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Fletcher J, Martino D, MacMaster F, Wilcox G, Pringsheim T. The Tourette OCD Alberta Network: Development of a Continuing Professional Development Program for Community Based Mental Health Therapists. Child Psychiatry Hum Dev 2024; 55:1423-1430. [PMID: 36759397 DOI: 10.1007/s10578-023-01503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/11/2023]
Abstract
The Tourette OCD Alberta Network (TOAN) supports mental health therapists to improve the delivery of care to patients with Tourette syndrome (TS) and OCD in Alberta. We evaluated the professional development needs of health care workers to develop a continuing professional development (CPD) webinar series. Health care workers demonstrated an urgent need to access a CPD program grounded in evidenced based knowledge about TS and OCD. While 80% of health care workers treated children with TS and OCD, 50% had no formal training. A curriculum consisting of a series of twelve live, online webinars was developed and delivered between September 2020 and June 2021, covering a range of clinical topics. The webinars were attended on average by 63 attendees, with the outcome of a positive knowledge gain. In future, the educational program will need to reflect the ongoing developing clinical understanding of TS and OCD.
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Affiliation(s)
- Julian Fletcher
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Frank MacMaster
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Gabrielle Wilcox
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, AB, Canada.
- Mathison Centre for Mental Health Education and Research, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
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Tay J, Widger K, Steele R, Stremler R, Pole JD. Examining emotional and behavioural trajectories in siblings of children with life-limiting conditions. BMC Palliat Care 2024; 23:205. [PMID: 39129022 PMCID: PMC11318302 DOI: 10.1186/s12904-024-01535-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Healthy siblings of children with life-limiting conditions often experience emotional and behavioural struggles over the course of the ill child's condition(s). Resources to support these siblings are limited due to a lack of understanding about their needs. Therefore, this study was designed to characterize the emotional and behavioural trajectories among siblings of children with progressive, life-limiting genetic, metabolic, or neurological conditions over a 12-month observation period. METHODS Seventy siblings were recruited from a large-survey based study (Charting the Territory) that examined the bio-psychosocial health outcomes of parents and siblings. Linear mixed effect models were used to assess the association between siblings' emotions and behaviour trajectories and selected demographic variables. Siblings' emotions and behaviour were measured with Child Behaviour Checklist (CBCL). RESULTS Siblings' mean age was 11.2 years at baseline and Internalizing, Externalizing, and Total Behaviour Problems mean scores were within normal ranges across time. However, 7-25% of siblings had scores within the clinical range. Brothers had higher levels of Internalizing Problems than sisters, whereas sisters had higher levels of Externalizing Problems than brothers. When treatment was first sought for the ill child less than a year prior to study participation, siblings had higher levels of Internalizing and Externalizing Problems compared with siblings who participated more than one year after treatment was sought. CONCLUSION Healthy siblings experience emotional and behavioural problems early in the child's disease trajectory. Although these problems improve with time, our findings show that brothers and sisters experience different types of challenges. Therefore, timely support for siblings is important as they navigate through the uncertainties and challenges.
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Affiliation(s)
- Joanne Tay
- Faculty of Nursing, University of Windsor, Room 317, Toldo Health Education Centre, 401 Sunset Avenue, Windsor, ON, N9B 3P4, Canada.
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
| | - Kimberley Widger
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, Canada
- Life Stage Program, ICES, Toronto, Canada
| | - Rose Steele
- School of Nursing, York University, Toronto, Canada
| | - Robyn Stremler
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
| | - Jason D Pole
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Cancer Research Program, ICES, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Džakula A, Lukačević Lovrenčić I. Children as complex patients. Croat Med J 2024; 65:70-72. [PMID: 38433516 PMCID: PMC10915768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Affiliation(s)
| | - Iva Lukačević Lovrenčić
- Iva Lukačević Lovrenčić, Department of Social Medicine and Organization of Health Care, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia,
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Calear AL, Batterham PJ, McCallum SM, Banfield M, Moore E, Johnson N, Morse AR. Designing a Web-Based Navigation Tool to Support Access to Youth Mental Health Services: Qualitative Study. JMIR Form Res 2024; 8:e48945. [PMID: 38236625 PMCID: PMC10835581 DOI: 10.2196/48945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Many young people with mental health problems do not readily seek help or receive treatment and support. One way to address low help-seeking behavior is to improve access to information on mental health services and how to navigate the mental health system via a web-based tool. Seeking input from the end users (young people and parents or caregivers) on key features of the tool is imperative to ensure that it is relevant, engaging, and likely to meet their needs and expectations. OBJECTIVE This study aims to investigate young person and parent or caregiver views on the design, content, functioning, and user experience of a web-based mental health navigation tool to support connection to mental health services for children and young people aged up to 25 years. METHODS A total of 4 online focus groups were conducted: 2 with young people aged 16 years and older (total n=15) and 2 with parents or caregivers (total n=13). Focus groups were structured around a series of guiding questions to explore participants' views on content, features, user experience, and design of a mental health navigation website. Focus groups were audio recorded with detailed notes taken. In addition, 53 young people aged 16-25 years and 97 parents or caregivers completed an online survey, comprising closed- and open-ended questions; open-ended responses were included with the focus group data in the qualitative analysis. All qualitative data were analyzed using thematic analysis. RESULTS A total of 2 topic areas and 7 themes were developed. The first topic area covered the types of information needs of young people and parents. Identified themes concerned the scope of the navigation website, as well as the provision of up-to-date and practical information on how to navigate the whole help-seeking process. The second topic area covered website features that would be beneficial and included the consideration of the website design; search engines; supported navigation; and forums, reviews, and user accounts. CONCLUSIONS This study provides important insights into the navigation needs of young people and parents or caregivers in seeking mental health services. Key findings identified through this research have directly informed the development of MindMap, a web-based youth navigation tool providing a searchable database of local services, including a clear description, their location, and potential wait times. The website can be navigated independently or with support.
