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Article
Publication date: 21 March 2016

Valentina Baltag and Chiara Servili

Mental health problems make a significant contribution to morbidity and mortality in adolescents worldwide. To address mental health in adolescents policy response should…

Abstract

Purpose

Mental health problems make a significant contribution to morbidity and mortality in adolescents worldwide. To address mental health in adolescents policy response should intertwine the life course approach and the ecological model that positions adolescents in the context of multifactorial influences. The purpose of this paper is to describe policy response at four levels: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress. It aims to analyse the implications for adolescent mental health of key recent global commitments including the sustainable development goals (SDGs) and the Global Strategy for Women’s, Children’s and Adolescents’ Health.

Design/methodology/approach

Multisector policies and interventions on determinants of adolescent mental health and well-being are drawn from the Global Strategy for Women’s, Children’s and Adolescents’ Health. Key health systems actions are derived from the Comprehensive Mental Health Action Plan (2013-2020). In both cases, policies and interventions are made specific for provisions relevant to adolescents. Examples of implementation of policies and interventions are drawn from a World Health Organization (WHO) review of national policy documents found in WHO MiNDbank. A list of indicators to monitor progress is being proposed based on Mental Health Atlas and WHO indicators for adolescent health.

Findings

With some notable exceptions, the mental health of adolescents is not adequately addressed by national health policies. There is a considerable body of evidence on the effectiveness of policies and interventions, and recent global commitments give new hope for promoting adolescent mental health through a multisectoral response, within which the health sector has an important role to play. Global reporting mechanisms, including the Mental Health Atlas, should be “adolescent-sensitive”, meaning that adolescent specific impact, outcomes, inputs and determinants should be measured, reported and acted upon.

Originality/value

This paper analyses the meaning specific to adolescents in the policies and interventions promoted in the SDGs, the Global Strategy for Women’s, Children’s and Adolescents’ Health and the Comprehensive Mental Health Action Plan (2013-2020). For the first time a four-levels policy response specific to adolescent mental health is put together: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress.

Details

Journal of Public Mental Health, vol. 15 no. 1
Type: Research Article
ISSN: 1746-5729

Keywords

Abstract

Purpose

Young people transitioning from child to adult mental health services are frequently also known to social services, but the role of such services in this study and their interplay with mental healthcare system lacks evidence in the European panorama. This study aims to gather information on the characteristics and the involvement of social services supporting young people approaching transition.

Design/methodology/approach

A survey of 16 European Union countries was conducted. Country respondents, representing social services’ point of view, completed an ad hoc questionnaire. Information sought included details on social service availability and the characteristics of their interplay with mental health services.

Findings

Service availability ranges from a low of 3/100,000 social workers working with young people of transition age in Spain to a high 500/100,000 social workers in Poland, with heterogeneous involvement in youth health care. Community-based residential facilities and services for youth under custodial measures were the most commonly type of social service involved. In 80% of the surveyed countries, youth protection from abuse/neglect is overall regulated by national protocols or written agreements between mental health and social services, with the exception of Czech Republic and Greece, where poor or no protocols apply. Lack of connection between child and adult mental health services has been identified as the major obstacles to transition (93.8%), together with insufficient involvement of stakeholders throughout the process.

Research limitations/implications

Marked heterogeneity across countries may suggest weaknesses in youth mental health policy-making at the European level. Greater inclusion of relevant stakeholders is needed to inform the development and implementation of person-centered health-care models. Disconnection between child and adult mental health services is widely recognized in the social services arena as the major barrier faced by young service users in transition; this “outside” perspective provides further support for an urgent re-configuration of services and the need to address unaligned working practices and service cultures.

Originality/value

This is the first survey gathering information on social service provision at the time of mental health services transition at a European level; its findings may help to inform services to offer a better coordinated social health care for young people with mental health disorders.

