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Ball WP, Anderson C, Black C, Gordon S, Lackenby M, Murchie M, Ostrovska B, O'Sullivan K, Rowlands H, Rzewuska Díaz M, Butler JE. Mental health service use in children at risk of significant harm: A record linkage study of a child protection register. Soc Sci Med 2024; 353:117057. [PMID: 38905923 DOI: 10.1016/j.socscimed.2024.117057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/13/2024] [Accepted: 06/14/2024] [Indexed: 06/23/2024]
Abstract
Children with experience of maltreatment, abuse or neglect have higher prevalence of poor mental health. In the United Kingdom, child protection services identify children at risk of significant harm on the Child Protection Register (CPR) and intervene to reduce risk. Prevalence and incidence of mental health service use among this population of children are not well understood. We analysed records from one Scottish Local Authority's CPR, linked to electronic health records for all children in the broader health board region aged 0-17 years. We described mental health service use among children with a CPR registration using measures of mental health prescribing and referrals to child and adolescent mental health services (CAMHS). We calculated age- and sex-specific incidence rates for comparison with the general population. Between 2012 and 2022, we found 1498 children with a CPR registration, with 69% successfully linked to their health records. 20% were registered before birth and median age at registration was 3 years. Incidence rates in all measures of mental health service use were higher in children with a CPR record across all ages (at outcome) and genders compared to the general population. The largest absolute difference was for boys aged 5-9 with a CPR record, who had 31.8 additional mental health prescriptions per 1000 person-years compared to the general population (50.4 vs. 18.6 prescriptions per 1000 person-years, IRR: 2.7). Girls aged 0-4 years with a CPR registration had the largest relative difference, with a rate of CAMHS referral 5.4 times higher than the general population (12.3 vs. 2.3 per 1000 person-years). Our reproducible record linkage of the CPR to health records reveals an increased risk of mental health service use during childhood. Our findings have relevance to public mental health surveillance, service prioritisation and wider policy aiming to reduce childhood exposure to risk of harm.
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Affiliation(s)
| | | | - Corri Black
- University of Aberdeen, Aberdeen, Scotland, UK; NHS Grampian, Aberdeen, Scotland, UK
| | | | | | | | - Bārbala Ostrovska
- Aberdeen Centre for Health Data Science PPIE Group, Aberdeen, Scotland, UK
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2
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Green MJ, Watkeys OJ, Harris F, O'Hare K, Whitten T, Tzoumakis S, Laurens KR, Carpendale EJ, Dean K, Carr VJ. Cohort Profile Update: The New South Wales Child Development Study (NSW-CDS) - Wave 3 (child age ∼18 years). Int J Epidemiol 2024; 53:dyae069. [PMID: 38796754 DOI: 10.1093/ije/dyae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 05/02/2024] [Indexed: 05/28/2024] Open
Affiliation(s)
- Melissa J Green
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Oliver J Watkeys
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Felicity Harris
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Kirstie O'Hare
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Tyson Whitten
- Centre for Law and Justice, Charles Sturt University, Port Macquarie, NSW, Australia
| | - Stacy Tzoumakis
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Criminology and Criminal Justice, Griffith University, Southport, QLD, Australia
| | - Kristin R Laurens
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Emma J Carpendale
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Kimberlie Dean
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Justice Health and Forensic Mental Health Network, Sydney, NSW, Australia
| | - Vaughan J Carr
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Psychiatry, Monash University, Melbourne, VIC, Australia
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3
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Drever S, Foord R, Mendoza Diaz A, Eapen V, Jairam R. Outcomes for young people in out of home care accessing tiered mental health services in Sydney, Australia. Clin Child Psychol Psychiatry 2024; 29:116-126. [PMID: 37485848 DOI: 10.1177/13591045231191443] [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: 07/25/2023]
Abstract
Young people in OOHC have complex mental health concerns, therefore the South Western Sydney Local Health District (SWSLHD) has trialled a tiered model of mental health care. Under this model the OOHC mental health team (OOHC-MHT) provides specialist tier four service delivery for those with the most severe, intense mental health needs. OOHC consumers with a reduced level of severity access services at a tier three centre-based iCAMHS. This study aims to understand the characteristics of young people in OOHC accessing different service provision options in Sydney, Australia. Sixty-six OOHC consumers 8-17 years accessing mental health services across SWSLHD from January 2020-December 2021 participated in the study. Group differences in OOHC-MHT and iCAMHS outcome measures were compared. HoNOSCA scores were significantly worse for OOHC-MHT than iCAMHS, indicating more severe psychopathology for OOHC-MHT at baseline. In OOHC-MHT, HoNOSCA decreased significantly from admission to discharge and scores on the CGAS increased significantly, indicating significant improvements in psychopathology and functioning. In the iCAMHS group scores on the HoNOSCA significantly decreased indicating improved psychopathology over this period. These findings support a tiered model of service delivery for OOHC consumers, with this tailored level of care resulting in significantly improved outcomes across a range of complexity.
