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The European Early Promotion Project: description of the service and evaluation study
- Authors:
- PUURA Kaija, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.17-31.
- Publisher:
- Taylor and Francis
Describes an innovative cross-cultural method of working with families to promote the psychosocial wellbeing of children and prevent the development of psychological and social problems. Also presents a study designed to evaluate the effects of the service. Primary health care workers in 5 countries of northern, central and southern Europe were trained to conduct promotional interviews with all prospective mothers in their area one month before and one month after birth. They were also taught to work with mothers identified as in need of support as a parent, using a specific counselling model to try to prevent the onset of child mental health difficulties. Effects of the intervention on children's psychological development and family adaptation were evaluated at 2 years of age in comparison with matched groups not receiving the intervention, using a set of questionnaires, interviews and observation methods. The total sample at initial assessment was 824 families, of which 705 (85.65) were retained for outcome assessment. Part of a special issue on the European Early Promotion Project (EEPP).
Child and family outcomes of the European Early Promotion Project
- Authors:
- DAVIS Hilton, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.63-81.
- Publisher:
- Taylor and Francis
This paper, part of a special issue on the European Early Promotion Project (EEPP), concerns outcomes for families involved in the Project and presents data collected when the children were between 6-8 and 24 months old. A total of 824 families were recruited from the 5 countries involved. At baseline, differences were found between country samples in extent and type of need (Finnish families having the lowest risk factor rates and Serbia the highest, for example), but recruitment was generally successful in including families from the whole range of need, excluding those with the severest physical and psychiatric problems. Although not randomised, intervention families (receiving the EEPP service) were reasonably matched with comparison families (receiving usual services) on most variables initially, except in Greece, where intervention families were somewhat more at risk. At 24 months, in spite of low intensity of service provision and methodological difficulties likely to reduce effects, there was evidence, particularly in Greece, of differences in outcome favouring the intervention group, who also showed significantly higher levels of satisfaction with the intervention received. It was concluded that the service merits further exploration to assist in understanding promotional and preventative processes.
Primary prevention of child mental health problems using primary health care professionals: cost comparisons
- Authors:
- KNAPP Martin, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.95-102.
- Publisher:
- Taylor and Francis
The importance of economic dimension in planning, delivery and evaluation of care and support for children and families is widely recognised. This paper reports a cost analysis of a primary prevention programme in 4 European centres using primary health care professionals trained to promote the psychosocial adaptation of children from birth. The cost of the intervention in training and supervision for each country was estimated, and the impact on service use and cost 2 months after the birth of the index child was measured. Total costs incurred by families at comparison sites where no such training was provided were also calculated and compared with total costs at intervention sites. Cost differences between countries were also explored. Differences in total costs between the groups were small and did not reach statistical significance. However, total costs varied substantially between countries. Training primary health care professionals in primary prevention of child mental health problems is found to be inexpensive and does not appear to affect total costs in the years immediately following. Given the outcome findings, the cost evaluation provides encouragement for wide establishment and examination of this preventative intervention. Part of a special issue on the European Early Promotion Project (EEPP).
Training for primary health care practitioners
- Authors:
- LAYIOU-LIGNOS, Effie, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.41-53.
- Publisher:
- Taylor and Francis
Describes in detail the training course for primary health care practitioners (PHCPs) designed for the needs of the European Early Promotion Project (EEPP), aiming to promote parent-infant interaction and ensure that resources are targeted to families in need of more support. The course is based on the principles of adult learning models and uses a partnership approach to the helping process, combining the Parent Adviser model, promotional interviewing from the EU/WHO project and the theory and skills of assessing and supporting early parent-infant interaction and the psychosocial development of infants. It provides a step-by-step exposition of how to train PHCPs, stressing the importance of the helper-parent relationship and ways of facilitating parent-child communication. It gives an analytic description of the course content and training methods. It describes in detail the supervision which followed the training and accompanied the PHCPs throughout the implementation phase, elaborating on the supervisory relationship and the alliance necessary for the supervision to be effective. It concludes with some remarks about training and supervision and their role in the project. Part of a special issue on the EEPP.
The effects of the European Early Promotion Project training on primary health care professionals
- Authors:
- PAPADOPOLOU Kalliroi, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.54-62.
- Publisher:
- Taylor and Francis
Explores the effects of the European Early Promotion Project (EEPP) training on primary health care professionals with regard to knowledge, self-efficacy and ability to identify need in families, and to their satisfaction with training received. A quasi-experimental group comparison design was developed in which an intervention and a comparison group were assessed twice: the intervention group before and after the special EEPP training and the comparison at the same time but without the training. Overall results show a tendency for the intervention group to improve in knowledge and perceived self-efficacy, and a significant improvement in their accuracy of need identification in families, compared with the comparison group. These results were more prominent in Greece, Serbia and the UK than in Finland and Cyprus, whereas training satisfaction was high in all sites. The results are discussed in terms of their implications for early intervention as well as for training primary health care professionals to conduct preventative and promotional work with families. Part of a special issue on the EEPP.