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Affiliation(s)
- Alison L Calear
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Sonia M McCallum
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
- ALIVE National Centre for Mental Health Research Translation, Melbourne, Australia
| | - Elizabeth Moore
- Office for Mental Health and Wellbeing, ACT Health, Canberra, Australia
| | - Natalie Johnson
- Office for Mental Health and Wellbeing, ACT Health, Canberra, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
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Townsend ML, Matthews EL, Miller CE, Grenyer BF. Adolescent self-harm: Parents' experiences of supporting their child and help-seeking. J Child Health Care 2023; 27:516-530. [PMID: 35313747 DOI: 10.1177/13674935211062334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Self-harm in children and adolescents is a growing public health issue. Parents are forefront in identifying, responding to and supporting their child to seek help. A sequential mixed-method study which included an online survey (N = 37) and a semi-structured interview (n = 10) was conducted to understand parents' experiences of supporting and accessing help for their child. Parents (M = 45.70 years, SD = 6.18) with a child who has engaged in self-harm behaviours (M = 16.89 years, SD = 3.91) participated. Parents sought help from a range of services and perceived psychiatrists, private psychologists and friends as the most helpful and school psychologists, paediatricians, Emergency Department (ED) and the national youth mental health organisation as the least helpful. Two themes were interpreted from the qualitative data: (1) An emotional journey into the dark unknown, and (2) The promise of psychological help. A series of recommendations for other parents in similar situations, as well as health professionals were made. Parents want health professionals to provide appropriate referrals, work collaboratively with families, meaningfully connect with and validate parents, provide practical and psychological support for families and establish parent support groups. There remains a need for widely available evidence-informed resources, information and support for parents.
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Affiliation(s)
- Michelle L Townsend
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Emily L Matthews
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Caitlin E Miller
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Brin Fs Grenyer
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
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Neufeld A, Rahman A, Orakwue-Ononye N. Community physician perceptions of managing complex child and adolescent psychiatric patients: a self-determination theory perspective. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2023; 32:264-271. [PMID: 38034410 PMCID: PMC10686220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 03/20/2023] [Indexed: 12/02/2023]
Abstract
Children and adolescents with complex mental health needs often require a level of care that is unsustainable in tertiary settings. Yet, the psychological impact of this on community physicians, who are tasked with providing quality care to this population, is not well understood. Grounded in Self-Determination Theory (SDT), the present study explores how the challenges of caring for these patients is affecting community physicians' basic psychological needs (autonomy, competence, and relatedness) and intrinsic motivation. Participants from Calgary, Alberta, Canada, were invited to complete an anonymous online survey containing questions about managing complex child and adolescent psychiatric patients. We used SDT's needs-based framework and 22-item Intrinsic Motivation Inventory as a component of our pilot study, to explore and understand their ideas. Community physicians reported moderate-high interest/enjoyment and moderate perceived competence in managing complex child and adolescent patients, but little perceived choice and high tension/pressure in carrying out this task. Physician remarks provided meaningful insights into how these clinical experiences are impacting them, psychologically, and where opportunities may exist for interventions to support them and their patients. Findings from this study suggest that the participating community physicians feel interested and adequately skilled to manage complex child and adolescent psychiatric patients, but that systemic barriers are hindering their basic psychological needs and intrinsic motivation to do so. Potential explanations and implications for these findings are discussed.
