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Supporting Troubled Young People provides a vital and much-needed resource for anyone involved with children and young people who are suffering from or at risk of developing, mental health problems. Problems such as self-harm, eating disorders, and anxiety and depression are increasing, while young men, in particular, are at increasing risk of suicide. This is against a backdrop of NHS CAMH services unable to cope with demand and resources in the voluntary sector being stretched beyond their capacity. This means parents, teachers, social workers and nurses are often the first and only help available. This book gives them a jargon-free, accessible guide to help them assess situations, provide skills and guidance to support children and young people, and know how and where to get more help for them. Full of practical tips, advice, exercises and case studies. Articulates gender, multi-cultural, spirituality and sexuality issues. Tackles contemporary issues such as cyber bullying, eating disorders and self-harm. Uses research and established theory in an engaging way enabling the reader to translate ideas into modern multi-cultural practice. Supporting Troubled Young People provides any worker involved in supporting, helping and caring for young people with a practical resource to use in their work as teachers, social workers, nurses, youth workers, doctors, foster carers, residential staff, psychologists and psychiatrists. Parents and young people will also find much of value here. This book makes a rich contribution to the understanding and treatment of children's mental health at a time when this is desperately needed. It is well-informed, full of case illustrations to guide the reader, and is written by a compassionate therapist and researcher with a solid grasp of the complex social environment in which children live today. Dr Chris Nicholson - Head of the Department of Psychosocial and Psychoanalytic Studies, University of Essex

This in-depth exploration uses individual portraits to show what parents face as they love and care for their mentally ill children and cope with how the mental health system has failed them.- More than 40 in-depth interviews giving parents the opportunity to tell their stories about caring for a child with a mental disorder- An extensive bibliography of relevant material

In a rapidly expanding field, this text summarizes and critiques evidence-based treatment methods for pediatric patients from infancy to adolescence, helping researchers and clinicians navigate the knowledge base as well as they do the nuances of diagnosis.

The manual developed for Riverview Children’s Hospital

A personal history of the groundbreaking children’s mental health facility

Background In 2010, changes were made to the Norwegian Health Personnel Act. This led to all health personnel being obliged to support the patients’ children and families. The aims of this study were to investigate whether health personnel contacted or referred the patients’ children to family/friends or public services. We also investigated if there were factors in the family or the services that increased or decreased the degree of contacts and referrals. In addition the patients were asked whether the law had been a help or even a burden. This study was part of a larger multi-site study of children of ill parents conducted in five health trusts in Norway. Method We used cross-sectional data from 518 patients and 278 health personnel. The informants completed a questionnaire addressing the law. Data were analyzed by factor analysis and logistic regression. Results The health personnel contacted/referred children to different services, but not to the degree desired by their parents. Only a few contacted family/friends, or the school and/or the public health nurse, those representing the helpers who live closest to the child, and thus well situated to participate in help and preventive efforts. The service most often referred to was the child welfare service. Conclusion The results indicate a change in contacts/referrals for children from their parents’ health personnel but also reveal remaining needs for support/help for these children. Health personnel should strive to write more referrals and take more contacts than the current study suggests, to secure adequate support for children of ill parents in Norway, as intended in The Health Personnel Act.

Purpose This systematic review of systematic reviews aims to provide the first global picture of the prevalence and correlates of perinatal depression, and to explore the commonalities and discrepancies of the literature. Methods Seven databases were searched from inception until April 2022. Full-text screening and data extraction were performed independently by two researchers and the AMSTAR tool was used to assess the methodological quality. Results 128 systematic reviews were included in the analysis. Mean overall prevalence of perinatal depression, antenatal depression and postnatal depression was 26.3%, 28.5% and 27.6%, respectively. Mean prevalence was significantly higher (27.4%; SD = 12.6) in studies using self-reported measures compared with structured interviews (17.0%, SD = 4.5; d  = 1.0) and among potentially vulnerable populations (32.5%; SD = 16.7, e.g. HIV-infected African women) compared to the general population (24.5%; SD = 8.1; d  = 0.6). Personal history of mental illness, experiencing stressful life events, lack of social support, lifetime history of abuse, marital conflicts, maternity blues, child care stress, chronic physical health conditions, preeclampsia, gestational diabetes mellitus, being exposed to second-hand smoke and sleep disturbance were among the major correlates of perinatal depression. Conclusion Although the included systematic reviews were all of medium–high quality, improvements in the quality of primary research in this area should be encouraged. The standardisation of perinatal depression assessment, diagnosis and measurement, the implementation of longitudinal designs in studies, inclusions of samples that better represent the population and better control of potentially confounding variables are encouraged.

