Priorities for Mental Health Research in Children and Young People

There has been recent focus on the state of mental health for Children and Young People (CYP), and a variety of initiatives developed to improve this, such as the CYP Improving Access to Psychological Therapies (IAPT) programme, and the developing Government Green Paper for CYP mental health. However, there has been little focus on the role mental health research can play.

The McPin Foundation, a charity focussing on mental health research, recently published a report outlining their identified top ten research priorities for CYP, with the aim of influencing policy and practice.

How was the research carried out?

The McPin Foundation set up an Advisory Group with seven young people between the ages of 14 – 23 years, and a Steering Group that included a range of individuals – from research funding organisations to parents and teachers. The Groups created a Young People’s mental health survey, and asked members of the public to put forward research questions around the topic (n = 2566). The Groups then developed the largest theme identified from their data – Intervention and Services, and with the help of a second survey (n = 753), narrowed down the questions posed to 25.  The final 10 priorities were selected in a workshop which included the advisory and steering groups, in addition to new members to the project (e.g., young people, professionals, parents).

What kind of research priorities for CYP were identified?

The top 10 research questions included early identification and screening of mental health difficulties, calls for further evidence on the effectiveness of therapies/strategies/resources/training, and exploration of how family/parental relationships contribute to treatment outcomes for CYP. Further research priorities (Top 25) were also identified and were more varied, including exploring effective methods for supporting young men in recognising symptoms of mental ill-health (Priority 15), and the impact of waiting list times on treatment and mental health outcomes (Priority 21). The full list of research priorities can be viewed here.

What next?

The McPin Foundation are keen for young people, researchers, and potential partners (e.g., individuals, organisations etc.) to get in touch:

 

 

Young people

  • Young people can sign up to the Network and receive emails about taking part in research. To do so, sign up via mcpin.org/young-people/

Researchers

  • Researchers can ask the Young People’s Network for feedback on and help shaping their research that address the priorities identified in the report. In addition, the McPin Foundation are keen for researchers to keep them up to date with their research on the identified priorities. Get in touch via contact@mcpin.org.

Partners

  • Individuals may be interested in working with the McPin Foundation on the identified priorities – get in touch via contact@mcpin.org.

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associate on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology). 

Children of the Millennium

The Centre for Mental Health, in partnership with the Institute of Education at UCL, recently published a report outlining the current understanding of conduct problems and their course through childhood. The study team (Gutman, Joshi, Khan, & Schoon, 2018) examined longitudinal data obtained from a sample of over 19,000 children born in the United Kingdom between 2000-2002 for the Millennium Cohort Study.

What is conduct disorder?

Clinical guidance from the National Institute for Health and Care Excellence (NICE) and the Social Care Institute for Excellence (SCIE) defines conduct disorders as “repetitive and persistent patterns of antisocial, aggression or defiant behaviour that amounts to significant and persistent violations of age-appropriate social expectations”. Examples of violations of age-appropriate social expectations include angry outbursts or physical aggression towards other children between the ages of 3-7 years; violence, robbery or substance misuse between the ages  of 12 – 17 years amongst others. The scale of the conduct problems is significant as the child or young person’s daily functioning is disrupted, and distress is experienced by those around them. The prevalence of conduct problems is around 5% (for children and young people between 5 – 16 years; Green, McGinnity, Meltzer, Ford, & Goodman, 2004), and is considered the most commonly diagnosed mental health condition for children between 5- 10 years.

Key results

Pathways of childhood conduct problems by gender

  • The prevalence of conduct problems is higher in boys, compared to girls, between the ages of 3 – 11 years (e.g., at 3 years old: boys = 22% and girls = 19%; at 11 years old: boys = 14% and girls = 9%).
  • Between 3 – 11 years old, the majority of girls (78%) and around half of boys (54%) had a low risk of developing severe conduct problems.

Pathways of childhood conduct problems and the impact of multiple risks over time

  • Between the ages of 3 – 14 years, the majority of children in the sample (56%) had a low risk of severe conduct problems, whereas 8% of children had a high risk.
  • Whilst 13% of children were identified to have a low risk of severe conduct disorder from 3 – 7 years, this increased by age 14.
  • A subset of children (23%) were identified as having a moderate to high risk of developing severe conduct problems by age 3 years, but this then declined with age.

Pathways of childhood conduct problems and co-occurring mental health difficulties

  • Different groups of children were identified who also presented who co-occurring mental health conditions (conduct problems, hyperactivity/inattention, emotional problems, and problems with peer interactions) between 3 – 11 years:
    • Low problems (52%)
    • Moderate externalising, low internalising (27%)
    • Moderate internalising, low externalising (12%)
    • Persistent high problems (8%)

Recommendations (for England only)

Gutman et al. (2018) proposed 10 recommendations for key stakeholders (e.g., the Government, NHS England, NICE), based on the findings of their report. Recommendations include calls for improved cross-agency working, quality of support available, and guidance. The full report can be viewed here.

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associate on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology). 

 

 

Mental health equality in Great Britain

Today, the Equality and Human Rights Commission published a pre-publication draft of their report ‘Is Britain Fairer’ – a review on the state of equality and human rights in Britain. The current blog post will focus on the mental health sub-theme.

Key findings

Mental health and wellbeing

  • Across England, Wales and Scotland, women reported poorer mental health and wellbeing compared to men, disabled people reported poorer mental health wellbeing compared to non-disabled individuals, and those that  identified as Lesbian, Gay, Bisexual, Trans (LGBT) reported poorer mental health and wellbeing compared to those that identified as heterosexual (for LGBT – England only).
  • People who experience homelessness are more likely to have mental health conditions, compared to the general population.
  • There are no official/robust figures for the number or prevalence of people in prison who have a mental health condition in England, Wales or Scotland.

Access and quality of services/therapies

Immigration

  • Mental health provision for those in immigration detention is variable – from excellent in Scotland (e.g., Dungavel) to significant barriers reported in England and Wales.

Looked after children

Deaths by suicide

Restraint

Legislation

Conclusions

The Governments of England, Wales and Scotland have highlighted their commitment to establishing a parity of esteem between physical and mental health, and have implemented policies which represent steps towards this.

However, further work (including collection of reliable data collection and evaluation) needs to be conducted to ensure that all individuals, including those under protected characteristics (e.g., sexual orientation, ethnicity etc.) can access specialist treatment. Moreover, that the healthcare experiences of those under protected characteristics improves, as well as their mental health outcomes.

The full ‘Is Britain Fairer’ report can be accessed here, whilst the executive summary (shortened, concise version) can be accessed here. The report has been published in pre-publication form, and will be finalised following presentation to Parliament.

 

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associate on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology).