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Abstract: Purpose: The primary aim of this study is to examine the extent to which running away from home as a child is associated with behavioral problems and victimization during childhood and with suicidal behavior and substance abuse during early adulthood. Methods: A random probability sample comprising 7,461 respondents was interviewed for the 2007 survey of psychiatric morbidity of adults in England. A subsample of 16- to 34-year-old individuals was selected for secondary analysis (N = 2,247). All survey respondents were asked whether they had run away from home and asked specific questions on being physically, emotionally and sexually abused as children. They were also asked about suicidal behavior and alcohol and drug dependence in early adulthood. Results: Approximately 7% of 16- to 34-year-old individuals reported running away from home before the age of 16 years, with higher rates in women than in men (9.8% compared with 5.3%). Overall, 45.3% reported being bullied, 25.3% experienced violence at home, and 8.8% reported unwanted sexual intercourse. Runaways were far more likely than other children to have suffered victimization and family difficulties and to exhibit behavioral problems. Adults who reported running away from home were three times more likely than other adults to have thought about or attempted suicide, but the relationship with substance abuse was far less pronounced. Conclusions: Sexual, physical, and emotional abuse, along with family difficulties, can all impact children who run away from home. Running away from home was strongly associated with suicidal behavior in adulthood, regardless of other childhood adversities. [Copyright &y& Elsevier]

Accessible summary Study reveals that alcohol and substance use and abuse is common among adolescents sampled from developing countries, and that it may be as high as have been reported in the developed nations. The risk factors also appear similar., To this extent, current strategies to combat adolescent alcohol and substance abuse in developed countries can be adopted in developing countries as well. There is, however, a need to adapt some of these well-established intervention programmes into the reality of the developing countries. Peculiar challenge in these countries includes lack of human resource capacity in child and adolescent psychiatry. Therefore, such programmes will necessarily have to be simplified and implementable by allied professionals like teachers, social workers, school counsellors, nurses and spiritual advisers. Family cohesion - which is a potential strength of developing countries - also needs to be strengthened as a bulwark against adolescent involvement in social vices like alcohol and substance abuse., Abstract Most studies examining adolescent alcohol and substance use or abuse hardly include samples from developing countries. To bridge some gap, the prevalence and associated social correlates of alcohol and substance use and abuse was examined among a cohort of school-going adolescents sampled from seven developing countries. Alcohol and substance abuse was measured using the CRAFFT instrument, independent socio-demographic correlates were determined using regression models. A total of 2454 adolescents completed the study, among which 40.9% reported using either alcohol or at least one other substance during the previous 12 months. This was mostly alcohol (37.8%), followed by marijuana/hashish (8.6%) and other substances (8.1%). Among the adolescents who reported using at least one substance, 45% (18.3% of total sample) had CRAFFT scores indicative of problematic or hazardous substance use. Several personal and family factors were independently associated with use/abuse, and the modifiable nature of these factors calls for appropriate intervention strategies. [ABSTRACT FROM AUTHOR]

For health policies to be effective in practice, they need to be communicated and translated at strategic and operational levels and to be integrated into clinical practice. There is little empirical evidence to understand whether this happens and, if it does, whether it does so effectively. In the present study the views of professional healthcare staff from one service field (child mental health) are explored in order to ascertain their views on the translation of policy into practice through thematic analysis. Key themes of limited awareness, lack of strategic policies and problems in linking evidence carry implications for the development and strategies of policies. The interviews demonstrate that there is limited evidence that policies are being communicated as effectively as they could be, and we make recommendations on how these could be translated and implemented more effectively in the future. [ABSTRACT FROM AUTHOR]

Looked after children are at high risk of developing mental health problems and these are often complex and related to other needs and agency involvement. Consequently, there is increasing policy emphasis on the importance of joint service planning and implementation. In practice, however, the distinction between mental health needs, problems and disorders is not clearly defined. Therefore, there is considerable service variation, lack of models and consensus on which children and young people would benefit from specialist child and adolescent mental health services (CAMHS) input. Pradeep Rao, Alvina Ali and Panos Vostanis report on a study that aimed to compare the characteristics of looked after and adopted children referred to a designated CAMHS team, and to identify whether these fell within the perceived remit of specialist CAMHS. The referrals, over one year, were rated by an independent researcher using a checklist that contained details of the referrer, the child's placement and reason for referral, outcome and reasons for decisions. Children with indication of likely disorders were accepted, while there was less consistency on decisions related to attachment and behavioural problems, and the role of different agencies. Mental health and social care services for vulnerable children need jointly to develop clear care pathways, with definition of agency roles. The presence of behavioural and attachment problems per se should not justify referral to specialist CAMHS, which would depend on other concurrent mental health difficulties and risk factors involved. Implications for defining the role and components of mental health services for vulnerable children and young people are discussed. [ABSTRACT FROM AUTHOR]

