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Background: Many studies have described associations between adult psychiatric disorder among adults and their biographic, socio-demographic and social capital characteristics. Fewer studies have focused on children, and most of these have looked at structural indicators of the neighbourhood. Our objective was to examine one aspect of social capital--perceived neighbourhood trust and safety in relation to childhood psychopathology. Methods: Data on childhood psychopathology and perceived neighbourhood trust and safety were obtained on 3,340 11 to 16-year-olds included in a large survey of the mental health carried out in 426 postal sectors in Great Britain. Data were collected on biographic and socio-demographic characteristics of the child and the family, measures of social capital and neighbourhood prosperity. We entered all these variables into a logistic regression analysis to establish the strength of association between perceived neighbourhood trust and safety separately for emotional and conduct disorders. Results: Children's perception of their neighbourhoods in terms of the trustworthiness or honesty of the people who live there or feeling safe walking alone had a strong association with childhood psychopathology, particularly emotional disorders, rather than the nature of the neighbourhood itself. Children's behaviour, however, such as going to the park or shops alone, did not vary by measures of childhood psychopathology. Conclusions: Regeneration of less prosperous neighbourhoods is likely to increase children's positive perceptions of trust, honesty and safety which in turn can have a positive effect on their mental health.

Primary Mental Health Workers (PMHWs) have been deployed to address the mental health needs of young offenders in two UK areas. The mental health characteristics of 60 young people consecutively referred to these PMHWs, the assessment outcome and interventions offered, are described. Findings indicate the usefulness of such a model in providing an effective service to young people. (Contains 54 references and 5 tables.) (GCP)

Incidents of deliberate self-harm in young people has steadily increased. This study describes adolescents' experience with medical and psychiatric services following overdose from self-poisoning. In many of the cases, young people were experiencing multiple and complex psychological difficulties. The greatest positive factor was being treated in a friendly and nonjudgmental manner by staff. (Author/JDM)

Background: Self‐harm amongst young people is an increasing problem, with looked‐after young people at higher risk. Despite this, little research exists on what young people who self‐harm find helpful. Method: One hundred and twenty‐six 11–21 year olds (53 who had experience of the care system and 73 who did not) were recruited from the community and NHS. All participants had self‐harmed in the past 6 months. Participants completed an Audio Computer‐Assisted Self‐interview (ACASI) regarding their views about the support they had received, how helpful it was, and what further help they felt they needed. Results: Looked‐after young people reported the three most helpful sources of support were Child and Adolescent Mental Health Services (CAMHS), friends and pets and the least helpful were CAMHS, Accident and Emergency (A&E) and Social services. For non‐looked‐after young people, CAMHS, counselling and Harmless (user‐led support service for self‐harm) were most helpful and CAMHS, cognitive behavioural therapy (CBT) and general practitioner (GP) were the least. Compared with the other group, more looked‐after young people had received help from A&E and CAMHS, whereas more non‐looked‐after young people had accessed GPs, parents, psychological therapies, self‐help books and websites. More looked‐after young people found support groups helpful, and more non‐looked‐after young people reported that distraction techniques, medication and their siblings were helpful. Conclusion: Young people who self‐harm have mixed views about CAMHS. Differences in the pattern of access and preferences for support between looked‐after and non‐looked‐after young people should be reflected in service availability and commissioning. Key Practitioner Message: Little is known about what young people who self‐harm find helpful, particularly for looked‐after young people.CAMHS was named amongst the most helpful and the least helpful services by both looked‐after and non‐looked‐after young people.Social services and A&E were frequently cited amongst the least helpful sources of support.Young people report finding informal support helpful, including family and friends.There appears to be a need for explorations of the reasons behind the apparent negative perception of statutory services in young people, and what is required to shift that. [ABSTRACT FROM AUTHOR]

Background: Unaccompanied refugee minors present with disproportionately high prevalence of emotional and psychological morbidities. However, their utilization of mental health services has been shown to be significantly poorer than the indigenous population of the country they seek asylum in. Despite this, there is limited research exploring their perspectives on the barriers they face. Aims: This research aims to understand unaccompanied refugee minors' and their carers' perceptions of the barriers to utilize mental health services and to explore issues perceived to be related to poor engagement with services. Methods: Semi-structured interviews with 15 unaccompanied refugee minors and their carers were conducted. This was to elicit their views, perceptions and beliefs based on their experience of receiving treatment from a specialist mental health service in the UK. Results: Thematic analysis was used and the findings were categorised into two broad themes; the participants' perceptions of the intervention and perceptions of the professionals. Salient aspects of these are discussed. Conclusions: The findings have potential to stimulate further research into gaining a better understanding of the barriers these young people face in accessing help, and may contribute to developing services that are more efficient in engaging this vulnerable group and meeting their specific needs. [ABSTRACT FROM AUTHOR]

