidence in engaging fathers) were not as important to the panel as service-level and external-level issues for successful implementation. However, may have been influenced by the high proportion of experts who were not frontline practitioners.

Implications

  • The findings highlighted the importance of organisational processes and practices (such as effective leadership) for improving service-level provision of FIP.
  • The findings suggest that factors associated with resourcing, such as the availability of staff and financial resources may be less important than leadership and organisational prioritisation. As such, FIP implementation may be less resource intensive than previously assumed.
  • The authors also note the interdependence of facilitators for implementing FIP. Successful implementation may therefore require a systems approach.

 

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Facilitating peer support workers in youth mental health services

A systematic review exploring youth peer support for young people with mental health problems

Authors: de Beer, C. R. M., Nooteboom, L. A., van Domburgh, L., de Vreugd, M., Schoones, J. W., & Vermeiren, R. R. J. M.

Journal: European Child & Adolescent Psychiatry

Highlights

  • This systematic review aimed to identify barriers and facilitators for implementing youth peer support workers (YPSWs) in practice.
  • YPSWs are young adults with lived experience of mental illness who support young people receiving treatment in mental health services.
  • The authors suggest that YPSW’s can add value to services based on their age and lived experience. However, YPSWs often require specific supports.

Key findings

  • 24 studies on YPSWs supporting young people (8-26 years) were included in this review.
  • The authors found that YPSWs occupy various roles including engagement, emotional support, navigating and planning, advocacy, research, and educational roles.
  • The research found the following organisational factors can support YPSW implementation:
    • Balancing flexibility and direction, such as setting clear and realistic expectations around the scope of YPSW’s role but keeping guidelines flexible to meet the needs of YPSWs and to maintain the authenticity and utility of YPSW’s personal strengths.
    • Ongoing training, mentorship and coaching from YPSWs supervisors who are available to offer ad hoc support (e.g., in understanding administrative aspects and managing personal boundaries with clients).
    • Ensuring consideration of power imbalances between YPSWs and non-peer staff and that equal value is placed on both clinical and experiential expertise.
    • Providing time and space for YPSWs to explore their new identity (i.e., changing from service user to service provider), and encourage confidence, wellbeing, and readiness for them to fully embrace the role.
    • Fostering a growth mindset by embracing change and preparing staff for change.

Implications

  • The implementation of YPSW is regarded by the authors as a promising approach to assist youth mental health services, by providing more consumer-centred and recovery-oriented care.
  • The authors suggest that adequate time and resources should be provided to support implementation though the factors outlined above.

 

Read the full abstract

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