scholarly journals A systematic review of effectiveness and cost-effectiveness of school-based identification of children and young people at risk of, or currently experiencing mental health difficulties

2018 ◽  
Vol 49 (1) ◽  
pp. 9-19 ◽  
Author(s):  
Joanna K. Anderson ◽  
Tamsin Ford ◽  
Emma Soneson ◽  
Jo Thompson Coon ◽  
Ayla Humphrey ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Cost Effectiveness ◽  
Young People ◽  
Evidence Base ◽  
Bibliographic Databases ◽  
Children And Young People ◽  
Presenting Symptoms ◽  
School Based ◽  
Mental Health Difficulties

AbstractBackgroundAlthough school-based programmes for the identification of children and young people (CYP) with mental health difficulties (MHD) have the potential to improve short- and long-term outcomes across a range of mental disorders, the evidence-base on the effectiveness of these programmes is underdeveloped. In this systematic review, we sought to identify and synthesise evidence on the effectiveness and cost-effectiveness of school-based methods to identify students experiencing MHD, as measured by accurate identification, referral rates, and service uptake.MethodElectronic bibliographic databases: MEDLINE, Embase, PsycINFO, ERIC, British Education Index and ASSIA were searched. Comparative studies were included if they assessed the effectiveness or cost-effectiveness of strategies to identify students in formal education aged 3–18 years with MHD, presenting symptoms of mental ill health, or exposed to psychosocial risks that increase the likelihood of developing a MHD.ResultsWe identified 27 studies describing 44 unique identification programmes. Only one study was a randomised controlled trial. Most studies evaluated the utility of universal screening programmes; where comparison of identification rates was made, the comparator test varied across studies. The heterogeneity of studies, the absence of randomised studies and poor outcome reporting make for a weak evidence-base that only generate tentative conclusions about the effectiveness of school-based identification programmes.ConclusionsWell-designed pragmatic trials that include the evaluation of cost-effectiveness and detailed process evaluations are necessary to establish the accuracy of different identification models, as well as their effectiveness in connecting students to appropriate support in real-world settings.

scholarly journals Care-experienced cHildren and young people’s Interventions to improve Mental health and wEll-being outcomes: Systematic review (CHIMES) protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042815
Author(s):  
Rhiannon Evans ◽  
Maria Boffey ◽  
Sarah MacDonald ◽  
Jane Noyes ◽  
G.J. Melendez-Torres ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Young People ◽  
Well Being ◽  
Evidence Base ◽  
Bibliographic Databases ◽  
Subjective Well Being ◽  
Programme Theory ◽  
Children And Young People ◽  
Health And Well Being

IntroductionThe mental health and well-being of children and young people who have been in care (ie, care-experienced) are a priority. There are a range of interventions aimed at addressing these outcomes, but the international evidence-base remains ambiguous. There is a paucity of methodologically robust systematic reviews of intervention effectiveness, with few considering the contextual conditions under which evaluations were conducted. This is important in understanding the potential transferability of the evidence-base across contexts. The present systematic review will adopt a complex systems perspective to synthesise evidence reporting evaluations of mental health and well-being interventions for care-experienced children and young people. It will address impact, equity, cost-effectiveness, context, implementation and acceptability. Stakeholder consultation will prioritise a programme theory, and associated intervention, that may progress to further development and evaluation in the UK.Methods and analysisWe will search 16 bibliographic databases from 1990 to June 2020. Supplementary searching will include citation tracking, author recommendation, and identification of evidence clusters relevant to included evaluations. The eligible population is children and young people (aged ≤25 years) with experience of being in care. Outcomes are (1) mental, behavioural or neurodevelopmental disorders; (2) subjective well-being; (3) self-harm; suicidal ideation; suicide. Study quality will be appraised with methodologically appropriate tools. We will construct a taxonomy of programme theories and intervention types. Thematic synthesis will be used for qualitative data reporting context, implementation and acceptability. If appropriate, meta-analysis will be conducted with outcome and economic data. Convergent synthesis will be used to integrate syntheses of qualitative and quantitative data.Ethics and disseminationWe have a comprehensive strategy for engagement with care-experienced children and young people, carers and social care professionals. Dissemination will include academic and non-academic publications and conference presentations. Ethical approval from Cardiff University’s School of Social Sciences REC will be obtained if necessary.PROSPERO registration numberCRD42020177478.

scholarly journals Can physical exercise improve tics and associated mental health difficulties in Tourette syndrome? The jury is out

2019 ◽  
Keyword(s):  
Mental Health ◽  
Attention Deficit Hyperactivity Disorder ◽  
Young People ◽  
Physical Exercise ◽  
Tourette Syndrome ◽  
Mental Health Problems ◽  
Evidence Base ◽  
Children And Young People ◽  
Hyperactivity Disorder ◽  
Mental Health Difficulties

Physical exercise is increasingly being recommended as part of management for children and young people with mental health problems. There is a growing evidence base that shows physical exercise is associated with improvements in functioning for conditions such as attention deficit hyperactivity disorder (ADHD), although studies are small, they are signifcant. 

