Predictors of Service Use for Mental Health Problems Among British Schoolchildren.

BACKGROUND: Most previous studies of service use in relation to mental health have examined services in the USA. We wanted to provide up-to-date findings from a general population sample of British schoolchildren. METHOD: A total of 2461 children aged 5-15 from the 1999 British Child and Adolescent Mental Health Survey were followed up for 3 years. We examine the relationship between a wide variety of potential predictors gathered in 1999 and the use of services over the following 3 years. RESULTS: Contact with most services was predicted by three factors: the impact of psychopathology; contact with teachers or primary health care; and parents' and teachers' perceptions that the child had significant difficulties. Other predictors were specific to each service. CONCLUSIONS: Education of parents, teachers and other important adults might increase the proportion of children with impairing psychiatric disorders reaching services.

The children's services interview: validity and reliability.

BACKGROUND: The Children Service Interview was designed as a brief measure of service use related to mental health problems in Great Britain. METHOD: We validated the Children's Services Interview against medical records from a sample of 87 children, and assessed test-retest reliability from 25 parents completing two interviews. We examined criterion validity by looking at the service use patterns of children attending clinics for different types of disorders. RESULTS: The Children's Services Interview showed high levels of face validity and moderate or better concordance with medical records as far as contacts were recorded in the case notes. Test-retest reliability was moderate or better apart from contacts with the voluntary sector, teachers, and the number and duration of appointments with some professionals. CONCLUSION: The study suggests the Children's Services Interview can extract moderately valid and reliable data on service use. DECLARATION OF INTEREST: Tamsin Ford was supported by a Wellcome Clinical Training Fellowship in Health Services Research while completing this work.

Child Mental Health is Everybody's Business: The Prevalence of Contact with Public Sector Services by Type of Disorder Among British School Children in a Three-Year Period.

METHOD: A third of the children from the 1999 British Child and Adolescent Mental Health Survey were followed-up over 3 years. Parents provided summary information on service contacts in relation to mental health; selected subgroups provided more detailed information by telephone interview. RESULTS: Common overlaps in service use were between health services, between teachers and educational specialists, and between the latter and CAMHS or social services. Services other than primary health care saw more children with externalising disorders, while children with anxiety disorders were less likely than children with other psychiatric disorders to be in contact with any service. CONCLUSIONS: Child mental health is everybody's business, and professionals need to be alert(ed) to the types of disorders that children using their service may have.

Service Contacts Among the Children Participating in the British Child and Adolescent Mental Health Surveys.

METHOD: A third of the children from the 1999 British Child and Adolescent Mental Health Survey were followed up over 3 years. Parents provided summary information on service contacts for emotional, behavioural and concentration difficulties, with more detailed information being obtained by telephone interview for selected subgroups. RESULTS: Having a psychiatric disorder predicted substantially increased contact with social services, special educational needs resources, the youth justice system and mental health services (district CAMHS and tier four, but not tier two). Of those children with psychiatric disorders, 58% had been in contact with at least one of these services for help with emotional, behavioural or concentration difficulties, including 23% who had been in contact with mental health services. CONCLUSIONS: British children attend a wide variety of services for help with emotional, behavioural and concentration difficulties. The proportion seeing specialist mental health services is higher than that generally reported in the research literature.

The use of the Strengths and Difficulties Questionnaire (SDQ) in Southern European countries.

This paper reports a selection of completed or ongoing studies that have evaluated or applied the Strengths and Difficulties Questionnaire (SDQ) in five countries of Southern Europe: Italy, Spain, Portugal, Croatia, and France. In Italy, the SDQ has been used to study its concurrent validity with other norm-based instruments (Child Behavior Checklist-CBCL and Disruptive Behavior Disorder Rating Scale-DBDRS), to assess the efficacy of a behavioural school training, and as part of an epidemiological study. In Spain, the SDQ was used to analyse the association between respiratory and other behavioural problems. In Portugal and Croatia, psychometric properties of the three versions of the SDQ (parent, teacher, and self-reports) were investigated in samples of children ranging from 5 to 16 years. Past and ongoing studies in France have administered the SDQ to estimate inter-rater agreement between parents, teachers, and pupils, to carry out a large-scale epidemiological study, and to evaluate the efficacy of a parent training programme. In a second section, scale means obtained with the teacher version of the SDQ in three community-based samples of 7-8 year-old children from Italy, Portugal, and Spain are compared. The results show that, according to their teachers' ratings, Italian pupils showed less prosocial behaviour than their Spanish and Portuguese agemates, whereas the Portuguese children were rated as being more hyperactive and inattentive than comparable Italian and Spanish children. Possible causes underlying the observed differences between national SDQ means are discussed.