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Affiliation(s)
- Saskia Drever
- South Western Sydney Local Health District (SWSLHD), Australia
| | - Rachael Foord
- Western Sydney Local Health District (WSLHD), Australia
| | - Antonio Mendoza Diaz
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Australia
| | - Valsa Eapen
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Australia
| | - Rajeev Jairam
- South Western Sydney Local Health District (SWSLHD), Australia
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4
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O'Hare K, Watkeys O, Whitten T, Dean K, Laurens KR, Harris F, Carr VJ, Green MJ. Cumulative environmental risk in early life is associated with mental disorders in childhood. Psychol Med 2023; 53:4762-4771. [PMID: 35866367 DOI: 10.1017/s0033291722001702] [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: 11/05/2022]
Abstract
BACKGROUND No single environmental factor is a necessary or sufficient cause of mental disorder; multifactorial and transdiagnostic approaches are needed to understand the impact of the environment on the development of mental disorders across the life course. METHOD Using linked multi-agency administrative data for 71 932 children from the New South Wales Child Developmental Study, using logistic regression, we examined associations between 16 environmental risk factors in early life (prenatal period to <6 years of age) and later diagnoses of mental disorder recorded in health service data (from age 6 to 13 years), both individually and summed as an environmental risk score (ERS). RESULTS The ERS was associated with all types of mental disorder diagnoses in a dose-response fashion, such that 2.8% of children with no exposure to any of the environmental factors (ERS = 0), compared to 18.3% of children with an ERS of 8 or more indicating exposure to 8 or more environmental factors (ERS ⩾ 8), had been diagnosed with any type of mental disorder up to age 13-14 years. Thirteen of the 16 environmental factors measured (including prenatal factors, neighbourhood characteristics and more proximal experiences of trauma or neglect) were positively associated with at least one category of mental disorder. CONCLUSION Exposure to cumulative environmental risk factors in early life is associated with an increased likelihood of presenting to health services in childhood for any kind of mental disorder. In many instances, these factors are preventable or capable of mitigation by appropriate public policy settings.
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Affiliation(s)
- Kirstie O'Hare
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Oliver Watkeys
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Tyson Whitten
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia
| | - Kristin R Laurens
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Felicity Harris
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Vaughan J Carr
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
- Department of Psychiatry, Monash University, Melbourne, Australia
| | - Melissa J Green
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
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5
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O'Hare K, Watkeys O, Harris F, Dean K, Carr VJ, Green MJ. Self-harm and suicidal ideation in children and adolescents in contact with child protection services. Med J Aust 2023; 218:526-527. [PMID: 36970987 PMCID: PMC10952315 DOI: 10.5694/mja2.51898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 03/24/2024]
Affiliation(s)
| | | | | | - Kimberlie Dean
- The University of New South WalesSydneyNSW
- Justice Health and Forensic Mental Health NetworkSydneyNSW
| | - Vaughan J Carr
- The University of New South WalesSydneyNSW
- Neuroscience Research AustraliaSydneyNSW
- Monash UniversityMelbourneVIC
| | - Melissa J Green
- The University of New South WalesSydneyNSW
- Neuroscience Research AustraliaSydneyNSW
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McKenna S, O’Reilly D, Maguire A. The mental health of all children in contact with social services: a population-wide record-linkage study in Northern Ireland. Epidemiol Psychiatr Sci 2023; 32:e35. [PMID: 37190768 PMCID: PMC10227534 DOI: 10.1017/s2045796023000276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/17/2023] Open
Abstract
AIMS Children in contact with social services are at high risk for mental ill health, but it is not known what proportion of the child population has contact with social services or how risk varies within this group compared to unexposed peers. We aim to quantify the extent and nature of contact with social services within the child population in Northern Ireland (NI) and the association with mental ill health. We also examine which social care experiences identify those most at risk. METHODS This is a population-based record-linkage study of 497,269 children (aged under 18 years) alive and resident in NI in 2015 using routinely collected health and social care data. Exposure was categorized as (1) no contact, (2) referred but assessed as not in need (NIN), (3) child in need (CIN) and (4) child in care (CIC). Multilevel logistic regression analyses estimated odds ratios (ORs) for mental ill health indicated by receipt of psychotropic medication (antidepressants, anxiolytics, antipsychotics and hypnotics), psychiatric hospital admission and hospital-presenting self-harm or ideation. RESULTS Over one in six children (17.2%, n = 85,792) were currently or previously in contact with social services, and almost one child in every 20 (4.8%, n = 23,975) had contact in 2015. Likelihood of any mental ill health outcome increased incrementally with the level of contact with social services relative to unexposed peers: NIN (OR 5.90 [95% confidence interval (CI) 5.10-6.83]), CIN (OR 5.99 [95% CI 5.50-6.53]) and CIC (OR 12.60 [95% CI 10.63-14.95]). All tiers of contact, number of referrals, number of care episodes and placement type were strongly associated with the likelihood of mental ill health. CONCLUSION Children who have contact with social services account for a large and disproportionate amount of mental ill health in the child population. Likelihood of poor mental health across indicators is highest in care experienced children but also extends to the much larger population of children in contact with social services but never in care. Findings suggest a need for targeted mental health screening and enhanced support for all children in contact with social services.
