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Waiting-list interventions for children and young people using child and adolescent mental health services: a
Althea Z Valentine1, Sophie S Hall2, Kapil Sayal3
1NIHR MindTech MedTech Co-operative, Institute of Mental Health, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK althea.valentine@nottingham.ac.uk.
Insights
Mental health waiting list interventions show promising results for children and young people, despite limited research. Further robust studies are needed to confirm benefits and explore service efficiency.
Area of Science:
- Child and Adolescent Mental Health
- Systematic Review
- Intervention Research
Background:
- Children and young people face significant delays in accessing mental health services.
- Waiting list periods can exacerbate mental health conditions.
- There is a need to identify effective interventions during these waiting periods.
Approach:
- A systematic literature search was conducted across major databases (2000-2023).
- Included studies focused on interventions supporting youth on mental health service waiting lists.
- Data were extracted and synthesized narratively.
Key Points:
- Eighteen studies involving 1253 youth were reviewed, covering diverse conditions like autism, anxiety, and self-harm.
- Interventions were often multi-component, frequently including psychoeducation, parental support, and coaching.
- All studies reported positive clinical outcomes, feasibility, or acceptability, though service efficiency was under-researched.
Conclusions:
- While research is limited, findings from small-scale studies on waiting list interventions are promising.
- Further high-quality research with robust designs is essential.
- Real-world implementation studies are needed to validate these interventions.
Question:
Children and young people experience delays in assessment and/or treatment within mental health services. The objective of this systematic review, funded by the Emerging Minds Network, was to explore the current evidence base for mental health waiting list interventions to support children and young people.
Study Selection And Analysis:
A literature search was conducted in MEDLINE, PsycINFO, Web of Science and the Cochrane databases from 2000 to 2023 (last searched October 2023). Included studies described interventions to support children and young people and/or their family while on a waiting list for child and adolescent mental health services. Titles and abstracts were screened independently by two reviewers, data were extracted by one reviewer, confirmed by a second and a narrative synthesis was provided.
Findings:
Eighteen studies including 1253 children and young people were identified. Studies described waiting list interventions for autism spectrum disorders, eating disorders, generic conditions, transgender health, anxiety/depression, self-harm and suicide and behavioural issues. Many interventions were multicomponent; 94% involved psychoeducation, other components included parental support, bibliotherapy and coaching. Duration of the interventions ranged from a single session to over a year; 66% involved face-to-face contact. All studies demonstrated benefits in terms of improved clinical outcomes and/or feasibility/acceptability. Evidence for service outcomes/efficiency was largely unexplored. Limitations of the underpinning research, such as sample size and low-quality papers, limit the findings.
Conclusions:
There is limited research exploring waiting list interventions, however, the findings from small-scale studies are promising. Further research using robust study designs and real-world implementation studies are warranted.
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