Evaluation of reliable improvement rates in depression and anxiety at the end of treatment in adolescents

Abstract: Literature has focused on effect sizes rather than individual-level improvement rates to determine how effectively services address burgeoning numbers of adolescents with anxiety and depression. The aim was to consider how many adolescents report reliable improvement in anxiety, depression and comorbid depression and anxiety by end of treatment.

Edbrooke-Childs, J., Wolpert, M., Zamperoni, V., Napoleone, E., Bear,  H. (2018). Evaluation of reliable improvement rates in depression and anxiety at the end of treatment in adolescents. BJPsych Open, 4, 250-255.


Strategies not accompanied by a mental health professional to address anxiety and depression in children and young people: a scoping review of range and a systematic review of effectiveness

Abstract: This Review reports on a scoping review followed by a systematic review to consider interventions designed to address or manage depression or anxiety in children and young people up to the age of 25 years without the need to involve mental health professionals. Evidence suggested that light therapy could be effective for season depression and that digital interventions based on attention bias modification are ineffective for anxiety. Mixed evidence was available on the effectiveness of computerised cognitive behavioural therapy for depression and anxiety, and of physical exercise for depression. All other studies had insufficient certainty to obtain even tentative conclusions about effectiveness. These results highlight the disparity between the extensive range of approaches identified in the scoping review and the restricted number and focus found in the systematic review of effectiveness of these approaches. We call for an expanded research agenda that brings evaluation rigour to a wide range of self or community approaches.

Wolpert, M., Dalzell, K., Ullman, R., Garland, L., Cortina, M., Hayes, D., Patalay, P., & Law, D. (2018) Strategies not accompanied by a mental health professional to address anxiety and depression in children and young people: a scoping review of range and a systematic review of effectiveness. The Lancet Psychiatry, doi: 10.1016/S2215-0366(18)30465-6.


Review: What Outcomes Count? Outcomes Measured for Adolescent Depression Between 2007 and 2017

Abstract: Measurement of treatment outcomes in childhood depression has traditionally focused on assessing symptoms from the clinician’s perspective, without exploring other outcome domains or considering young people’s perspectives. This systematic review explored the extent to which multidimensional and multi-informant outcome measurements have been used in clinical research for adolescent depression in the past decade and how patterns have evolved over time.

Krause, K., Bear, H., Edbrooke-Childs, J., & Wolpert, M. (2018) What Outcomes Count? A Review of Outcomes Measured for Adolescent Depression Between 2007 and 2017. Journal of the American Academy of Child and Adolescent Psychiatry. doi: 10.1016/j.jaac.2018.07.893


Barriers and facilitators to shared decision making in child and youth  mental health: clinician perspectives using the Theoretical Domains Framework

Abstract: Shared decision making (SDM) is increasingly being suggested as an integral part of mental health provision. Yet, there is little research on what clinicians believe the barriers and facilitators around practice to be. At the same time, there is also increasing recognition of a theory–practice gap within the field, with calls for more pragmatic uses of theory to inform and improve clinical practice. Using the Theoretical Domains Framework (TDF), a comprehensive, theoretical-led framework, underpinned by 33 behaviour change theories and 128 constructs, clinician perceived barriers and facilitators to SDM are investigated.

Hayes, D., Edbrooke-Childs, J., Town, R., Wolpert, M., & Midgley, N. (2018). Barriers and facilitators to shared decision making in child and youth mental health: clinician perspectives using the Theoretical Domains Framework. European Child & Adolescent Psychiatry. doi: 10.1007/s00787-018-1230-0 


A qualitative exploration of the role of leadership in service transformation in child and adolescent mental health services

Abstract: Recent policy in England has called on services for children and young people's mental health and well‐being to develop and deliver local transformation plans to increase the provision of evidence‐based, outcomes‐informed and service user‐informed treatments. The role of local leadership in service transformation is poorly understood, despite evidence suggesting it is key to enacting change.