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Affiliation(s)
- Sarah McKenna
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Queen’s University Belfast, Belfast, Northern Ireland
| | - Dermot O’Reilly
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Queen’s University Belfast, Belfast, Northern Ireland
| | - Aideen Maguire
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Queen’s University Belfast, Belfast, Northern Ireland
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7
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Segal L, Amos J. The serious health consequences of abuse and neglect in early life. BMJ 2023; 381:930. [PMID: 37137517 DOI: 10.1136/bmj.p930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Leonie Segal
- University of South Australia, Adelaide, Australia
| | - Jackie Amos
- University of South Australia, Adelaide, Australia
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8
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O'Hare K, Tzoumakis S, Watkeys O, Katz I, Laurens KR, Butler M, Harris F, Carr VJ, Green MJ. Out-of-home care characteristics associated with childhood educational underachievement, mental disorder, and police contacts in an Australian population sample. CHILD ABUSE & NEGLECT 2023; 139:106120. [PMID: 36863202 DOI: 10.1016/j.chiabu.2023.106120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/01/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Children in out-of-home care (OOHC) are generally at increased risk of health and social adversities compared to their peers. However, the experiences of children in OOHC are not uniform and their associated health and social indices may vary in relation to characteristics of OOHC placements and child protection contact. OBJECTIVE To examine associations between a range of characteristics of OOHC placements and child protection contact (e.g., number, type, and age of placement) with educational underachievement, mental disorder, and police contact (as a victim, witness, or person of interest) in childhood. PARTICIPANTS AND SETTING Participants were Australian children drawn from the New South Wales Child Development Study cohort who had been placed in OOHC at least once between the ages of 0-13 years (n = 2082). METHODS Logistic regression was used to examine prospective associations of OOHC placement and child protection contact characteristics (type of carer, placement instability, duration and frequency of maltreatment, and amount of time in care) with educational underachievement, mental disorder diagnosis and any type of police contact. RESULTS Placements with foster carers, greater placement instability, longer and more frequent exposure to maltreatment, and longer time spent in care were each associated with greater likelihood of consequences in all domains of functioning. CONCLUSIONS Children with certain placement characteristics are at higher risk of adverse consequences and should be prioritised for support services. The magnitude of relationships was not uniform across different health and social indices, highlighting the need for holistic, multiagency approaches to support children placed in care.
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Affiliation(s)
- Kirstie O'Hare
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Stacy Tzoumakis
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia; School of Criminology and Criminal Justice, Griffith University, Southport, Australia
| | - Oliver Watkeys
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ilan Katz
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Kristin R Laurens
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia; Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, Australia
| | - Merran Butler
- New South Wales Department of Communities and Justice, Australia
| | - Felicity Harris
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Vaughan J Carr
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Department of Psychiatry, Monash University, Melbourne, Australia
| | - Melissa J Green
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia.
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9
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O’Hare K, Watkeys O, Whitten T, Dean K, Laurens KR, Tzoumakis S, Harris F, Carr VJ, Green MJ. Cumulative Environmental Risk in Early Life: Associations With Schizotypy in Childhood. Schizophr Bull 2023; 49:244-254. [PMID: 36302227 PMCID: PMC10016419 DOI: 10.1093/schbul/sbac160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND HYPOTHESIS Psychotic disorders are associated with a growing number of recognized environmental exposures. Cumulative exposure to multiple environmental risk factors in childhood may contribute to the development of different patterns of schizotypy evident in early life. Hypotheses were that distinct profiles of schizotypy would have differential associations with a cumulative score of environmental risk factors. STUDY DESIGN We prospectively examined the relationship between 19 environmental exposures (which had demonstrated replicated associations with psychosis) measured from the prenatal period through to age 11 years, and 3 profiles of schizotypy in children (mean age = 11.9 years, n = 20 599) that have been established in population data from the New South Wales-Child Development Study. Multinomial logistic regression was used to examine associations between membership in each of 3 schizotypy profiles (true schizotypy, introverted schizotypy, and affective schizotypy) and exposure to a range of 19 environmental risk factors for psychosis (both individually and summed as a cumulative environmental risk score [ERS]), relative to children showing no risk. RESULTS Almost all environmental factors were associated with at least 1 schizotypy profile. The cumulative ERS was most strongly associated with the true schizotypy profile (OR = 1.61, 95% CI = 1.52-1.70), followed by the affective (OR = 1.33, 95% CI = 1.28-1.38), and introverted (OR = 1.32, 95% CI = 1.28-1.37) schizotypy profiles. CONCLUSIONS Consistent with the cumulative risk hypothesis, results indicate that an increased number of risk exposures is associated with an increased likelihood of membership in the 3 schizotypy profiles identified in middle childhood, relative to children with no schizotypy profile.
