09:09pm Tuesday 22 October 2019

Stark evidence about child and adolescent mental health

Evidence from four Health Research Board funded studies will be discussed at the first national research conference on Youth Mental Health taking place on Friday 14th October in the Royal College of Surgeons in Ireland (RCSI).

Speaking about her research project which examined rates of psychiatric illness among Irish adolescents, Professor Mary Cannon, a HRB-Clinician Scientist and Consultant Psychiatrist at Beaumont Hospital and RCSI says,

‘We conducted a HRB-funded survey of 11-13 year old primary school students in North and West Dublin and Kildare. In total 1,131 children were surveyed using a Strengths and Difficulties Questionnaire This is a simple yet effective screening tool which can reliably indicate children at risk of suffering from a mental health disorder. From that 21.5% were found to have scores indicating risk for psychiatric disorder.

We then invited a random sample of these children for full clinical interview and found that 15% fulfilled criteria for a current mental disorder and 37% had experienced a diagnosable mental disorder at some stage in their lifetime.

The commonest mental disorders were anxiety and depressive disorders which, between them accounted for 66% of the lifetime disorders among these young people.

Many children had more than one diagnosis as 15% of children had two or more disorders while 5% had three or more.

These figures match with a study done 10 years ago by UCD Professor Carol Fitzpatrick in North Dublin and our figures are in broad agreement with similar studies from the UK.

International research strongly indicates that the economic costs related to childhood mental disorders are far more important than physical illnesses during childhood and that effective early intervention and treatment would have long lasting beneficial impacts for both the patient and society. Currently children’s medical services would appear to be heavily geared towards physical ailments, and this research, amongst others would suggest that we may need to realign physical and mental health services, and also include a more holistic approach to identify and treat at risk children. This would involve parents, teachers and medical professionals. We hope to re-survey the children in a few years and track these rates over time.’

A second HRB-funded project aims to provide comprehensive policy recommendations to manage the transition from child to adult mental health services. According to Dr Niamh McNamara, a HRB-Postdoctoral Research Fellow in the School of Medicine and Medical Science, UCD,

‘Our research is the first attempt in Ireland to fully understand the process involved when young people transfer from child and adolescent mental health services to adult services. Given the enduring nature of some psychiatric illnesses, many young people will require transfer from youth services to adult services. It is very important for their care, that there should be a smooth transition.

The development of policy should consider current practice on the ground and the available resources. Consequently our project is divided into three stages so that we can get as many relevant perspectives on this issue as possible, and hence come up with a solid evidence base for our recommendations. Stage one of the project involves looking at what actually happens during the transition process at the moment by speaking to clinicians and conducting a thorough audit of cases. At Stage two we’ll speak to young people themselves, their parents or carers, and GPs, essentially as many people as possible in order to get a broad overview of the experience of transition. And at stage three we hope to recruit young people about to go through the transition in order to document their experiences as they happen.

After all this, we aim to produce a comprehensive set of evidenced-based recommendations that will inform national policy and ensure consistent and appropriate care during young peoples’ transition from child to adult mental health services.’

Professor Fiona McNicholas, Consultant in Child Psychiatry at Lucena Clinic and Our Lady’s Hospital for Sick Children, Crumlin and the principal investigator on the project adds,

‘The preliminary data from stage one of the project suggests that there is a lack of formalised transition care arrangements and lack of uniformity around the age of transition and potentially a need for services to work together to jointly manage the transition process.

‘These research studies will provide a solid base upon which to devise national policies’, says Mr Enda Connolly, Chief Executive of the HRB. ‘It is timely that in World Mental Health Week, our funded research is making a genuine contribution to better care for Irish patients.’

Both of the above papers will be presented at the first national research conference on Youth Mental Health which will take place on Friday 14th October at the Royal College of Surgeons in Ireland, St Stephens Green Dublin. The conference will be launched by Minister Kathleen Lynch T.D., Minister of State for Mental Health. The full programme of speakers is available in the document attached below. Members of the media are welcome to attend the event for free, but pre-registration is required.

Registration queries should be addressed to Sophie Hinton-Lever at sophie.hinton-lever@acamh.com


Notes for editors:

The Health Research Board (HRB) was established in 1986. For the last 25 years it has been Ireland’s lead agency in supporting and funding health research. The HRB’s mission is to improve people’s health, patient care and health service through leading and supporting research and generating knowledge and promoting its application in policy and practice. The HRB has supported research which has played a key role in innovation in Ireland’s health system and its economic development.

The four Health Research Board funded projects amongst the full programme are:

Prevalence of psychiatric disorders among young people in Dublin: a community-based study: Professor Mary Cannon, RCSI and Beaumont Hospital.

Transition from CAMHS to adult mental health services in Ireland: An investigation of operational policies for 16 to 18 year olds: Dr Niamh McNamara, School of Medicine and Medical Sciences, UCD.

Working Things Out – an evidence-based programme to engage young people: Professor Carol Fitzpatrick, UCD and Mater Hospital Dublin. (Link to recent HRB news story about the Working Things Out programme.)

Screening and Early Intervention for Mental and Substance Use Disorders in the Community: Professor Walter Cullen, Dept of Primary Care, University of Limerick.

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