Zeiad Al Sayed

Clinical Psychologist, Riyadh, Saudi Arabia

Exposure to Trauma and Social Phobias Among Children Attending a Mental Health Service in Riyadh, Saudi Arabia

Background: Traumatic events can lead to a range of mental health problems. Previous research has largely focused on the association between trauma and post-traumatic stress disorders (PTSD), and found trauma exposure as the strongest predictor of PTSD. Various researchers have studied the association between trauma, depression, or/and anxiety. They found that mediating factors such as parental mental health and/or the individual's own response contribute to the development of these disorders. Other studies have investigated the relationship between trauma and phobia in general such as travelling phobia or agoraphobia, but there is limited knowledge on the association between trauma and social phobia. This was the rationale for this project.
Method: The broad research aim is to investigate the relationship between exposure to trauma and social phobia in children referred to hospitals providing mental health services in Riyadh city. The sample ages were range between 9 to 16 years. 97 children were recruited. Four groups of tools were used to collect data from the participants: first tool was for the socio-demographic, second tool was semi-structured diagnostic interview, third tool measure emotional symptoms, and fourth define mediating factors.  
Results: The primary result of this study demonstrates that there is a significant correlation between trauma and PTSD; in addition, there is association between the anxiety and depression with trauma and parental mediating factor. Moreover, there were significant correlation between social phobia and exposure to trauma, when analysed separately, although this association disappeared when social phobia comprising among the group. More examinations are in present action between the variables to explorer more correlations.   

Sarah Hogan

Nurse Consultant, Northamptonshire CAMHS

Partnerships: Are Child Mental Health and Education Services Ready?

The aim of this study is to establish how CAMHS are working in partnership with schools and educational services, and how the two organisations are set up and prepared to meet the new partnership-driven initiatives.

The importance of partnership working has been specifically defined in several policy documents (DoH, 1997, 1999, 2001, 2002; Audit Commission, 1998). For example, the NHS Plan (2000) announced the new agreement to pool budgets in new health and social care organisations. In others, partnership working has become inherent in the description of future services and expectations (DoH, 2003a and 2004; DfES, 2003). Despite this continued policy drive, how prepared are child mental health and education services for this change of direction and practice?

This qualitative research project will explore the following research questions:

• Are CAMHS working in partnership with schools and educational services?
• Do both services have sufficient knowledge and awareness of how each service supports the well-being of children and young people?
• How is the partnership working organised?
• Are CAMHS and educational services equipped to participate in the new planned service initiatives that outline the necessity for partnership working?
• Is partnership being valued?
• Are the goals of partnership working compatible with other goals?

The above will be established from the perspectives of key professional groups and managers across statutory health, and educational services. The definition of partnership working for this study will thus include a broad perspective from a fully integrated multi-agency team to collaboration between agencies. This will cover the breadth of policy, research and practice in this field.

  Tania Morris 

Senior Lecturer, University of Northampton

A qualitative study exploring how young people with mental health difficulties can be better supported in mainstream education

This study explores how young people with mental health difficulties can be 'better' supported in mainstream education. This study focuses on the school experiences of young people, aged 14 to 16 years of age, who are being supported by Specialist Child and Adolescent Services (CAMHS).

Little research is available into how young people identified with mental health difficulties view and interpret their school experiences. This study recognises the intrinsic link made between a young person's academic achievement and mental health wellbeing, noting the research, which suggests that young people with mental health problems are more likely to underachieve, putting them more at risk of social exclusion, unemployment and continued mental health problems.

Data will be obtained from three distinct groups: young people, their parents, and, their teachers using a semi structured interviewing technique. Consenting young people and their parents will be recruited via Northamptonshire Specialist CAMHS. Both parents and children will be interviewed in order to explore their perspectives of how learning can be 'better' supported. Permission will also be requested from the young person to contact a supporting teacher.
The teacher will then be interviewed to ascertain their perspectives on how they feel children with mental health difficulties can be 'best' supported. It is anticipated that around 18 participants from each sample group will be interviewed. The data will be collected and analysed with the aid of specialist software (Nvivo 7).