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Affiliation(s)
- Kirstie O’Hare
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Oliver Watkeys
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Tyson Whitten
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- School of Social Sciences, University of Adelaide, South Australia, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia
| | - Kristin R Laurens
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, Australia
| | - Stacy Tzoumakis
- School of Criminology and Criminal Justice, Griffith University, Southport, Australia
- Griffith Criminology Institute, Griffith University, Southport, Australia
| | - Felicity Harris
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Vaughan J Carr
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
- Department of Psychiatry, Monash University, Melbourne, Australia
| | - Melissa J Green
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
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10
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O'Hare K, Hussain A, Laurens KR, Hindmarsh G, Carr VJ, Tzoumakis S, Harris F, Green MJ. Self-reported mental health of children known to child protection services: an Australian population-based record linkage study. Eur Child Adolesc Psychiatry 2023; 32:101-112. [PMID: 34247296 DOI: 10.1007/s00787-021-01841-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
Maltreated children are vulnerable to adverse mental health outcomes. Information about how children's mental health needs vary according to different levels of child protection contact (potentially culminating in out-of-home care [OOHC]) is valuable for the effective provision of services. This study aimed to examine associations between different levels of contact with child protection services before the age of 10 years and self-reported mental health difficulties at age 11 years. Participants (n = 26,960) were drawn from the New South Wales Child Development Study, a multiagency, multigenerational, longitudinal record linkage study that combines administrative records with cross-sectional survey data. We examined associations between four levels of child protection response (non-threshold reports, unsubstantiated reports, substantiated reports, OOHC; each relative to no report) and six domains of self-reported mental health difficulties (including internalising and externalising symptoms, and psychotic-like experiences). All levels of contact with child protection services were associated with increased odds of mental health difficulties in all domains. Children who had been placed in OOHC and children with substantiated reports had the highest odds of reporting clinical levels of mental health difficulties; 48.1% of children with an OOHC placement and 45.6% of those with substantiated child protection reports showed clinical levels of mental health difficulties in at least one domain. Children with child protection reports that were unsubstantiated, or determined not to meet the threshold for risk-of-significant harm, were also at increased risk of mental health difficulties in middle childhood. These findings underscore the importance of early detection and intervention for all children at risk of maltreatment.
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Affiliation(s)
- Kirstie O'Hare
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Aniqa Hussain
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Kristin R Laurens
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.,School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Gabrielle Hindmarsh
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.,Neuroscience Research Australia, Sydney, Australia.,Department of Psychiatry, Monash University, Melbourne, Australia
| | - Stacy Tzoumakis
- School of Criminology and Criminal Justice, Griffith University, Southport, Australia
| | - Felicity Harris
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia. .,Neuroscience Research Australia, Sydney, Australia.
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11
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Drever S, Tarren-Sweeney M, Nunn K, Jairam R. Helping Young People in Out-of-Home Care: Basic Elements. J Am Acad Child Adolesc Psychiatry 2023; 62:8-11. [PMID: 35944755 DOI: 10.1016/j.jaac.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/27/2022] [Accepted: 07/27/2022] [Indexed: 01/03/2023]
Abstract
Children and adolescents (young people) who experience maltreatment early in life and are subsequently placed in out-of-home care (OOHC) are specifically at risk for poor mental health outcomes.1 Although rates vary by survey and location, up to half of these young people have clinical-level mental health difficulties, and another 20% to 25% have difficulties approaching clinical significance.2 These difficulties are characterized by high symptom complexity and severity, and include maltreatment-related mental health symptoms.2 Many young people in OOHC are difficult to engage with and retain in treatment, compounded by a lack of specialized mental health services3 and a history of problematic social interactions with supports.4 They are often reluctant to seek help because of stigmatization and confidentiality concerns, limited opportunities for decision making, service inaccessibility, distrust of mental health services, and their perception that professionals do not understand their circumstances.5 We propose 6 clinical practice modifications for mental health services working with young people in OOHC to enhance therapeutic engagement and to maximize their therapeutic outcomes.
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Affiliation(s)
- Saskia Drever
- South Western Sydney Local Health District (SWSLHD) NSW Health, Australia.
| | | | - Kenneth Nunn
- South Western Sydney Local Health District (SWSLHD) NSW Health, Australia; Children's Hospital Westmead, Sydney Children's Hospital Network, NSW Health, Australia; University of Sydney (Westmead Campus), NSW, Australia
| | - Rajeev Jairam
- South Western Sydney Local Health District (SWSLHD) NSW Health, Australia; University of New South Wales, NSW, Australia; Western Sydney University, NSW, Australia
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12
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Watkeys OJ, O'Hare K, Dean K, Laurens KR, Harris F, Carr VJ, Green MJ. Early childhood developmental vulnerability associated with parental mental disorder comorbidity. Aust N Z J Psychiatry 2022:48674221116806. [PMID: 35999694 DOI: 10.1177/00048674221116806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Parental mental health has a profound influence on the mental health and well-being of their offspring. With comorbid mental disorders generally the rule rather than the exception, increased knowledge of the impact of parental mental disorder comorbidity on early child development may facilitate improved targeting and delivery of early intervention for vulnerable offspring. METHODS Participants were 66,154 children and their parents in the New South Wales Child Development Study - a prospective, longitudinal, record-linkage study of a population cohort of children born in NSW between 2002 and 2004. Early childhood developmental vulnerability was assessed at age ~5 years using the Australian Early Development Census, and information on parental mental disorders was obtained from administrative health records. Binomial and multinomial logistic regression were used to assess the relationship between parental mental disorders and early childhood developmental vulnerability on emotional and behavioural domains, as well as membership of latent developmental risk classes reflecting particular classes of vulnerability. RESULTS Multiple diagnoses of mental disorders in mothers and fathers were associated with an increased likelihood of early childhood emotional and behavioural developmental vulnerability in offspring, relative to parents without mental disorder. The likelihood of offspring vulnerability increased with the number of parental comorbidities, particularly maternal comorbidities. CONCLUSION Early childhood developmental vulnerability was strongly associated with parental mental ill-health, with the strength of associations increasing in line with a greater number of mental disorder diagnoses among mothers and fathers. New and expectant parents diagnosed with multiple mental disorders should be prioritised for intervention, including attention to the developmental well-being of their offspring.
