A public mental health approach to identifying children and young people with mental health difficulties: are school-based programmes feasible and acceptable?
PHE ePoster Library. Soneson E. Apr 9, 2019; 259601; 15566
Emma Soneson
Emma Soneson
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Abstract
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Abstract Background

One in eight children and young people (CYP) in the UK experiences a diagnosable mental disorder, yet many do not receive care. Low rates of identification contribute to this treatment gap. Schools have potential to help provide the public health response to mental health difficulties (MHD) in CYP through improving identification.

Methods:

Systematic review: We conducted a systematic review of the feasibility of school-based programmes to identify existing MHD, symptoms of MHD, and/or risk for MHD. Feasibility categories included 1) intervention fit, 2) cost and resource implications, 3) intervention complexity, flexibility, manualisation, and time concerns, and 4) adverse events. Parent survey: Parents from four UK primary schools completed a survey about school-wide MHD screening. The survey measured beliefs about early identification, harms/benefits of screening, and desirable programme components. FindingsSystematic review: We included twenty-one studies, which examined universal/targeted screening, teacher training, and curriculum-based models. No model was clearly most feasible. Programmes usually matched school priorities but varied in appropriateness for pupils. Time, cost, and resource requirements were significant barriers. We found no harms associated with school-based identification. Parent survey: Two hundred ninety parents (61%) returned surveys. Parents generally thought early identification was important (N=254; 98%) and that schools should promote pupils' emotional health (N=251; 97%). Most viewed screening as helpful (N=213; 82%), but some thought it might be harmful (N=34; 13%). Parents had concerns about inaccurate identification, stigma, and availability of care/support. There was no clear consensus on key programme components.

Discussion

Policy is increasingly recognising the role of schools in CYP's mental health. Although school-based identification programmes seem to be acceptable, there are key barriers and potential harms that must be addressed before scale-up. Education, health, and government sectors must work together to ensure CYP with MHD receive appropriate and timely support. Funding NIHR CLAHRC East of England
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