The research findings will be disseminated and it is hoped that this information will be used by specialist CAMHS practitioners and teachers to enable them to better support the education of young people with mental health difficulties.

 Lisa Marriott-Anderson  

Investigating Trainee Teachers and Teachers In-Practise Understanding of Mental Health and Child Development

Background: It is well documented that children and young people have high levels of unmet mental health need. Up to one in three children may have problems that require some support and one in ten may have more serious difficulties that impact on their functioning. However, only one in five children who require mental health services actually receives them. Unmet mental health needs can lead to distress for the individual child as well as their families and carers, and are associated with educational underachievement, family disruption, secondary impairment, peer relationship difficulties, and antisocial behaviour.

Schools have a significant influence on children’s development, and thus have an opportunity to detect mental health problems, manage those of lesser severity and complexity, and recognise and appropriately refer those who require specialist interventions. Teachers represent role models in their students lives and it is part of their role to be supportive and aware of difficulties with direct them to appropriate support when required. Accessing more specialist care relies on primary care workers to have ability to detect problems and have propensity to refer. However studies indicate that teachers often feel unconfident and untrained in dealing with children’s mental health issues. They cite limited and fragmented training as the most significant barrier in supporting individuals. Few teachers receive formal pre- or in-school training with regards to mental health and have a tendency to address behaviours in relation to learning abilities and focus on educational attainment rather than emotional need.

Objectives: To investigate trainee teachers and teachers in practise understanding of mental health and child development. Their attitudes towards mental health and the role they play in promoting mental health.

Pallab Majumder

Experiences of Unaccompanied Refugee Minors of their Contact with a Specialist Mental Health Service

This project has been continuing for approximately the last one and a half years. This will try to fill the gap in the knowledge on the experiences of unaccompanied refugee minors of their contact with the specialist mental health services. The sample consists of refugee children and young people who are unaccompanied. Data will be collected by interviewing the young people from the consecutive referrals to a Tier 3 CAMHS team for looked after children. Young people and their carers will be interviewed using a semi structured interview schedule. This project now has a full ethical approval and is at the stage of data collection.

This qualitative study will explore beliefs, perceptions and experiences of these unaccompanied refugee minors of their contact with specialist mental health service. All the possible ethical concerns have been taken into consideration in the research procedure to protect this sensitive and vulnerable young group. Once the data collection is completed, it will be transcribed and analysed using models of thematic analysis.

Elizabeth Hale

Children of parents with chronic inflammatory musculoskeletal diseases: Experiences, needs and resources

There are currently no educational resources for the children of parents with chronic inflammatory musculoskeletal diseases, yet data from the researcher’s early work in systemic lupus erythematosus (SLE) suggest major effects on the children and family unit. In other diseases it has been shown that the children of parents with long term conditions not only care for themselves, the ill parent and other family members, but also perform less well at school. Other studies suggest that having a parent with a chronic health condition can also have positive effects on the children within the family.
This project aims to discover what impact the children, the parents and their partners perceive that an inflammatory musculoskeletal disease such as SLE, Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Ankylosing Spondylitis (AS) have had on the family unit, what informational needs the children have, what resources they want, in what format, and when and by whom they should be delivered.  Mixed qualitative methodologies will include interviews, with the option for children to supplement their data by creating drawings and posters or story-boards to express their views.  Interview and visual data analysis will be carried out using Interpretative Phenomenological Analysis (IPA), a qualitative approach increasingly used in healthcare research.
These data will help us to understand the impact of a parent’s chronic inflammatory musculoskeletal disorder upon the family unit and what educational resources the children within these families would like to have to help them understand their parents’ condition. We will also ascertain what format these resources should take, and at what stage they should be made available to the children and families and whether they should be ‘stand alone’ resources or delivered by a third party.