Background Children with medical complexity (CMC) are children who have a range of chronic physical, developmental, and behavioral conditions. CMC is a vulnerable population that requires special care and receives support from multidisciplinary teams. The COVID-19 pandemic reshaped healthcare practices, with long-term consequences. CMC was particularly impacted, encountering medical, behavioral, and social challenges due to disruptions in care and pandemic-related restrictions. This qualitative study aims to understand the impact of the COVID-19 pandemic on the CMC care journey from a healthcare provider’s perspective. Understanding COVID-19 challenges will help refine healthcare strategies, improve patient safety, and ensure CMC care meets their unique needs. Methods In this qualitative study, we captured views from various providers who cared for CMC during the pandemic. We conducted semi-structured interviews between May 2023 and December 2023. In total, we had 24 healthcare providers participate in the study, including 4 Hospitalists, 13 Specialists, 2 Outpatient Pediatricians, and 5 Home Nurses. Interviews were audio recorded to ensure accuracy in transcription and analysis. We used an inductive thematic analysis with a codebook approach for our coding process. Results As a result of inductive thematic analysis, ten primary themes emerged from the data related to CMC care challenges during the COVID-19 pandemic from the healthcare providers’ perspective. Each theme consists of a set of subthemes. Themes are clustered into three main categories: (1) Access and Continuity of Care, (2) Families, Staff, and Collaborative Care, and (3) Infection Risk and Prevention Strategies. Conclusions This study highlights the challenges of caring for CMC during the COVID-19 pandemic, focusing on system vulnerabilities and the resilience of healthcare providers and families. It shows the need for family-centered care, better telehealth integration, and comprehensive support for providers.

While a core aim of early intervention psychosis services (EIPS) is to prevent hospitalisation, many with a first episode of psychosis (FEP) will require inpatient care. We explored young people's (YP) and their carers' hospitalisation experiences prior to and during EIPS engagement and how factors across these services influenced these experiences. Using purposive sampling, we recruited twenty-seven YP, all of whom had been involved with the hospital system at some stage, and twelve support persons (parents and partners of YP) from state and federally funded EIPS in Australia with different models of care and integration with secondary mental health care. Audio-recorded interviews were conducted face-to-face or via phone. A diverse research team (including lived experience, clinician, and academic researchers) used an inductive thematic analysis process. Four key themes were identified as influential in shaping participant's hospital experiences and provide ideas for an approach to care that is improved by the effective coordination of that care, and includes this care being delivered in a trauma informed manner: (1) A two-way street: EIPS affected how participants experienced hospitalisation, and vice versa; (2) It's about people: the quality and continuity of relationships participants had with staff, in hospital and at their EIPS, was central to their experience; (3) A gradual feeling of agency: participants viewed EIPS as both reducing involuntary care and supporting their self-management; and (4) Care coordination as navigation for the healthcare system: great when it works; frustrating when it breaks down. Hospitalisation was viewed as a stressful and frequently traumatic event, but a approach to care founded on trust, transparency, and collaboration that is trauma-informed ameliorated this negative experience. Consistent EIPS care coordination was reported as essential in assisting YP and carers navigate the hospital system; conversely, discontinuity in EIPS staff and lack of integration of EIPS with hospital care undermined the positive impact of the EIPS care coordinator during hospitalisation. Care coordinator involvement as a facilitator, information provider, and collaborator in inpatient treatment decisions may improve the usefulness and meaningfulness of hospital interventions.

Background Emergency departments (EDs) are often the first access point for children and youth seeking mental health (MH) and addiction care. However, many EDs are unprepared to manage large volumes of pediatric MH patients. In addition, the fragmented Canadian MH system is challenged in connecting youth seen in the ED for follow-up community services. A provincial Emergency Department Mental Health Clinical Pathway (EDMHCP) for children and youth presenting to the ED with MH concerns was developed to address these challenges. The objective of the current study was to determine if EDMHCP implementation resulted in: (1) pathway use, (2) more patients discharged with MH recommendations, (3) MH service recommendations that aligned with patients’ risk assessments, and (4) changes in service outcomes, including ED length of stay (LOS), revisits, and admissions/transfers. Methods We implemented the pathway at four ED sites from 2018 to 2019 using the Theoretical Domains Framework to develop a tailored strategy at each site. We conducted chart reviews retrospectively in 2017–2018 (pre-implementation) and prospectively in 2019–2020 (post-implementation). Non-parametric tests examined differences in service outcomes between the implementation periods. Results Pathway use varied widely across sites, ranging from 3.1% at site 4 to 83.0% at the lead site (site 2). More referrals to community MH agencies ( p  <.001) were made at discharge during post-implementation at the lead site compared to pre-implementation, and mixed results were obtained regarding whether clinicians’ risk assessments aligned with MH service recommendations. LOS significantly increased at the lead site ( p  <.001) and non-lead sites (sites 1, 3, 4; p  =.02) between pre- and post-implementation. Revisits and admissions/transfers did not change significantly at any site. Conclusion Implementation was partially successful at the lead site, showing high pathway use and greater referrals to community MH agencies. These findings emphasize the complexity of implementing pathways in various ED settings. Successful implementation requires integration into existing workflows. Trial registration ClinicalTrials.gov (NCT02590302). Registered on 29 October 2015.