Details

Journal of Children's Services, vol. 15 no. 3
Type: Research Article
ISSN: 1746-6660

Keywords

Article
Publication date: 14 April 2010

Rachel Jenkins, Howard Meltzer, Brian Jacobs and David McDaid

The European Union‐supported Child and Adolescent Mental Health in an Enlarged Europe (CAMHEE) project aimed to provide an overview of the challenges, current practice and…

Abstract

The European Union‐supported Child and Adolescent Mental Health in an Enlarged Europe (CAMHEE) project aimed to provide an overview of the challenges, current practice and guidelines for developing effective mental health promotion and mental illness prevention policy and practice across Europe. As part of this work, an analysis was undertaken of the situation in England, making use of a bespoke data collection instrument and protocol.Our analysis suggests that there has been significant effort and investment in research, needs assessment, policy, human resource and service developments in CAMHS over the last 20 years, leading to a more detailed understanding and availability of services. Much of the emphasis has been on assessment and management of difficulties, however in recent years attention has begun to focus on mental health promotion. National standards and programmes such as Every Child Matters (Department for Education and Skills, 2004) have acted as catalysts for a number of national initiatives.

Details

Journal of Public Mental Health, vol. 9 no. 1
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 1 September 2008

Steven Walker

This paper describes and discusses the evaluation of an innovative child and adolescent mental health project located in a large county in eastern England. The project was one of…

137

Abstract

This paper describes and discusses the evaluation of an innovative child and adolescent mental health project located in a large county in eastern England. The project was one of eight located in the voluntary sector and supported by the Mental Health Foundation as part of a national initiative aimed at responding in new, accessible ways to young people requiring help for emotional and mental health problems. Traditional specialist CAMH services are overwhelmed by demand while also failing to engage many young people. This study provides evidence of how new services can develop to meet the needs of troubled young people in appropriate and acceptable ways.

Details

The Journal of Mental Health Training, Education and Practice, vol. 3 no. 3
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 2 April 2010

Chih Sin, Rob Francis and Chloe Cook

Despite laudable intentions and evidence of progress, significant barriers remain in relation to the access to and experiences of child and adolescent mental health services…

Abstract

Despite laudable intentions and evidence of progress, significant barriers remain in relation to the access to and experiences of child and adolescent mental health services (CAMHS). This article draws on the findings of a literature review and reports a number of barriers and their impact on children and young people with learning disabilities. Children and young people with learning disabilities are at a disproportionate risk of experiencing mental health problems yet access and experience of CAMHS can be highly uneven. Families are often unclear about how to access mental health services and what services are available. Such information and knowledge‐related barriers are particularly significant for certain minority ethnic groups. Barriers related to the CAMHS workforce mix, skills and staff attitudes can also mean that skills required for working with people with both mental health conditions and learning disabilities can be lacking. At a macro level, systems‐related barriers include a lack of joint commissioning and planning, unclear care pathways, the lack of a single point of referral, difficult transition to adult mental health services and a lack of inappropriate services.

Details

Mental Health Review Journal, vol. 15 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 21 June 2013

John Sinclair and Stephanie Holden

This article aims to demonstrate a different approach to identify and assess adolescents experiencing mental health problems, within a school setting. Presently we rely on primary…

Abstract

Purpose

This article aims to demonstrate a different approach to identify and assess adolescents experiencing mental health problems, within a school setting. Presently we rely on primary care professionals to identify mental health problems and adolescents are often reluctant to access such services. One of the benefits of utilising a mental health surveillance screening tool is to identify mental health problems in adolescents and to implement early intervention.

Design/methodology/approach

A cross‐sectional survey of school pupils from a secondary school was conducted, using the Paediatric Symptom Checklist for Youths (PSCY). The self‐administered questionnaire was completed and identified adolescents were then assessed by the Child and Adolescent Mental Health Services (CAMHS). Out of 247 pupils, 84 per cent of the adolescents completed the questionnaire.

Findings

From the screening tool, 25 per cent were identified for assessment. During their assessment 64 per cent of the young people were given self‐help guides and health promotion advice. The remaining 26 per cent of the adolescents were provided treatment sessions by CAMHS or by Children's Service Worker. Only 10 per cent of these adolescents had been previously seen within the CAMHS.

Research limitations/implications

The PSCY is a useful tool for identifying and assessing adolescents with mental health problems. However, these results are the preliminary findings of a feasibility study. This subject area is a rich source for future research.

Practical implications

Findings from this project will influence wider mental health surveillance of our adolescent population.

Social implications

This approach will also influence future service provision, for such a vulnerable population.

Originality/value

No comparative studies of this nature were found in the United Kingdom.

Details

Mental Health Review Journal, vol. 18 no. 2
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 24 November 2023

Michelle Y. Martin Romero, Dorcas Mabiala Johnson, Esther Mununga and Gabriela Livas Stein

This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among…

Abstract

Purpose

This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population.

Design/methodology/approach

Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns.