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Affiliation(s)
- Oliver J Watkeys
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - Kirstie O'Hare
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales, Sydney, NSW, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales, Sydney, NSW, Australia.,Justice Health & Forensic Mental Network, Matraville, NSW, Australia
| | - Kristin R Laurens
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales, Sydney, NSW, Australia.,School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Felicity Harris
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales, Sydney, NSW, Australia
| | - Vaughan J Carr
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia.,Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Melissa J Green
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
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13
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O'Hare K, Watkeys O, Whitten T, Dean K, Laurens KR, Harris F, Carr VJ, Green MJ. Parental and community risk factors for childhood self-harm thoughts and behaviours. J Affect Disord 2022; 310:279-283. [PMID: 35569604 DOI: 10.1016/j.jad.2022.05.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 04/25/2022] [Accepted: 05/08/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Childhood self-harm is rare but increasing in frequency. Little is known about risk factors specifically for self-harm in preteen children. METHODS We examined self-harm thoughts and behaviours in children aged 3-14 years in association with parental and community-level risk factors, using a large general population-based record linkage sample (n = 74,479). RESULTS Parental factors were strongly associated with childhood self-harm, with over three-quarters of children with self-harm having a parent with a history of mental disorder and/or criminal offending. Community-level factors (socioeconomic deprivation, remote or regional location, and neighbourhood crime rate) were not associated with childhood self-harm after adjustment for confounding factors. LIMITATIONS Measures of self-harm thoughts and behaviours derived from administrative data likely underestimate the prevalence of self-harm in the population. CONCLUSIONS Intergenerational transmission of risk factors is likely an important contributor to childhood self-harm.
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Affiliation(s)
- Kirstie O'Hare
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Oliver Watkeys
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Tyson Whitten
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; School of Social Sciences, University of Adelaide, South Australia, Australia
| | - Kimberlie Dean
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia
| | - Kristin R Laurens
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, Australia
| | - Felicity Harris
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Vaughan J Carr
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Department of Psychiatry, Monash University, Melbourne, Australia
| | - Melissa J Green
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia.
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14
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Papalia N, Baidawi S, Luebbers S, Shepherd S, Ogloff JRP. Patterns of Maltreatment Co-Occurrence in Incarcerated Youth in Australia. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4341-NP4371. [PMID: 32946303 DOI: 10.1177/0886260520958639] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Child maltreatment research is increasingly recognizing the need to capture patterns of co-occurrence between different types of abuse/neglect and to consider their associations with psychosocial functioning. Few studies have examined these issues in justice-involved youth despite the fact that rates of maltreatment and trauma-related psychopathology are disproportionately high among this population. This study examined profiles of self-reported child physical abuse, sexual abuse, emotional abuse, and neglect among incarcerated juveniles in Victoria, Australia, using latent class analysis. We also investigated associations between maltreatment profiles and mental health and behavioral problems. Data pertaining to juveniles' experiences of maltreatment and mental health and behavioral functioning were collected from interviews, questionnaires, files, and administrative datasets. A three-class solution provided the best fit for the data and was conceptually meaningful: a "low/rare maltreatment" class (41%); "high physical and emotional abuse" class (23%); and a "poly-victimization" class (36%). Youth in the "poly-victimization" class experienced especially serious mental health and behavioral disturbances, including higher rates of mental illness, greater severity of internalizing and externalizing symptoms, impulsivity, substance abuse, self-harm and suicidal behavior, irritability, and early-onset violence. Results suggest there may be benefit in considering screening and assessment procedures in youth justice settings to identify poly-victimized youth in need of more intensive monitoring and treatment to address their complex clinical and behavioral profiles.
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Affiliation(s)
- Nina Papalia
- Centre for Forensic Behavioural Science, Swinburne University of Technology and the Victorian Institute of Forensic Mental Health (Forensicare), Victoria, Australia
| | | | - Stefan Luebbers
- Centre for Forensic Behavioural Science, Swinburne University of Technology and the Victorian Institute of Forensic Mental Health (Forensicare), Victoria, Australia
| | - Stephane Shepherd
- Centre for Forensic Behavioural Science, Swinburne University of Technology and the Victorian Institute of Forensic Mental Health (Forensicare), Victoria, Australia
| | - James R P Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology and the Victorian Institute of Forensic Mental Health (Forensicare), Victoria, Australia
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15
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Green MJ, Watkeys OJ, Kariuki M, Hindmarsh G, Whitten T, Dean K, Laurens KR, Harris F, Carr VJ. Forecasting childhood adversities from conditions of birth. Paediatr Perinat Epidemiol 2022; 36:230-242. [PMID: 35107846 DOI: 10.1111/ppe.12828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Childbirth presents an optimal time for identifying high-risk families to commence intervention that could avert various childhood health and social adversities. OBJECTIVE We sought to establish the minimum set of exposures required to accurately predict a range of adverse childhood outcomes up to the age of 13 years, from a set of 14 individual and familial risk exposures evident at the time of birth. METHODS Participants were 72,059 Australian children and their parents drawn from a multi-register population cohort study (data spanning 1994-2018). Risk exposures included male sex, young mother (aged ≤21 years), no (or late first; >16 weeks) antenatal visit, maternal smoking during pregnancy, small for gestational age, preterm birth, pregnancy complications (any of hypertension, diabetes mellitus, gestational diabetes or pre-eclampsia), >2 previous pregnancies of ≥20 weeks, socio-economic disadvantage, prenatal child protection notification, and maternal or paternal mental disorder or criminal offending history. Individual outcomes included early childhood developmental vulnerability (age 5 years), sustained educational underachievement (age 8 and 10 years), mental disorder diagnoses, substantiated childhood maltreatment, and contact with the police as a victim or person-of-interest up to age 13-14 years. RESULTS Risk exposures at birth predicted individual childhood outcomes with fair to excellent accuracy: the area under the receiver operating characteristic curves ranged between 0.60 (95% CI 0.58, 0.62) for childhood mental disorder and 0.83 (95% CI 0.82, 0.85) for substantiated child maltreatment. The presence of five or more exposures characterised 12-25% of children with one or more adverse outcomes and showed high predictive certainty for models predicting multiple outcomes, which were apparent in 9% of the population. CONCLUSIONS Up to a quarter of the neonatal population at risk of multiple adverse outcomes can be detected at birth, with implications for population health screening. However, cautious implementation of these models is warranted, given their relatively low positive predictive values.