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Affiliation(s)
- Adam Neufeld
- Department of Academic Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Abdul Rahman
- Department of Child and Adolescent Psychiatry, University of Calgary, Calgary, Alberta
| | - Nneka Orakwue-Ononye
- Department of Child and Adolescent Psychiatry, University of Calgary, Calgary, Alberta
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Enelamah NV, Lombe M, Yu M, Villodas ML, Foell A, Newransky C, Smith LC, Nebbitt V. Structural and Intermediary Social Determinants of Health and the Emotional and Behavioral Health of US Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1100. [PMID: 37508597 PMCID: PMC10377858 DOI: 10.3390/children10071100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 07/30/2023]
Abstract
Children grow up in homes where varying environmental and socioeconomic contexts have a bearing on their emotional and behavioral health (EBH). This study used data from a representative sample of the child supplement of the US National Health Information Survey (NHIS) and applied the social determinants of health (SDoH) framework to explore factors associated with child EBH. We conducted a path analysis of the child's EBH measured by the strengths and difficulties questionnaire (SDQ) from their macro and socioeconomic contexts, e.g., policy, household, and other health system risk factors. For children in the sample, aged 4 to 17 years old (n = 9205), most path relationships to child SDQ scores were statistically significant. The total effects from a child's visit to a mental health specialist (0.28) and child's age (0.22) had the highest coefficients to child SDQ scores. A modified model showed a better fit with X2 (4) = 22.124, RMSEA = 0.021, and 90% CI [0.013-0.03], CFI = 0.98. Findings indicate that child factors such as being older, the use of mental healthcare services, and family socioeconomic status were significantly associated with EBH, calling attention to the need for more responsive policy and behavioral health interventions that address household/familial and child-level factors, critical determinants of child wellbeing.
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Affiliation(s)
- Ngozi V Enelamah
- Department of Social Work, College of Health and Human Services, University of New Hampshire, Durham, NH 03824, USA
| | - Margaret Lombe
- School of Social Work, Boston University, Boston, MA 02215, USA
| | - Mansoo Yu
- School of Social Work, Department of Public Health, College of Health Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Melissa L Villodas
- Department of Social Work, College of Public Health, George Mason University, Fairfax, VA 22030, USA
| | - Andrew Foell
- Jane Addams College of Social Work, University of Illinois, Chicago, IL 60612, USA
| | | | - Lisa C Smith
- The Grace Abbott School of Social Work, University of Nebraska-Omaha, Omaha, NE 68198, USA
| | - Von Nebbitt
- The Grace Abbott School of Social Work, University of Nebraska-Omaha, Omaha, NE 68198, USA
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Lu SV, Leung BMY, Bruton AM, Millington E, Alexander E, Camden K, Hatsu I, Johnstone JM, Arnold LE. Parents' priorities and preferences for treatment of children with ADHD: Qualitative inquiry in the MADDY study. Child Care Health Dev 2022; 48:852-861. [PMID: 35244227 DOI: 10.1111/cch.12995] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parents' lived experiences of having a child with ADHD may shape their decision making regarding ADHD treatment options for their child. The aim of this study was to explore parents' experiences of living with a child with ADHD in the family and how their experiences influence their perspectives on treatment preferences and priorities. METHODS A phenomenological qualitative design was used. Semistructured interviews were conducted with parents of children with ADHD who were enrolled in a multisite randomized controlled trial. Interviews were transcribed verbatim, and transcripts at each site were double coded. Initial codes were derived directly from the text. Qualitative data were analysed with an inductive approach. RESULTS Twenty-three parents were interviewed: eight from Alberta, Canada; eight from Portland, Oregon, USA; and seven from Columbus, Ohio, USA. Among the parents, 69% were married, 86% completed college education and 52% reported household income over $80,000. Among the children, the mean age was 9.6 years (SD = 1.8 years), 78% were boys and 48% were never medicated for their ADHD. Two major themes emerged from the analysis. Theme 1 was 'impact of ADHD on families within and outside the home' with the following subthemes: 'reconfiguring the home life', 'trial-and-error of accommodations at school' and 'responding to social pressures to fit in'. Theme 2 was 'enabling appropriate and accessible treatments for families' with the following subthemes: 'finding the "right fit" with professionals and treatments' and 'factors influencing inequitable access to treatments'. CONCLUSIONS Parents described shared experiences and identified similar barriers, preferences and priorities for ADHD treatments regardless of demographic differences by site. Families desired access to family-centred, multimodal approaches to ADHD treatment. Further research is needed to identify the specific structural changes to healthcare, services and policies that will better support this approach.
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Affiliation(s)
- Stacy V Lu
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Brenda M Y Leung
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Alisha M Bruton
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Elizabeth Millington
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - E Alexander
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
| | - Kelsey Camden
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Irene Hatsu
- Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, Ohio, USA
| | - Jeanette M Johnstone
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
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