Findings

Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors’ findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way.

Research limitations/implications

Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors’ findings are not reflective of new immigrants’ experiences. Parents’ perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo’s (DRC’s) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth’s perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors’ findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors’ study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community.

Practical implications

The authors’ findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures.

Originality/value

This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC.

Details

International Journal of Migration, Health and Social Care, vol. 20 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 11 July 2016

Renee Denham, Tara Renae McGee, Li Eriksson, John McGrath, Rosana Norman, Michael Sawyer and James Scott

Whilst overt bullying has received considerable attention for its negative impact on the emotional well-being of children and adolescents, peer problems such as excessive teasing…

Abstract

Purpose

Whilst overt bullying has received considerable attention for its negative impact on the emotional well-being of children and adolescents, peer problems such as excessive teasing and social exclusion have received less consideration. The purpose of this paper is to examine the prevalence, demographic, and clinical correlates of frequent peer problems in children and adolescents who participated in the Australian National Survey of Mental Health and Well-Being.

Design/methodology/approach

Participants were a nationally representative sample of 2,107 children (aged 6-12 years), and 1,490 adolescents (aged 13-17 years). Frequent peer problems (excessive teasing or social exclusion) were measured by parental report for children, and self and parental report for adolescents. Associations with a number of mental health problems were examined, including being in the clinical range for internalising and externalising symptoms, having major depressive disorder, attention deficit hyperactivity disorder or conduct disorder, low self-esteem, experiencing suicidal ideation and behaviour, or using marijuana and alcohol.

Findings

One in 30 children and one in 20 adolescents experienced frequent peer problems. Parents less commonly identified frequent peer problems than were self-reported by their adolescent children. Frequent peer problems were strongly associated with all mental health problems except alcohol and marijuana use.

Originality/value

Frequent peer problems are associated with a greatly increased risk of mental health problems. Identifying those children and adolescents with frequent peer problems provides opportunity for assessment and intervention of emotional and behavioural problems.

Details

Journal of Aggression, Conflict and Peace Research, vol. 8 no. 3
Type: Research Article
ISSN: 1759-6599

Keywords

Article
Publication date: 2 December 2010

Siu Chan and Ying Heidi

Despite the rich literature on the effects of parental mental health problems on child development, the needs of children of mentally ill parents have been overlooked in both…

Abstract

Despite the rich literature on the effects of parental mental health problems on child development, the needs of children of mentally ill parents have been overlooked in both research and services. This study investigated the needs of a neglected group, namely Chinese adolescent children of parents with schizophrenia, in order to gain insights into the design of programmes for these adolescents. In‐depth interviews were conducted individually with five Chinese adolescent girls whose mother or father was diagnosed with schizophrenia. Analysis of the interview data revealed four common themes: stigma and discrimination; mixed feelings of love and anger; the role of being a carer; and positive gains. The results shed light on the importance of taking cultural context into consideration when providing services for these children and further conducting research in this area. Although mental health problems are regarded as a taboo and associated with shame in Chinese culture, these children, out of a respect for their parents (‘filial piety’1), showed a strong sense of loyalty to their parents and suppressed their anger and sorrow for their parents' sake. Implications for social services for children whose parents have mental health problems and suggestions for future research are discussed.

Details

Journal of Children's Services, vol. 5 no. 4
Type: Research Article
ISSN: 1746-6660

Keywords

Article
Publication date: 11 December 2007

Barry Nixon

Workforce pressures are the key constraining factor in effective delivery of the CAMHS agenda (Kurtz et al, 2006). The continuing investment and expansion of Child and Adolescent…

Abstract

Workforce pressures are the key constraining factor in effective delivery of the CAMHS agenda (Kurtz et al, 2006). The continuing investment and expansion of Child and Adolescent Mental Health Services (CAMHS) has key implications for workforce planning, and improving outcomes for children and young people requires an adequately resourced, trained and motivated workforce. Every Child Matters: Change for children in health services and the National Service Framework for Children, Young People and Maternity Services establishes for the first time, clear standards for promoting the health and well‐being of children and young people, and for providing high quality services that meet their needs. This paper explores the key workforce issues facing child and adolescent mental health services as identified by child and adolescent practitioners. A number of key themes are identified along with the associated challenges.

Details

The Journal of Mental Health Training, Education and Practice, vol. 2 no. 4
Type: Research Article
ISSN: 1755-6228

Keywords

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