Understanding child mental health consultation from the perspective of primary health care professionals

Published version made available with permission from publisher. Version of record available here: im To explore the understanding of mental health consultation and its utilisation from the perspective of primary care workers working with children and young people who experience mental health issues. Background Recognition of mental health consultation is respected and advocated as a way forward to support those professionals who may not necessarily have the training or understanding of child mental health issues, yet come across them frequently as part of their daily practice. Little is known, however, about how primary care professionals understand or utilise mental health consultation. Design A qualitative research design informed by phenomenology. Methods: School nurses (n=6) were purposively sampled. Semi-structured interviews were undertaken, facilitated by the use of open-ended questions. All interviews were audio-recorded and transcribed, followed by vigorous thematic analysis. Results Five overarching themes were identified from the data. These included: communication; crisis identification; hindrances; resources; and expectations. Each main theme consisted of several sub-themes relating to issues of professional identity; blurring of professional boundaries; constraints such as time management and workload; and the participant’s own needs, including self-confidence and educational needs. Conclusions and implications for clinical practice When utilised, mental health consultation proved effective in supporting the participants to address the mental health needs of children and young people; however, there are several factors such as lack of resources, differing perceptions of mental health consultation and personal challenges that prevent full engagement. This research contributes to existing knowledge by advocating that all individuals participating in mental health consultation should be encouraged to embrace the practice and understand what it actually means within the context of their own discipline

Key findings from The Walking In ScHools (WISH) Study, a peer-led walking intervention for adolescent girls

Project Description: The effects of walking interventions on adult health are known, however the potential of walking to promote physical activity (PA) in adolescents is less known. This study evaluated the effectiveness of a novel, school-based walking intervention at increasing PA levels of adolescent girls. Female pupils aged 12-14 years, were recruited from eighteen (mixed or single-sex) schools across the Border Region of Ireland/Northern Ireland. Schools were randomised to control (usual physical activity; n9) or intervention (n9). In intervention schools, female pupils (15-18 years) were trained as walk leaders and led the younger pupils in 10-15min walks before school, at break and lunchtime. Walks were in school grounds and pupils were encouraged to join as many walks as possible. Excluding holidays, the intervention was delivered for a full school year (18-21 weeks). Accelerometers measured PA and the primary outcome was total PA (cpm). Impact: In total, 589 pupils were recruited (intervention: n286; control n303). Baseline moderate-vigorous PA (MVPA) for the intervention group was (median [IQR]) 36.1 (23.0) mins per day and 35.3 (19.8) mins per day in the control group. At baseline, only 15% (n37) of intervention and 10% (n29) of control participants met PA guidelines (60 mins MVPA per day). Post-intervention total PA (cpm) did not statistically differ between groups when adjusted for age, body mass index z-scores and baseline PA (mean difference, -33.5, 95% CI= -21.2 to 88.1; p=0.213). Learning: ‘Scaling-up’ PA interventions is challenging. Despite a promising feasibility study, the results of this fully powered trial indicate that in this context, the walking programme did not increase PA. Since the COVID-19 pandemic, school environments have changed and although pupils enjoyed the programme, attendance at walks was low. There is a need to better understand the implementation of interventions such as WISH within schools

"Including us, talking to us and creating a safe environment" - Youth Patient & Public Involvement and the Walking In ScHools (WISH) Study: Lessons learned

© 2023 The authors. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1111/hex.13885Background: Young people have the right to be informed and consulted about decisions affecting their lives. Patient and public involvement (PPI) ensures that research is carried out ‘with’ or ‘by’ young people rather than ‘to’, ‘about’ or ‘for’ them. The aim of this paper is to outline how youth PPI can be embedded within a physical activity intervention, reflect on the impact of PPI and provide recommendations for future PPI in a similar context. Methods: A Youth Advisory Group (YAG) was set up within the Walking In ScHools (WISH) Study to involve adolescent girls in the delivery, implementation and dissemination of a physical activity intervention targeted at adolescents. Schools invited pupils aged 12–14 years and 15–18 years to YAG meetings (n3, from 2019 to 2023). Participative methods were used to inform recruitment strategies and data collection methods for the WISH Study. Results: Across the three YAG meetings, n51 pupils from n8 schools were involved. Pupils enjoyed the YAG meetings, felt that their feedback was valued and considered the meetings a good way to get young people involved in research. The YAG advised on specific issues and although measuring impact was not the primary aim of the YAG meetings, over the course of the study there were many examples of the impact of PPI. Recruitment targets for the WISH Study were exceeded, the attrition rate was low and pupils were engaged in data collection. Conclusion: Youth PPI is a developing field and there are few physical activity studies that report the PPI work undertaken. Within the WISH Study, three YAG meetings were held successfully, and the views of adolescent girls were central to the development of the study. Considering the specific issues that the YAG advised on (study recruitment, attrition and data collection), there was evidence of a positive impact of PPI. Patient or Public Contribution: Pupils from post-primary schools interested/participating in the WISH Study were invited to attend YAG meetings. YAG meetings were set up to consult adolescent girls on the delivery, implementation and dissemination of the WISH intervention.The WISH Study was funded from INTERREG VA funding of €8.84m (including a 15% contribution from the Department of Health in NI and Republic of Ireland), which had been awarded to the HSC Research & Development Division of the Public Health Agency Northern Ireland and to the Health Research Board in Ireland for the Cross-border Healthcare Intervention Trials in Ireland Network project.Published versio