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Affiliation(s)
- Melissa J Green
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Oliver J Watkeys
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Maina Kariuki
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Gabrielle Hindmarsh
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Tyson Whitten
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Kimberlie Dean
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Justice Health & Forensic Mental Network, Matraville, New South Wales, Australia
| | - Kristin R Laurens
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Felicity Harris
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Sydney, New South Wales, Australia.,Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
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16
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Hickey L, Galvin K, Parolini A, Nguyen B, Lokmic-Tomkins Z, Toovey R, Skeat J, Wise S. The engagement of children in out-of-home care with nursing and allied health professionals: A scoping review. Child Care Health Dev 2021; 47:758-770. [PMID: 34250634 DOI: 10.1111/cch.12893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 02/04/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children living in out-of-home care (OOHC) have significant unmet health care needs and use more tertiary and specialist health care services compared with children from similar social and economic backgrounds. Allied health professionals and nurses have a central role in health care; however, very little is known about the engagement of children in OOHC with nursing and allied health professionals. This scoping review addresses this knowledge gap. METHODS A scoping review methodology framework was used to search for relevant articles published between January 1970 and November 2019, identified using three databases: MEDLINE, CINAHL and ProQuest. Selection of studies was based on empirical research about the health of children in OOHC and their engagement with nursing or allied health services. A total of 37 relevant articles met the eligibility criteria for inclusion in this review. RESULTS Findings could be summarized under five broad themes: (1) nursing and allied health professionals engaging with children in OOHC to support their health and development, (2) opportunities and challenges for nursing and allied health professionals to engage children in OOHC in healthcare, (3) identification and complexity of healthcare needs, (4) access to healthcare services and (5) coordination of healthcare. CONCLUSIONS Children in OOHC have multiple healthcare needs that require monitoring and treatment by allied health professionals and the health and development of these children is best supported through comprehensive health screening on entry into OOHC, and community-based, multidisciplinary healthcare while children are living in OOHC. While nurses in hospitals and community settings were found to play a role in health assessment and care coordination targeted at children in OOHC, the literature was silent on the role of allied health professionals in this healthcare approach.
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Affiliation(s)
- Lyndal Hickey
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
| | - Karyn Galvin
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Arno Parolini
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
| | - Bao Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Rachel Toovey
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.,Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jemma Skeat
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Wise
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
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17
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Neil AL, Chappell K, Wagg F, Miller A, Judd F. The Tasmanian Conception to Community (C2C) Study Database 2008-09 to 2013-14: Using linked health administrative data to address each piece in the puzzle. Soc Sci Med 2021; 284:114216. [PMID: 34274707 DOI: 10.1016/j.socscimed.2021.114216] [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: 05/06/2020] [Revised: 05/31/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Tasmania, Australia has a small widely dispersed regional and rural population. The Conception to Community (C2C) Study Database was established as a research platform to inform service planning and policy development and improve health outcomes for Tasmanian mothers and children. The aims of this study were to establish by maternal socio-demographic characteristics: 1) the distribution of births in Tasmania; 2) hospital utilisation for children from birth to 5-years; and 3) the association between child and maternal emergency department (ED) presentation rates. METHODS Perinatal and public hospital ED and admitted patient data were linked for every child born in Tasmania between 2008-09 to 2013-14, and their mothers. Individualised rates of ED presentations and hospital admissions were calculated from birth to 5-years. Frequent presenters to ED were defined as having at least four presentations per annum. Ratios of ED presentation and hospital admission rates by sociodemographic characteristics (region (north, north-west, south), rurality, maternal age, and area socioeconomic disadvantage) were estimated using mixed-effects negative binomial models, with random intercepts for each child and family. RESULTS The C2C Database is comprised of records for 37,041 children and 27,532 mothers. One-in-ten Tasmanian babies lived in a remote area. The mean yearly rate of ED presentations per child varied by sex, age, region and rurality. Frequent presenters were more likely to reside in the north-west or north, in urban areas, have mothers under 20- years, be male, and live in more disadvantaged areas, with 2.3% of children frequent presenters in their first year of life. The odds of a child being a frequent presenter during their first-year was 6.1- times higher if the mother was a frequent presenter during this period. CONCLUSION Associations between maternal and child health service use and combined effects of regionality and rurality highlight opportunities for targeted intervention and service innovations.