Background Children in the UK care system often face multiple disadvantages in terms of health, education and future employment. This is especially true of mental health where they present with greater mental health needs than other children. Although transition from care - the process of leaving the local authority as a child-in-care to independence - is a key juncture for young people, it is often experienced negatively with inconsistency in care and exacerbation of existing mental illness. Those receiving support from child and adolescent mental health services ( CAMHS), often experience an additional, concurrent transfer to adult services ( AMHS), which are guided by different service models which can create a care gap between services. Method This qualitative study explored care-leavers' experiences of mental illness, and transition in social care and mental health services. Twelve care-leavers with mental health needs were interviewed and data analysed using framework analysis. Results Sixteen individual themes were grouped into four superordinate themes: overarching attitudes towards the care journey, experience of social care, experience of mental health services and recommendations. Conclusions Existing social care and mental health teams can improve the care of care-leavers navigating multiple personal, practical and service transitions. Recommendations include effective Pathway Planning, multiagency coordination, and stating who is responsible for mental health care and its coordination. Participants asked that youth mental health services span the social care transition; and provide continuity of mental health provision when care-leavers are at risk of feeling abandoned and isolated, suffering deteriorating mental health and struggling to establish new relationships with professionals. Young people say that the key to successful transition and achieving independence is maintaining trust and support from services. [ABSTRACT FROM AUTHOR]

Adopted children tend to have high levels of emotional, behavioural and developmental need and are more likely to present to a range of services, including Child and Adolescent Mental Health Services (CAMHS). Although research exploring adopted children's perspectives is growing, it remains limited. Furthermore, there has been little work to engage adopted children in research. Our project aimed to examine adopted children's viewpoints of mental health and services alongside those of their adoptive carers. Results indicated that although there were some similarities between carer and child perspectives, they also frequently differed. They provided different constructions of the problem but agreed that family relationships were strained. Some acknowledgement of the role of the school was offered and other external sources of support cited. Coping was considered to be complex and while some issues were analogous to ‘normal’ family life, much was inherent to the adoption status. [ABSTRACT FROM AUTHOR]

Background: Unaccompanied refugee adolescents are a small but clinically significant group. This group is vulnerable with physical and psychiatric needs which are often not met. There are several barriers to providing care for this group, originating with the refugees but also due to service provision. Aims: The aim of this research is to appreciate the views and perceptions that unaccompanied minors hold about mental health and services. Method: Fifteen unaccompanied adolescents engaged with mental health services were interviewed, and thematic analysis was employed to explore relevant issues. Discussion: Their views reflected a range of opinions on mental health and the treatments they received, but many held negative attitudes toward mental health and had a lack of trust in services. This could be explained by their descriptions of their experiences within their home country of psychiatric care, their experiences of being a refugee/asylum-seeker or cultural differences. Conclusion: We argue it is important to engage this group in the development of policy and practice in child mental health, and in developing services. [ABSTRACT FROM AUTHOR]

This article presents the characteristics of 83 looked after and 67 adopted children at the time of their first assessment by a designated mental health team in the context of potential appropriateness of this service. Attachment and mental health problems were significantly associated across most subscales of the Relationships Problems (RPQ) and the Strengths and Difficulties Questionnaires (SDQ). Adopted children were younger and were rated higher on both measures. One-third of the children were rated below the clinical cut-off SDQ score. The service appeared to adopt broad referral criteria to include attachment difficulties rather than just mental health disorders. The findings are discussed in relation to the varied interpretation of the constructs of attachment difficulties and disorders, and the future development of care pathways for looked after and adopted children. [ABSTRACT FROM PUBLISHER]

Most studies show that religion is a protective factor for mental health. A few argue that it is detrimental and the remainder conclude it makes no difference. We investigate the religiosity correlates of childhood psychopathology – strength of belief, importance of being able to practice one’s religion, and worship frequency. Questions on religiosity were included in the mental health survey of children in Great Britain administered to 2992 11–19-year-olds in 2007. The Development and Well-Being Assessment was used to generate rates of clinically recognisable mental disorders. Logistic regression analysis was used to establish the magnitude of the religiosity correlates of emotional and conduct disorders. Young people with a stated religion who had weakly held beliefs or who regarded religious practice as unimportant were those with the greater likelihood of having emotional disorders. Regular attendance at religious services or prayer meetings reduced the likelihood of having a conduct disorder. [ABSTRACT FROM AUTHOR]

The voluntary sector has an important role to play in the provision of services for people with mental health needs of lesser severity, thus complementing statutory services, as suggested by recent national policy. This article describes such a service for young homeless people, and discusses the perceptions of key stakeholders of the benefits and challenges of such a service. The service largely met the mental health needs of young people who would not have easily accessed statutory mental health services, and who fulfilled the criteria (low/moderate need) of the service. Challenges for the future included the different organisational cultures, the professional isolation of the mental health practitioners and the lack of operational and commissioning links with statutory mental health services. [ABSTRACT FROM AUTHOR]

