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A systematic review of effectiveness and cost-effectiveness of school-based identification of children and young people at risk of, or currently experiencing mental health difficulties
- Joanna K. Anderson, Tamsin Ford, Emma Soneson, Jo Thompson Coon, Ayla Humphrey, Morwenna Rogers, Darren Moore, Peter B. Jones, Emmet Clarke, Emma Howarth
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- Journal:
- Psychological Medicine / Volume 49 / Issue 1 / January 2019
- Published online by Cambridge University Press:
- 13 September 2018, pp. 9-19
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- Article
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Background
Although school-based programmes for the identification of children and young people (CYP) with mental health difficulties (MHD) have the potential to improve short- and long-term outcomes across a range of mental disorders, the evidence-base on the effectiveness of these programmes is underdeveloped. In this systematic review, we sought to identify and synthesise evidence on the effectiveness and cost-effectiveness of school-based methods to identify students experiencing MHD, as measured by accurate identification, referral rates, and service uptake.
MethodElectronic bibliographic databases: MEDLINE, Embase, PsycINFO, ERIC, British Education Index and ASSIA were searched. Comparative studies were included if they assessed the effectiveness or cost-effectiveness of strategies to identify students in formal education aged 3–18 years with MHD, presenting symptoms of mental ill health, or exposed to psychosocial risks that increase the likelihood of developing a MHD.
ResultsWe identified 27 studies describing 44 unique identification programmes. Only one study was a randomised controlled trial. Most studies evaluated the utility of universal screening programmes; where comparison of identification rates was made, the comparator test varied across studies. The heterogeneity of studies, the absence of randomised studies and poor outcome reporting make for a weak evidence-base that only generate tentative conclusions about the effectiveness of school-based identification programmes.
ConclusionsWell-designed pragmatic trials that include the evaluation of cost-effectiveness and detailed process evaluations are necessary to establish the accuracy of different identification models, as well as their effectiveness in connecting students to appropriate support in real-world settings.
1 - Prevalence and physical health impact of domestic violence
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- By Emma Howarth, University of Bristol, Gene Feder, University of Bristol
- Edited by Louise Howard, Gene Feder, Roxanne Agnew-Davies
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- Book:
- Domestic Violence and Mental Health
- Published by:
- Royal College of Psychiatrists
- Published online:
- 25 February 2017, pp 1-17
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Summary
Domestic violence and abuse is threatening behaviour, violence or abuse between adults who are relatives, partners or ex-partners. It includes abuse from adult children and from parents of adult children. Domestic violence is a breach of human rights as well as a major public health and clinical problem. In this chapter we focus largely on violence between partners or ex-partners when discussing prevalence, and exclusively on partner violence when reviewing evidence on the health impact of domestic violence and abuse, as this is the focus of most research to date.
Definition of intimate partner violence
Intimate partner violence is a form of domestic violence occurring between intimate partners or ex-partners. Whereas violence between partners occurs in all types of relationships and cuts across all sections of society, intimate partner violence is recognised as a gendered issue where women are overwhelmingly more likely to be injured as a result of violence, require medical attention or hospital admission, and fear for their lives, and men are more likely to perpetrate violence. Internationally, there are no consistent demographic associations with intimate partner violence, such as ethnicity, age and number of children, other than relative poverty. Although it is prevalent across the socioeconomic spectrum, intimate partner violence is more common in families and communities which are relatively deprived (Pickett & Wilkinson, 2009). In the UK, the USA and Canada, younger women (aged between 16 and 34) experience the highest rates of intimate partner violence (Smith et al, 2011; Catalano, 2012; Sinha, 2012) and there is some evidence that women with disabilities are at increased risk (Mirlees-Black, 1999).
In earlier decades, terms such as wife abuse, conjugal violence and spousal abuse were commonplace, but they have been superseded by more general terms, such as domestic violence, in recognition that violence and abuse does not just occur between married couples. In the UK, domestic violence has a precise definition denoting violence between adults who are relatives, partners or ex-partners (Home Office, 2012). Intimate partner violence specifically refers to abuse from partners or ex-partners, distinguishing it from other forms of violence that may occur in a family or domestic setting.
1 - Prevalence and physical health impact of domestic violence
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- By Emma Howarth, Research Associate, School of Social and Community Medicine, University of Bristol, Gene Feder, Professor of Primary Health Care, School of Social and Community Medicine, University of Bristol
- Edited by Louise M. Howard, Gene Feder, Roxanne Agnew-Davies
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- Book:
- Domestic Violence and Mental Health
- Published online:
- 01 January 2018
- Print publication:
- 01 May 2013, pp 1-17
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- Chapter
- Export citation
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Summary
Domestic violence and abuse is threatening behaviour, violence or abuse between adults who are relatives, partners or ex-partners. It includes abuse from adult children and from parents of adult children. Domestic violence is a breach of human rights as well as a major public health and clinical problem. In this chapter we focus largely on violence between partners or ex-partners when discussing prevalence, and exclusively on partner violence when reviewing evidence on the health impact of domestic violence and abuse, as this is the focus of most research to date.
Definition of intimate partner violence
Intimate partner violence is a form of domestic violence occurring between intimate partners or ex-partners. Whereas violence between partners occurs in all types of relationships and cuts across all sections of society, intimate partner violence is recognised as a gendered issue where women are overwhelmingly more likely to be injured as a result of violence, require medical attention or hospital admission, and fear for their lives, and men are more likely to perpetrate violence. Internationally, there are no consistent demographic associations with intimate partner violence, such as ethnicity, age and number of children, other than relative poverty. Although it is prevalent across the socioeconomic spectrum, intimate partner violence is more common in families and communities which are relatively deprived (Pickett & Wilkinson, 2009). In the UK, the USA and Canada, younger women (aged between 16 and 34) experience the highest rates of intimate partner violence (Smith et al, 2011; Catalano, 2012; Sinha, 2012) and there is some evidence that women with disabilities are at increased risk (Mirlees-Black, 1999).
In earlier decades, terms such as wife abuse, conjugal violence and spousal abuse were commonplace, but they have been superseded by more general terms, such as domestic violence, in recognition that violence and abuse does not just occur between married couples. In the UK, domestic violence has a precise definition denoting violence between adults who are relatives, partners or ex-partners (Home Office, 2012). Intimate partner violence specifically refers to abuse from partners or ex-partners, distinguishing it from other forms of violence that may occur in a family or domestic setting.