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Affiliation(s)
- Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Australia.
| | - Kate Chappell
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Fiona Wagg
- Child and Adolescent Mental Health Services South, Tasmanian Health Service, Hobart, Australia
| | - April Miller
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Fiona Judd
- Menzies Institute for Medical Research, University of Tasmania, Australia; Perinatal and Infant Mental Health Team, CAMHS South, Tasmanian Health Service, Hobart, Australia
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18
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Say DF, Carison A, Hill A, Hiscock H, Babl FE, O'Donnell SM. Mental health presentations to the paediatric emergency department: A retrospective study. J Paediatr Child Health 2021; 57:684-695. [PMID: 33404176 DOI: 10.1111/jpc.15313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/27/2020] [Accepted: 11/30/2020] [Indexed: 02/05/2023]
Abstract
AIM To describe a cohort of patients aged 7-17 years presenting with mental health (MH) problems to an Australian tertiary paediatric emergency department (ED), in order to identify: (i) predictors of admission; and (ii) prolonged length of stay (LOS); (iii) reasons for ED presentation based on diagnosis and (iv) differences between major diagnostic groups. METHODS Data for all presentations from 1 January 2018 to 31 December 2018 were extracted and analysed from the hospital's electronic medical record system. MH presentations were identified though rule-based coding and manual file review. RESULTS In this 12-month period, 1071 children had 1690 emergency MH presentations constituting 6.7% of all ED presentations for children aged 7-17 years. Collectively, the leading cause for presentations was suicidal ideation, self-harm or drug overdose (55%). Compared to discharged patients, admitted patients were more likely to be female (odds ratio (OR) 1.82, confidence interval (CI) 1.41-2.35), aged over 14-years (OR 2.50, CI 1.98-3.15), triaged with high acuity (OR 2.70, CI 2.00-3.65) and arrive by ambulance or police (OR 1.31, CI 1.04-1.64). The highest risk diagnosis associated with admission was eating disorders (OR 9.19, CI 5.48-15.40). Patients with a prolonged LOS (>8 h) were more likely to need admission (OR 5.38, CI 3.81-7.61) and be diagnosed with drug overdose (OR 2.39, CI 1.51-3.80) or acute behavioural disturbance (OR 1.61, CI 1.09-2.39). CONCLUSION Mental health presentations constitute a large proportion of ED presentations. Suicidal behaviour and self-harm account for half of them. We have identified patients at increased risk of admission and prolonged ED LOS.
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Affiliation(s)
- Daniela F Say
- Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Anna Carison
- Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Ashley Hill
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Harriet Hiscock
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics and Centre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Franz E Babl
- Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics and Centre for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Sinead M O'Donnell
- Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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19
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Chikwava F, Cordier R, Ferrante A, O’Donnell M, Speyer R, Parsons L. Research using population-based administration data integrated with longitudinal data in child protection settings: A systematic review. PLoS One 2021; 16:e0249088. [PMID: 33760881 PMCID: PMC7990188 DOI: 10.1371/journal.pone.0249088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 03/11/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Over the past decade there has been a marked growth in the use of linked population administrative data for child protection research. This is the first systematic review of studies to report on research design and statistical methods used where population-based administrative data is integrated with longitudinal data in child protection settings. METHODS The systematic review was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. The electronic databases Medline (Ovid), PsycINFO, Embase, ERIC, and CINAHL were systematically searched in November 2019 to identify all the relevant studies. The protocol for this review was registered and published with Open Science Framework (Registration DOI: 10.17605/OSF.IO/96PX8). RESULTS The review identified 30 studies reporting on child maltreatment, mental health, drug and alcohol abuse and education. The quality of almost all studies was strong, however the studies rated poorly on the reporting of data linkage methods. The statistical analysis methods described failed to take into account mediating factors which may have an indirect effect on the outcomes of interest and there was lack of utilisation of multi-level analysis. CONCLUSION We recommend reporting of data linkage processes through following recommended and standardised data linkage processes, which can be achieved through greater co-ordination among data providers and researchers.
