Acceptability and Feasibility of Early Identification of Mental Health Difficulties in Primary Schools: A Qualitative Ex
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ORIGINAL PAPER
Acceptability and Feasibility of Early Identification of Mental Health Difficulties in Primary Schools: A Qualitative Exploration of UK School Staff and Parents’ Perceptions J. Childs‑Fegredo1,2 · A.‑M. Burn3 · R. Duschinsky1 · A. Humphrey4 · T. Ford3 · P. B. Jones4 · E. Howarth1,5 Accepted: 28 October 2020 © The Author(s) 2020
Abstract One in eight children aged 5–19 years in the UK suffer from a psychiatric disorder, while fewer than 35% are identified and only 25% of children access mental health services. Whilst government policy states that primary schools are well-placed to spot the early warning signs of mental health issues in children, the implementation of early identification methods in schools remains under-researched. This study aims to increase understanding of the acceptability and feasibility of different early identification methods in this setting. Four primary schools in the East of England in the UK participated in a qualitative exploration of views about different methods that might enhance the early identification of mental health difficulties (MHDs). Twenty-seven staff and 20 parents took part in semi-structured interviews to explore current and future strategies for identifying pupils at risk of experiencing MHDs. We presented participants with four examples of identification methods selected from a systematic review of the literature: a curriculum-based approach delivered to pupils, staff training, universal screening, and selective screening. We used NVivo to thematically code and analyse the data, examining which models were perceived as acceptable and feasible as well as participants’ explanations for their beliefs. Three main themes were identified; benefits and facilitators; barriers and harms, and the need for a tailored approach to implementation. Parents and staff perceived staff training as the most acceptable and feasible approach to systematic identification, followed by a curriculumbased approach. Universal and selective screening garnered mixed responses. Findings suggest that a systematic and tailored approach to early identification would be most acceptable and feasible, taking into consideration school context. Teacher training should be a core component in all schools. Keywords Early identification · Social emotional mental health · Screening · Primary schools
Introduction * J. Childs‑Fegredo [email protected] 1
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
2
Present Address: Department of Psychology, University of Roehampton, London SW15 4JD, UK
3
Department of Psychiatry, University of Cambridge, Cambridge, UK
4
Department of Psychiatry, University of Cambridge, NIHR Applied Research Collaboration East of England, and Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
5
Present Address: School of Psychology, University of East London, London, UK
One in eight children aged 5–19 years suffer from psychiatric disorder and many more experience symptoms that, whilst not reaching
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