Background: Mental health is a growing concern for organizations offering temporary accommodation to young homeless people.Aim: To establish the characteristics of homeless young people referred to a mental health service provided by the non-statutory sector, to determine the appropriateness of referral.Method: The service was provided by five mental health practitioners to 18 Foyers in five regions. Data was collected on 150 consecutively referred young people aged, 16-25 years on their psychosocial history, mental health problems and risk factors.Results: Young people reported multiple needs such as use of illicit drugs, experience of physical or sexual abuse, and self-harm. They presented with lengthy and recurrent mental health problems from childhood, with intermittent and usually fragmented contact with services. Young people presented with a range of mental complaints, predominantly depressive, anxiety and post-traumatic stress symptoms, as well as different risk factors.Conclusions: The young homeless people referred to the mental health service reported a range of complex mental health needs, the majority of which could not be met by statutory specialist services. Young people's lower to medium level mental health needs could be met by services operating on the interface with specialist services, if these are jointly planned and co-coordinated. [ABSTRACT FROM AUTHOR]

PURPOSE OF REVIEW: To critically discuss recent findings from studies using the Strengths and Difficulties Questionnaire, in relation to different research designs and clinical purposes. RECENT FINDINGS: A substantive body of research exists on the psychometric properties of the Strengths and Difficulties Questionnaire in different cultures. This body supports the validity and reliability of its versions for the parent, teacher and self-reporting purpose, despite some variation in cut-off scores. The Strengths and Difficulties Questionnaire is increasingly being used as a measure of child psychopathology in other types of research, that is, aetiological, longitudinal and service evaluation studies. Future studies need to address in more detail the Strengths and Difficulties Questionnaire diagnostic algorithms, added value score, impact and burden items and a preschool version. SUMMARY: The Strengths and Difficulties Questionnaire has been established as the most widely used instrument in child mental health research. It is easy to complete, is user friendly because of its positive attributes items, allows comparisons to be made between different populations and is sensitive to change. [ABSTRACT FROM AUTHOR]

PURPOSE OF REVIEW: To critically discuss recent findings from studies using the Strengths and Difficulties Questionnaire, in relation to different research designs and clinical purposes.RECENT FINDINGS: A substantive body of research exists on the psychometric properties of the Strengths and Difficulties Questionnaire in different cultures. This body supports the validity and reliability of its versions for the parent, teacher and self-reporting purpose, despite some variation in cut-off scores. The Strengths and Difficulties Questionnaire is increasingly being used as a measure of child psychopathology in other types of research, that is, aetiological, longitudinal and service evaluation studies. Future studies need to address in more detail the Strengths and Difficulties Questionnaire diagnostic algorithms, added value score, impact and burden items and a preschool version.SUMMARY: The Strengths and Difficulties Questionnaire has been established as the most widely used instrument in child mental health research. It is easy to complete, is user friendly because of its positive attributes items, allows comparisons to be made between different populations and is sensitive to change. [ABSTRACT FROM AUTHOR]

Children and their parents who become homeless constitute a group of families with a complex range of social care and health needs, including mental health difficulties. In response to this, a local authority housing department established a family support team (FST) that provides assessment and detection of a range of problems, support to parents and children, parenting interventions for child behavioural problems, liaison with other agencies, and referral to specialist services when appropriate. The aim of this study was to establish the perceptions of parents and staff on their experience of the service, and ways of improving it in the future. The study adopted a developmental evaluation approach and used multiple methods, including in-depth interviews with families; diaries; reflective activities; participatory learning and action; and observation of the FST. The study mapped the innovative service and captured the range of skills in the team and the complexity of agencies the team interacted with. It also identified areas for further development in terms of the mental health needs of children and parents who have become homeless. [ABSTRACT FROM AUTHOR]

PURPOSE OF REVIEW: The present review discusses critically recent research findings (published during the period 2003–2004) on the mental health needs of young people in transition (old adolescents and young adults), including those of young parents. Also, the evidence on effective interventions and service models is considered.RECENT FINDINGS: Emerging evidence indicates that young people have high rates of mental health needs (in addition to high prevalence of psychiatric disorders) that may be related to life transitions. These needs often fall between the remit of adolescent/adult and mental health/social care services, and therefore are not adequately met. With the exception of mental health interventions for early psychosis and psychosocial programmes for teenage parents, there is very limited knowledge on how best to meet the mental health needs of young people in transition.SUMMARY: It is widely recognized that young people in transition require services and interventions tailored to their characteristics, rather than a mere extension to either child/adolescent or adult services. Recent policies and research findings have led to the development of early psychosis interventions, with initial encouraging messages. Similar initiatives are required for young people with nonpsychotic disorders. [ABSTRACT FROM AUTHOR]

