I am a first year PhD student at UCL Great Ormond Street Institute of Child Health. My project is focused on implementing and evaluating mental health drop-in centres at paediatric hospitals. I am interested in brief and low-intensity psychological interventions for children and families with chronic illnesses who are concerned about their mental health. In the first year of my PhD I have been conducting a systematic review exploring the barriers and facilitators to implementing similar psychological interventions for children and young people and look forward to using these findings as we open our drop-in mental health centres at other hospitals across the UK.
Despite research demonstrating that brief and low intensity psychological interventions are beneficial for children and young people with emotional, behavioural or mental health difficulties, there remains a significant implementation gap, leaving many children awaiting treatment. Innovative approaches are needed to develop, disseminate and implement appropriate psychological interventions.
We conducted a rapid realist review to understand the barriers and facilitators to implementing brief or low-intensity psychological interventions in children and young people (PROSPERO protocol: CRD42022307367). We searched PsycInfo, EMBASE and Medline from inception to March 2022. Papers included in the review identified methods, factors and/or processes for the adoption, implementation or sustainability of brief and/or low intensity psychological interventions for children and young people (5-25 years) with emotional, behavioural or mental health difficulties. A systematic approach to data extraction using Normalisation Process Theory (NPT) highlighted key barriers and facilitators.
9 papers, including 10 interventions with over 500 participants, met eligibility criteria. A variety of brief and/or low intensity psychological interventions were delivered across different settings by a range of individuals and common mechanisms were identified that promoted or impeded implementation. . Barriers included: 1) organisational demands such as cost, capacity and time restraints 2) poor training and communication and 3) mental health stigma. Facilitators to implementation were 1) the availability of an implementation strategy, 2) interventions that are easily explained to children and families and 3) detailed training and continued communication.
Our rapid realist review identified mechanisms and factors that need to be considered to optimise the implementation of brief and low-intensity interventions for children and young people with emotional, behavioural or mental health needs. Our findings can inform future implementation studies. Future research could consider creating a toolkit to help monitor and evaluate uptake into routine practice.