Primary care clinicians’ use of standardized psychiatric diagnoses
- Authors:
- GARNER W., et al
- Journal article citation:
- Child: Care, Health and Development, 30(5), September 2004, pp.401-412.
- Publisher:
- Wiley
Treatment of child mental health (MH) problems should be informed by psychiatric diagnosis. Whether primary care clinicians (PCCs) use standardized psychiatric diagnostic criteria to direct the treatment of child MH problems is unknown. This study investigated PCCs’ use of Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria during office visits. The data were obtained from 3674 children ages 4–15 years who were recognized as having one or more MH problems during office visits by clinicians participating in the Child Behaviour Study. Parents completed questionnaires before seeing the clinician. Clinicians completed a survey after the visit. The primary outcome was whether PCCs used standardized criteria to generate a diagnosis for children with recognized MH problems. Clinicians used DSM criteria in 23% of visits in which a psychosocial problem was recognized, and 57% of PCCs reported no use of DSM. DSM criteria were used most frequently (38% of visits) when PCCs reported attention problems. Medications were much more likely to be prescribed during visits when PCCs diagnosed using DSM criteria (63% of visits vs. 19% when criteria were not used). However, only 51% of psychotropic medication prescriptions were based on a DSM diagnosis. Clinicians used standardized criteria infrequently, and primarily to diagnose attention problems.
Detection of child mental health disorders by general practitioners
- Authors:
- SAYAL Kapil, TAYLOR Eric
- Journal article citation:
- British Journal of General Practice, 54(502), May 2004, pp.348-352.
- Publisher:
- Royal College of General Practitioners
This study compares GP recognition of disorders with child mental health data and examines factors affecting recognition, in particular whether recognition is enhanced if the parent expresses concern during the consultation. The study involved a two-phase design involving an initial community survey of children between the ages of 5 and 11 years. In the second phase, primary care attenders who were regarded by their GP as having a mental health disorder were compared with those who were not. For 186 children attending primary care, GP recognition was compared with the results of a child mental health questionnaire completed by parents. Accuracy and predictors of GP recognition were examined. Seventy four percent of children meeting criteria for caseness were not recognised by GP's as having a mental health disorder. The expression of parental concern in the consultation about a mental health problem increased the sensitivity of recognition from 26% to 88%. Expression of concern also increased GP recognition of non-cases; this reflected GP identification of other mental health and learning problems. Only a third of parents who had concerns expressed these during the consultation.
Interdisciplinary working in mental health
- Author:
- BAILEY Di
- Publisher:
- Palgrave Macmillan
- Publication year:
- 2012
- Pagination:
- 256p.
- Place of publication:
- Basingstoke
This book presents a model for interdisciplinary working, and offers an overview of practice and policy across a range of mental health settings. It explores how to combine skills, theories and expertise from a range of disciplines in response to the diverse needs of service users, from children to older people, and those with complex needs. Chapters include: the evolution of interdisciplinary working: definitions and policy context; models and values for interdisciplinary working in mental health; interdisciplinary working and the mental health legislation; interdisciplinary care planning in mental health; interdisciplinary risk assessment planning and management; involving people who use services in interdisciplinary working in mental health; interdisciplinary working with people with mental health problems in primary care; interdisciplinary working with children and young people with mental health problems; interdisciplinary working with older adults with mental health needs; interdisciplinary working with individuals with complex needs; interdisciplinary education and training; and managing interdisciplinary working and practice in mental health.
Examining mental health service needs in pediatric primary care settings
- Authors:
- RUFFOLO Mary C., et al
- Journal article citation:
- Social Work in Mental Health, 4(1), 2005, pp.33-48.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
While integration of the primary health care system and mental health system is viewed as a way to improve early detection of emotional and behavioral problems in children and increase their access to mental health services, less is known about the extent to which parents bring concerns about their child's mental health to pediatricians. In this study, we assessed the mental health needs and service use of a diverse sample of 228 youth, ages 4-17, in pediatric primary care settings. The central research question examined whether parents who identify child mental health concerns talk about these concerns with pediatricians. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Child psychiatric disorders among primary mental health service attenders
- Authors:
- ARCELUS Jon, VOSTANTIS Panos
- Journal article citation:
- British Journal of General Practice, 53(488), March 2003, pp.214-216.
- Publisher:
- Royal College of General Practitioners
The aim of this study was to establish the range of psychiatric disorders and psychiatric comorbidity among children and adolescents attending a primary mental health service (PMHS). The main psychiatric diagnostic categories were: oppositional defiant disorders (ODDs) (75.3%), anxiety disorders (36.1%), mood disorders (35.1%), and attention deficit hyperactivity disorders (ADHDs) (28.9%). The study found high rates (61.8%) of psychiatric comorbidity. It concludes that training in the recognition of likely psychiatric comorbidity in this population is essential for professionals working in the interface between primary and specialist services.