PURPOSE OF REVIEW: This review covers recent research findings (published during 2003) on various aspects of the impact of trauma on children''s mental health, including epidemiology, diagnostic and measurement issues, aetiological mechanisms, interventions and services. RECENT FINDINGS: The association between trauma and child psychopathology has been well established, but there is less knowledge on the underlying mechanisms and mediating factors, particularly among children facing interlinked trauma and environmental adversities (war conflict, migration, community and domestic violence). A number of measures have been developed and validated. Evaluated interventions mainly consist of group cognitive-behavioural therapy, with initial promising findings. These target either child populations exposed to trauma (universal), and are linked to local non-statutory services, or traumatized children with mental health problems of clinical significance, who are often provided by, or seen in association with, specialist mental health services for children. There is a striking absence of child-based evidence across all research topics. SUMMARY: Acute and chronic trauma constitute high risk factors for a range of mental health problems, although these should be distinguished from '''normal''' emotional responses. The impact of trauma is compounded by different parental, family and environmental factors. Consequently, these need to be taken into consideration in the setting up of services that can provide multi-level interventions for different levels of need. [ABSTRACT FROM AUTHOR]

The objective of the present study was to establish the psychosocial characteristics and perspectives of 49 consecutive homeless families who received input from a new designated family support worker (FSW) post at a large statutory hostel for homeless parents and children. The FSW provided: assessment of social, educational and health needs; support and parent training; and liaison with and referral to specialist services. Measures included quantitative questionnaires (i.e. the Hospital Anxiety and Depression Scale, the Parenting Daily Hassles Scale, the Eyberg Child Behaviour Inventory, and the Health of the Nation Outcome Scales for Children and Adolescents), and a qualitative (semistructured) interview on service experiences and satisfaction. The psychosocial measures indicated high rates of parenting difficulties, mental health and related needs among children and their parents. Parenting difficulties were associated with child behaviour problems. Parents expressed satisfaction with the service whilst they were residents at the hostel, but they were often not clear about the objectives of agencies and interventions. Family support interventions have a key role in service provision for homeless and other vulnerable families by providing direct parenting interventions and ensuring that specialist agencies are appropriately involved. Family support worker involvement needs to continue when families are re-housed in the community. [ABSTRACT FROM AUTHOR]

This qualitative study investigated the need for transitional mental health services for young people aged 16-19 years in a health district, as perceived by professionals from mental health, social, education and non-statutory services. Semi-structured interviews with 39 managers and practitioners who planned or provided services for this age range, from a wide range of agencies, explored issues related to older adolescents' needs, service communication, transfer arrangements, current gaps, and recommendations. Interviews were transcribed verbatim and themes emerged according to grounded theory. The four identified themes, with 21 categories, were: (i) older adolescents have multi-faceted needs, (ii) statutory mental health services are not geared towards this age group, (iii) communication between services is variable, and (iv) there are no formal transfer arrangements from child to adult services. The findings support the need for specialist transitional services, and the adoption of an interprofessional service model incorporating education, social services and non-statutory agencies. [ABSTRACT FROM AUTHOR]

Background Children living in war zones are at high risk of developing post-traumatic stress and other emotional disorders, but little is known about the effect of traumatic events during war. We aimed to assess the nature and severity of emotional problems in Palestinian children whose homes had been bombarded and demolished during the crisis in Palestine, compared with children living in other parts of the Gaza strip.Methods 91 children exposed to home bombardment and demolition during Al Aqsa Intifada and 89 controls who had been exposed to other types of traumatic events related to political violence completed self-report measures of post-traumatic stress, anxiety, and fears.Findings Significantly more children exposed to bombardment and home demolition reported symptoms of post-traumatic stress (p=0·0008) and fear (p=0·002) than controls. 54 (59%) of 91 exposed children and 22 (25%) of 89 controls reported post-traumatic stress reactions of clinical importance. Exposure to bombardment was the strongest socioeconomic predictor of post-traumatic stress reactions (odds ratio 0·25 [95% CI 0·12–0·53], p=0·0008). By contrast, children exposed to other events, mainly through the media and adults, reported more anticipatory anxiety and cognitive expressions of distress (p=0·001) than children who were directly exposed.Interpretation Children living in war zones can express acute distress from various traumatic events through emotional problems that are not usually recognised. Health professionals and other agencies coming in contact with children who have been affected by war and political violence need to be trained in detection and treatment of such presentations. [Copyright &y& Elsevier]