Background Children with conduct disorders and their families come into contact with a range of community and specialist agencies. Methods The aim of this study was to establish the lifetime service utilisation rates among children with conduct disorders from the Great Britain National Study (N = 10,438), and to examine the association between comorbid disorders, family and social factors, and service utilisation. The Development and Well-Being Assessment, a service checklist, and a battery of family and social functioning measures were used. Results The weighted prevalence of oppositional and conduct disorders was 5.4 %. Within this group (N =403), 241 (59.8%) had conduct disorder only 79 (19.6%) comorbid emotional, 72 (17.9%) comorbid hyperkinetic, and 11(2.7%) comorbid emotional and hyperkinetic disorders. These subgroups were compared on service utilisation with children with other psychiatric disorders (N=351). Children with conduct disorders had significantly higher lifetime rates of utilisation of social and educational services than children with other psychiatric disorders. Contact with primary health, specialist health, and educational services was significantly associated with comorbid physical and psychiatric disorders. In contrast, contact with social services was associated with family discord and social sector tenancy. Conclusions The findings are discussed in the context of organisation and coordination of health, other statutory, and non-statutory services, also taking into account previous research on interventions for children with conduct disorders and their families. [ABSTRACT FROM AUTHOR]

An inter-agency training programme in child and adolescent mental health for primary care staff has been developed in a UK area serving a general population of 900 000. This was initiated with a training needs and resources analysis across all the joint strategy partners (three local authorities, one health authority and the voluntary sector). Training is provided to inter-agency groups of professionals in 12 localities. To date, 150 staff have been through the two-day introductory/foundation course, which is complemented by three subsequent training days on the assessment and management of children and families. Staff evaluation ratings are presented. On the whole, primary healthcare staff rated their awareness of mental health issues and their knowledge of staff roles within child mental health services significantly higher, in contrast with education staff who rated these components lower. Inter-agency training has been achieved with some difficulties needing to be overcome, but the participants' feedback indicates that the expected output is beginning to be realized. The implications of the project are discussed. [ABSTRACT FROM AUTHOR]

Presents the psychological characteristics of Greek young offenders attending a probation service in Great Britain. Identification of main offenses; Percentage of recurrent offending; Evidence of a high rate of borderline to mild learning disability.

Discusses the implications of the Child and Adolescent Mental Health (CAMH) chapter of the National Service Framework (NSF) in Great Britain. Principles and philosophies for child and adolescent mental health services in different countries; Developmental perspective of services for children and young people with mental needs; Types of health services discusses in the NSF and CAMH.

Abstract Background Children in out-of-home care are consistently found to have poor mental health compared to children in the general population. However, UK research has so far failed to disentangle the impact of the care system on children's mental health outcomes from the effects of the adverse circumstances that led to their admission to care. Objective This research investigated the association between care placement and the presence of child mental health problems after controlling for children's pre-care experiences. It also identified factors associated with mental health problems among children in care. Participants and Setting The sample comprised three groups of children involved with child welfare services due to maltreatment, including children in out-of-home care (n = 122), reunified children (n = 82) and those who had never been in care (n = 159). Methods The mental health of the children in the three groups was compared, using information collected from their parents/foster carers and social workers. Results The odds of a child in out-of-home care having a mental health problem were not significantly higher than those of a child who had never been in care (AOR = 1.24; p = 0.462). However, the odds of a child in out-of-home care having reactive attachment disorder (RAD) were significantly higher than those of a child who had never been in care (AOR=1.92; p = 0.032). Conclusions These findings make an important contribution to international debates about whether placing children in care is beneficial or detrimental to their wellbeing, and highlight a range of inter-linking factors associated with the mental health of children in out-of-home care. [ABSTRACT FROM AUTHOR]

Rationale: Self-harm in young people is of significant clinical concern. Multiple psychological, social and clinical factors contribute to self-harm, but it remains a poorly understood phenomenon with limited effective treatment options., Objective: To explore young women's experience of self-harm in the context of interpersonal stressors and supports., Method: Fourteen adolescent females (13-18 years) who had self-harmed in the last six months completed semi-structured interviews about self-harm and supports. Interpretative phenomenological analysis was undertaken., Results: Themes identified were: 1) Arguments and worries about family breakdown; 2) Unhelpful parental response when self-harm discovered and impact on seeking support; 3) Ongoing parental support; 4) Long-term peer victimization/bullying as a backdrop to self-harm; 5) Mutual support and reactive support from friends (and instances of a lack of support); 6) Emotions shaped by others (shame, regret and feeling 'stupid to self-harm'); and 7) 'Empty promises' - feeling personally let down by clinical services. These themes were organised under two broad meta-themes (psychosocial stressors, psychosocial supports). Two additional interconnected meta-themes were identified: Difficulties talking about self-harm and distress; and Impact on help-seeking., Conclusion: Parents and peers play a key role in both precipitating self-harm and in supporting young people who self-harm. The identified themes, and the apparent inter-relationships between them, illustrate the complexity of self-harm experienced in the context of interpersonal difficulties, supports, and emotions. These results have implications for improving support from both informal and clinical sources., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

