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Towards a definition of multiple and complex needs in children and youth: Delphi study in Flanders and international

Helena Van den Steene1,2, Dirk van West1,2,3, Inge Glazemakers1,2

  • 1Collaborative Antwerp Psychiatric Research Institute - Youth, University of Antwerp, Belgium.

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology
|February 1, 2021
PubMed

Insights

A new definition for children and youth with multiple and complex needs (MCN) was developed. This agreed-upon definition will help professionals optimize care and conduct research for this vulnerable population.

Area of Science:

  • Child and Adolescent Health
  • Social Work and Public Health
  • Psychiatry and Psychology

Background:

  • Children and youth with multiple and complex needs (MCN) face developmental challenges and difficulties interacting with various professionals.
  • Currently, there is no universally accepted definition for this vulnerable population, hindering effective support.
  • The lack of a clear definition complicates care delivery and professional collaboration.

Purpose of the Study:

  • To establish a consensus-based definition of 'multiple and complex needs in children and youth' (MCN).
  • To create a definition that is practical and meaningful for all professionals involved in the care of these young individuals.
  • To improve the understanding and identification of children and adolescents requiring specialized support.

Main Methods:

  • A Delphi study involving 47 multidisciplinary experts from Flanders (mental health, youth care, juvenile justice, education).
  • Qualitative analysis of initial responses, followed by ranking of definition options and agreement ratings.
  • International expert validation through an additional survey with 25 experts.

Main Results:

  • A consensus definition was reached: Children and adolescents with profound, interacting needs across multiple life domains (family, societal functioning) and psychiatric issues.
  • Their needs exceed current service capacities, leading to fragmented care.
  • The definition was highly endorsed by Flemish (93.2%) and international (88%) experts, highlighting its relevance.
  • High response rates (76.6% to 91.3%) across Delphi rounds indicate robust consensus.

Conclusions:

  • The Delphi method successfully generated an internationally relevant definition for children and youth with MCN.
  • An agreed-upon definition is crucial for enhancing care delivery and advancing research in this field.
  • This definition provides a foundation for integrated, assertive, and effective support systems.
Abstract

Keywords:
Delphi studychild serving agencieschildren and adolescentsdefinitionmultiple and complex needs

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