Edbrooke-Childs, J., Calderon, A., McDonnell, M., Hirvonen, H., Deighton, J., & Wolpert, M. (2018) A qualitative exploration of the role of leadership in service transformation in child and adolescent mental health services. Child and Adolescent Mental Health. doi: 10.1111/camh.12303


Mental health and well-being trends among children and young people in the UK, 1995–2014: analysis of repeated cross-sectional national health surveys

Background: There is a growing concern about the mental health of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for self-harm and referrals to mental health services. We investigated whether there have been similar recent trends in selected mental health outcomes among CYP in national health surveys from England, Scotland and Wales.

Pitchforth, J., Fahy, K., Ford, T., Wolpert, M., Viner, R., & Hargreaves, D. (2018). Mental health and well-being trends among children and young people in the UK, 1995–2014: Analysis of repeated cross-sectional national health surveys. Psychological Medicine, 1-11. 


Using flawed, uncertain, proximate and sparse (FUPS) data in the context of complexity: learning from the case of child mental health

Abstract: The use of routinely collected data that are flawed and limited to inform service development in healthcare systems needs to be considered, both theoretically and practically, given the reality in many areas of healthcare that only poor-quality data are available for use in complex adaptive systems. Data may be compromised in a range of ways. The term ‘FUPS’ is proposed to describe these flawed, uncertain, proximate and sparse datasets. Many of the systems that seek to use FUPS data may be characterised as dynamic and complex, involving a wide range of agents whose actions impact on each other in reverberating ways, leading to feedback and adaptation. This paper presents an example of the use of a FUPS dataset in the complex system of child mental healthcare. The dataset comprised routinely collected data from services that were part of a national service transformation initiative in child mental health from 2011 to 2015. 

Wolpert, M., Rutter, H. (2018). Using flawed, uncertain, proximate and sparse (FUPS) data in the context of complexity: learning from the case of child mental health. BMC Medicine, 16(82).


Power Up: Patient and public involvement in developing a shared decision-making app for mental health

Abstract: Young people as active partners in the design of interventions is increasingly considered an integral part of research. This article presents results from a project involving young people as co-designers in a digital intervention for shared decision-making in mental health services.

Edridge, C. L., Edbrooke-Childs, J., Martin, K., Delane, L., Averill, P., Feltham, A., Rees, J., Jeremy, G., Chapman, L., Craven, M.P., Wolpert, M. (2018). Power Up: Patient and public involvement in developing a shared decision-making app for mental health. The Journal of Health Design, 3(1), 63–74.


Assessing the readability of the self-reported Strengths and Difficulties Questionnaire

Abstract: The Strengths and Difficulties Questionnaire (SDQ) is one of the most widely used measures in child and adolescent mental health in clinical practice, community-based screening and research. Assessing the readability of such questionnaires is important as young people may not comprehend items above their reading ability when self-reporting. Analyses of readability in the present study indicate that the self-report SDQ might not be suitable for young people with a reading age below 13–14 years and highlight differences in readability between subscales. The findings suggest a need for caution in using the SDQ as a self-report measure for children below the age of 13, and highlight considerations of readability in measure development, selection and interpretation.

Patalay, P., Hayes, D., & Wolpert, M. (2018). Assessing the readability of the self-reported Strengths and Difficulties Questionnaire. BJPsych Open, 4(2), 55–57.


Rethinking public mental health: learning from obesity

Abstract: Stanley J Ulijaszek’s new book Models of Obesity (published October, 2017) might be thought to be primarily of interest to obesity researchers, but in fact it offers potential applications beyond obesity, in the field of public mental health.1 Parallels between public health responses to obesity and mental health issues are already apparent. In both cases, concern about their rising levels has increased, what constitutes normality is contested, the extent to which they are socially constructed or appropriately medicalised is debated, and the focus on intervening during childhood is increasing. But parallels also exist that, although less immediately obvious, might be of crucial importance in understanding and advancing the practice of public mental health.

Wolpert, M. (2018). Rethinking public mental health: learning from obesity. The Lancet Psychiatry, 5(6), 458–60. 

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