There is a growing appreciation that child functioning in different domains, levels, or systems are interrelated over time. Here, we investigate links between internalizing symptoms, externalizing problems, and academic attainment during middle childhood and early adolescence, drawing on two large data sets (child: mean age 8.7 at enrolment, n = 5,878; adolescent: mean age 11.7, n = 6,388). Using a 2-year cross-lag design, we test three hypotheses - adjustment erosion, academic incompetence, and shared risk - while also examining the moderating influence of gender. Multilevel structural equation models provided consistent evidence of the deleterious effect of externalizing problems on later academic achievement in both cohorts, supporting the adjustment-erosion hypothesis. Evidence supporting the academic-incompetence hypothesis was restricted to the middle childhood cohort, revealing links between early academic failure and later internalizing symptoms. In both cohorts, inclusion of shared-risk variables improved model fit and rendered some previously established cross-lag pathways non-significant. Implications of these findings are discussed, and study strengths and limitations noted. Statement of contribution What is already known on this subject? Longitudinal research and in particular developmental cascades literature make the case for weaker associations between internalizing symptoms and academic performance than between externalizing problems and academic performance. Findings vary in terms of the magnitude and inferred direction of effects. Inconsistencies may be explained by different age ranges, prevalence of small-to-modest sample sizes, and large time lags between measurement points. Gender differences remain underexamined. What does this study add? The present study used cross-lagged models to examine longitudinal associations in age groups (middle child and adolescence) in a large-scale British sample. The large sample size not only allows for improvements on previous measurement models (e.g., allowing the analysis to account for nesting, and estimation of latent variables) but also allows for examination of gender differences. The findings clarify the role of shared-risk factors in accounting for associations between internalizing, externalizing, and academic performance, by demonstrating that shared-risk factors do not fully account for relationships between internalizing, externalizing, and academic achievement. Specifically, some pathways between mental health and academic attainment consistently remain, even after shared-risk variables have been accounted for. Findings also present consistent support for the potential impact of behavioural problems on children's academic attainment. The negative relationship between low academic attainment and subsequent internalizing symptoms for younger children is also noteworthy., (© 2017 The British Psychological Society.)

Children with conduct disorders (CD) and their families are in contact with multiple agencies, but there is limited evidence on their patterns of service utilization. The aim of this study was to establish the patterns, barriers and correlates of service use by analysing the cohort of the 2004 Great Britain child mental health survey (N = 7,977). Use of social services was significantly higher by children with CD than emotional disorders (ED) in the absence of co-morbidity, while use of specialist child mental health and paediatric was significantly higher by children with hyperkinetic disorders (HD) than CD. Children who had comorbid physical disorders used more primary healthcare services compared to those without physical disorders. Utilization of specialist child mental heath and social services was significantly higher among children with unsocialized CD than socialized CD and oppositional defiant disorders. Services utilization and its correlates varied with the type of service. Overall, specialist services use was associated with co-morbidity with learning disabilities, physical and psychiatric disorders. Several correlates of services use in CD appeared non-specific, i.e. associated with use of different services indicating the possibility of indiscriminate use of different types of services. The findings led to the conclusion that there is the need for effective organization and co-ordination of services, and clear care pathways. Involvement of specialist child mental health services should be requested in the presence of mental health co-morbidity.

The aim of this study was to investigate young homeless people's experiences of ;Strong Minded', a new mental health service set up within selected homeless shelters and run by a voluntary sector organization. Semi-structured interviews were conducted with 19 residents from five homeless shelters across the UK. All of the young people who had accessed Strong Minded had benefited from their engagement. The young people also identified several key inherent and important aspects of Strong Minded relating to both the practical, supportive therapeutic approach and the flexibility of the interventions offered, which contributed to the service's success. This service model of engaging vulnerable young people in transition could have useful implications for the future interface between voluntary and statutory mental health services.

The aim of this study was to explore Gujarati parents' and adolescents' perceptions of child and adolescent mental health services and how these should be improved to best meet their needs. Semi-structured qualitative interviews were carried out with 15 parents and 15 young people, recruited from a community centre. Overall, the quality of the service appeared more important than its responsiveness to culture or ethnicity for both young people and their parents. These findings indicate the need for further evidence and debate on whether Black and ethnic minority families should be treated as though they are a homogenous group.