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Published on: September 19, 2019
Universal Child Mental Health Screening for Parents: a Systematic Review of the Evidence
Shona K Brinley1, Lucy A Tully2, Talia Carl2
1The School of Psychology, The Faculty of Science, The University of Sydney, Sydney, NSW, Australia. shona.brinley@anu.edu.au.
Insights
Parent reported universal mental health screening (UMHS) is generally accepted by parents for early identification of child mental health risks. However, more research is needed to confirm its effectiveness and address barriers like stigma.
Area of Science:
- Child and Adolescent Psychiatry
- Public Health
- Mental Health Services Research
Background:
- Early identification of child mental health disorders is crucial, but many cases are missed or diagnosed late.
- Parent reported universal mental health screening (UMHS) aims to improve early detection and intervention for at-risk children.
- Existing research on the effectiveness and parental engagement with UMHS is limited.
Approach:
- A systematic review was conducted by searching six databases for peer-reviewed primary research on parent-reported UMHS.
- Ten studies involving 3,464 parents of children aged 0-18 years were included, focusing on effectiveness, acceptability, barriers, and enablers.
- Studies were assessed for quality using the Mixed Methods Appraisal Tool, revealing varied quality across the included research.
Key Points:
- Parents generally express support and acceptance for UMHS.
- Limited evidence suggests UMHS may increase referrals and adherence to follow-up care.
- Common barriers to UMHS implementation include concerns about confidentiality and social stigma.
Conclusions:
- Parental attitudes towards UMHS are vital for successful implementation and improved child mental health outcomes.
- There is a significant need for more high-quality research, including randomized controlled trials, to establish the effectiveness and acceptability of UMHS.
- Addressing parental concerns and understanding contextual factors are essential for optimizing UMHS in diverse settings.
Abstract:
Childhood represents a critical window for the emergence and treatment of mental health disorders, yet many are not being identified, or are identified too late to receive adequate intervention. This systematic review (Prospero registration: CRD42022299560) aimed to determine the effectiveness and acceptability of parent reported universal mental health screening (UMHS) to improve the early identification of children at-risk of mental health difficulties, and to identify barriers and enablers that may influence parental engagement. Six databases were searched in February 2022 for peer-reviewed, primary research. Studies conducted in targeted populations, evaluating psychometric properties, or focused on screening non-psychological problems were excluded. Ten studies examined parent reported (n = 3,464 parents) UMHS for children from birth to 18 years, suggesting an overall scarcity of research. Findings are presented in a table of study characteristics and a narrative summary of acceptability, effectiveness, barriers, and enablers. Quantitative findings indicated that parents generally support and accept UMHS. Research assessing effectiveness was limited, although two studies indicated increased referrals and referral adherence following positive screens. Confidentiality and stigma were commonly identified barriers. Quality assessment using the Mixed Methods Appraisal Tool indicated that studies varied in quality, meeting four to seven of the seven quality criteria. Understanding and addressing parent attitudes to UMHS across settings is necessary for the successful implementation of screening and improvement of child mental health outcomes. More high-quality research studies, including randomized controlled trials are therefore needed to examine the acceptability and effectiveness of UMHS for parents and their children.