scholarly journals Improving continence in children and young people with neurodisability: a systematic review and survey

2021 ◽  
Vol 25 (73) ◽  
pp. 1-258
Author(s):  
Helen Eke ◽  
Harriet Hunt ◽  
Susan Ball ◽  
Morwenna Rogers ◽  
Rebecca Whear ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Cost Effectiveness ◽  
Young People ◽  
Technology Assessment ◽  
Health Professionals ◽  
Current Practice ◽  
Health Technology ◽  
Care Staff ◽  
Children And Young People

Background Children and young people with neurodisability often need help to achieve socially acceptable bladder and bowel control. Approaches vary depending on whether or not the impairment results from spinal cord pathology that impairs motor control and sensation of the bladder and bowel. Currently, there is uncertainty about which interventions are effective. Objective The objective was to summarise the available evidence on and current practice for improving continence in children and young people with neurodisability. Design A systematic review of the effectiveness, cost-effectiveness and factors that modify intervention implementation, alongside a cross-sectional, online survey of current practice with health professionals, parent carers, school and care staff and young people with neurodisability. Results Twelve databases were searched in the review, resulting in 5756 references; 71 studies (72 papers) were included in the analyses. Most of the evidence was for children with spinal cord pathology, which involved evaluations of pharmacological approaches and surgical techniques, whereas the evidence pertaining to those with non-spinal-cord-related pathology tended to be for behavioural interventions. The methodological quality of studies was rated as being moderate to poor. There were three robust qualitative studies about the experience of continence among children with spinal cord pathology. We found substantial heterogeneity across the interventions that we evaluated in terms of quality, study design and outcomes measured. No economic studies were found. The results were synthesised narratively and reported in text and tables. We did not find any eligible studies evaluating interventions using toilet and clothing adaptations in the review, although the survey highlighted that these types of interventions are frequently used and considered. In total, 949 people responded to the survey: 202 health professionals, 605 parent carers, 122 school and social care staff, and 20 young people. The survey results illustrated the different roles that professionals have in improving continence, highlighting the importance of a multidisciplinary approach to supporting children and young people and their families. Clinicians employ a range of assessments and interventions to improve continence or independent toileting, depending on the needs of the child. Limitations Quantitative studies in the review were not methodologically robust. The survey had a risk of response bias. Conclusions Our research found a dearth of good-quality evidence for many of the interventions currently in use, and no evidence of experiences of implementing interventions for children with non-spinal-cord-related pathology. There was also no evidence of cost-effectiveness of any of the interventions. Future work There is a need to involve young people and families in the design of high-quality evaluative research for interventions that aim to improve continence. This is especially the case for children with autism and learning disability, who have been neglected in previous evaluative and qualitative research. We recommend better training for health, education and care professionals about toileting, informed by evidence and the lived experiences of children and their families. We recommend a joined-up multidisciplinary and holistic approach to improving continence to maximise independence, dignity and comfort. It is vital that children and young people with neurodisability have early access to regular, integrated assessment of their bladder and bowel health, and are fully supported with appropriate personalised treatment. Study registration This study is registered as PROSPERO CRD42018100572. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 73. See the NIHR Journals Library website for further project information.

Internet use among young people with and without mental health difficulties

2016 ◽  
Vol 35 (1) ◽  
pp. 11-21 ◽  
Author(s):  
G. Mullen ◽  
C. Dowling ◽  
G. O’Reilly
Keyword(s):  
Mental Health ◽  
Young People ◽  
Internet Use ◽  
Online Survey ◽  
Evidence Base ◽  
The Internet ◽  
Outpatient Services ◽  
Community Group ◽  
Clinical Support ◽  
Mental Health Difficulties

ObjectivesResearch regarding adolescent internet use and mental health is sparse. However, awareness of a young person’s internet use is becoming increasingly recognised as an important element of clinical assessment and intervention, and requires the development of an evidence base. The aim of the present study was to better understand the internet use of young people experiencing mental health difficulties and to contrast it with those who currently report no concerns.MethodIn total, 299 young people aged 12–19 years, across a continuum of mental health difficulties, completed an online survey measuring internet use and related experiences. Young people were assigned to four groups: (a) attending inpatient services; (b) attending outpatient services; (c) a community group with mental health concerns and no clinical support; and (d) a regular community group.ResultsThose in the inpatient and outpatient groups visited more potentially harmful websites. Young people attending inpatient and outpatient services showed aspects of both more risky and less risky use. The community group reporting no mental health difficulties showed least risky use. The group experiencing difficulties but not receiving support showed consistently high risky use, suggesting this is a particularly vulnerable group.ConclusionsDespite methodological limitations, findings suggest that those with mental health difficulties may experience more of the risks and fewer of the benefits offered by the internet. Though further research is needed to clarify these findings, clinicians should consider routine assessment of Internet use when planning interventions for young people experiencing mental health difficulties.

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