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Affiliation(s)
- Fadzai Chikwava
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Reinie Cordier
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle, United Kingdom
| | - Anna Ferrante
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Melissa O’Donnell
- Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia
- Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia
| | - Renée Speyer
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Lauren Parsons
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
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20
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Toros K, Tart K, Falch-Eriksen A. Collaboration of Child Protective Services and Early Childhood Educators: Enhancing the Well-Being of Children in Need. EARLY CHILDHOOD EDUCATION JOURNAL 2021; 49:995-1006. [PMID: 33456299 PMCID: PMC7794075 DOI: 10.1007/s10643-020-01149-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2020] [Indexed: 05/07/2023]
Abstract
This paper examines the role of interprofessional collaboration in the identification and reporting of a child in need. Such collaboration is especially important in the context of the global pandemic caused by the novel Coronavirus disease of 2019, known as COVID-19. The child protection system must have the capacity and resources to respond to increased demands during this time, and early childhood educators serve as an essential link for child protective services in identifying and reporting a child in need. As an effective system to accomplish these two aims requires a working collaboration among its participants, Bronstein's interdisciplinary collaboration model was used as a framework to interpret this practice. A small-scale qualitative study was conducted that included principals of nursery schools and child protection workers from one region in Estonia. Findings indicate that effective collaboration was believed to require communication and ongoing systematic relationship building. Collaboration in practice varied, as principals reported a high turnover rate for the child protection workers, which hindered the development of a working relationship and support for the process of noticing and thereby identifying a child in need. In contrast, child protection workers assessed collaboration more positively, recognizing the need to have a supportive system in place for nursery schools. Both groups of collaborators acknowledged the need to train teachers, particularly to conduct joint training exercises to foster a common understanding of the child in need and of the intervention process itself.
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Affiliation(s)
- Karmen Toros
- Tallinn University, Narva mnt 25, 10120 Tallinn, Estonia
| | - Keidy Tart
- Tallinn University, Narva mnt 25, 10120 Tallinn, Estonia
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21
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McCalman J, Bainbridge R, James YC, Bailie R, Tsey K, Matthews V, Ungar M, Askew D, Fagan R, Visser H, Spurling G, Percival N, Blignault I, Doran C. Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children: protocol for a community-driven continuous quality improvement approach. BMC Public Health 2020; 20:1810. [PMID: 33246445 PMCID: PMC7694265 DOI: 10.1186/s12889-020-09885-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children works towards developing a spectrum of effective, community-based services and supports. These services and supports are organised into a coordinated network, build meaningful partnerships with families and address their cultural and linguistic needs, to help children to function better at home, in school, in the community, and throughout life. This study is conducted in partnership with primary healthcare (PHC) and other services in three diverse Indigenous Australian communities. It entails conceptualising, co-designing, implementing, and evaluating the effectiveness of systems integration to promote the mental health and wellbeing of Indigenous school-aged children (4-17 years). This paper outlines a protocol for implementing such complex community-driven research. METHODS/DESIGN Using continuous quality improvement processes, community co-designed strategies for improved systems integration will be informed by narratives from yarning circles with Indigenous children and service providers, and quantitative data from surveys of service providers and audits of PHC client records and intersectoral systems. Agreed strategies to improve the integration of community-based services and supports will be modelled using microsimulation software, with a preferred model implemented in each community. The evaluation will investigate changes in the: 1) availability of services that are community-driven, youth-informed and culturally competent; 2) extent of collaborative service networks; 3) identification by PHC services of children's social and emotional wellbeing concerns; and 4) ratio of children receiving services to identified need. Costs and benefits of improvements to systems integration will also be calculated. DISCUSSION The study will provide evidence-informed, community-driven, and tested models that can be used for implementing systems integration to promote the mental health and wellbeing of Indigenous children. It will identify the situational enablers and barriers that impact systems integration and determine the extent to which systems integration improves service availability, systems and child outcomes. Evidence for the cost effectiveness of systems-level integration will contribute to national mental health policy reform.
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Affiliation(s)
- Janya McCalman
- Centre for Indigenous Health Equity Research, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia.
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia.
| | - Roxanne Bainbridge
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
| | - Yvonne Cadet James
- Apunipima Cape York Health Council, 186 McCoombe St, Cairns, QLD, 4870, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, 61 Uralba St, Lismore, NSW, 2480, Australia
| | - Komla Tsey
- The Cairns Institute, James Cook University, McGregor Rd, Cairns, QLD, 4878, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, 61 Uralba St, Lismore, NSW, 2480, Australia
| | - Michael Ungar
- Resilience Research Centre, Dalhousie University, 6420 Coburg Rd, Halifax, NS, B3H 4R2, Canada
| | - Deborah Askew
- Primary Care Clinical Unit, The University of Queensland, Brisbane, Qld, 4072, Australia
- Southern Queensland Health Centre of Excellence in Aboriginal and Torres Strait Islander Primary Healthcare, Building 2/37 Wirraway Parade, Inala, QLD, 4077, Australia
| | - Ruth Fagan
- Gurriny Yealamucka Health Service, Bukki Rd, Yarrabah, QLD, 4871, Australia
| | - Hannah Visser
- Bulgarr Ngaru Medical Aboriginal Corporation, 153 Canterbury St, Casino, NSW, 2470, Australia
| | - Geoffrey Spurling
- Primary Care Clinical Unit, The University of Queensland, Brisbane, Qld, 4072, Australia
- Southern Queensland Health Centre of Excellence in Aboriginal and Torres Strait Islander Primary Healthcare, Building 2/37 Wirraway Parade, Inala, QLD, 4077, Australia
| | - Nikki Percival
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, 235 Jones St, Ultimo, NSW, 2007, Australia
| | - Ilse Blignault
- Translational Health Research Institute, University of Western Sydney, School of Medicine, Campbelltown Campus, NSW, 2560, Australia
| | - Chris Doran
- Centre for Indigenous Health Equity Research, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
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22
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Kisely S, Najman J. Prospective data confirm the lasting effects of maltreatment on children. Med J Aust 2020; 212:15-16. [DOI: 10.5694/mja2.50445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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