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Introduction: The COVID-19 pandemic has introduced new stressors for parents ('caregivers') that may affect their own and their child's mental health (MH). We explored self-reported levels of caregiver strain (parents' perceived ability to meet parenting demands), and the MH and sociodemographic factors of caregivers to identify predictors of strain that can be used to guide MH service delivery for families. Methods: We administered a web-based survey to Ontario caregivers with a child between 4 and 25 years old, between April and June 2020. We analyzed information from 570 maternal caregivers on their sociodemographics, youngest (or only) child's MH, their own MH, and the degree of caregiver strain experienced since the pandemic. We used linear regressions (unadjusted and adjusted models) to explore the relationship between caregiver strain and sociodemographics, child MH and caregiver MH. Results: Over 75% of participants reported 'moderate-to-high' caregiver strain. More than 25% of caregivers rated their MH as 'poor' and 20% reported moderate-to-severe anxiety. Forty-five percent of the variance in caregiver strain was accounted for by child age, caregiver anxiety, and multiple child and caregiver MH variables. Younger child age and higher caregiver anxiety were the greatest predictors of caregiver strain. Conclusion: We found a relationship between child age, child and caregiver MH variables, and caregiver strain. Given the interrelatedness of these factors, supporting caregivers' MH and lessening their role strain becomes critical for family well-being. Evidence-based individual, family, and public health strategies are needed to alleviate pandemic-related strain. Keywords: parents, caregivers, caregiver strain, COVID-19, mental health, Introduction The COVID-19 pandemic has introduced new stressors for parents ('caregivers') by increasing their roles and responsibilities, while restricting their social supports and usual coping strategies (Fontanesi et al., 2020). [...]

Communimetric screening tools help clinicians identify and communicate their patient's areas of need and the corresponding level of action. However, few tools exist to identify mental health (MH) and developmental needs in young children. We aimed to implement and evaluate a new communimetric MH and developmental screening tool for children under 6 (HEADS‐ED Under 6) in a community MH agency in Ontario, Canada. Using a prospective cohort design, we explored how intake workers used the HEADS‐ED Under 6 screening tool from November 2019 to March 2021. 94.5% of children (n = 535/566) were screened with the HEADS‐ED at intake. Total HEADS‐ED scores and domains were used to inform the intensity of recommended services. Three clinical domains (Eating & sleeping, Development, speech/language/motor, and Emotions & behaviors) also independently predicted a priority recommendation. The tool showed good concordance with the InterRAI Early Years for children under 4 years old. The HEADS‐ED Under 6 was a brief, easy, and valid screening tool, and can be used to identify important MH and developmental domains early, rate level of action/impairment, communicate severity of needs, and help determine intensity of service required. [ABSTRACT FROM AUTHOR]

Trauma-informed care (TIC) is an approach to care emerging in research and in practice that involves addressing the needs of individuals with histories of trauma. The aim of this scoping review was to examine the current literature relating to TIC interventions used in pediatric mental health inpatient and residential settings. We sought to answer the following two research questions: (a) What are the TIC interventions used in pediatric inpatient and residential treatment mental healthcare settings and what are their components? and (b) What are the implementation goals and strategies used with these TIC interventions? We conducted this scoping review according to JBI (formerly Joanna Briggs Institute) methodology for scoping reviews. We included any primary study describing a TIC intervention that was implemented at a specific site which identified and described implementation strategies used. Of 1,571 identified citations and 54 full-text articles located by handsearching, 49 met the eligibility criteria and were included, representing 21 distinct TIC interventions. We present the reported aim, ingredients, mechanism, and delivery (AIMD) of TIC interventions as well as the implementation goals and strategies used, which varied in detail, ranging from very little information to more detailed descriptions. In the context of these findings, we emphasize the complexity of TIC and of TIC interventions, and the importance of identifying and clearly reporting TIC intervention goals, intervention details, and implementation strategies. We suggest applying intervention frameworks or reporting guidelines to support clear and comprehensive reporting, which would better facilitate replication and synthesis of published TIC interventions. [ABSTRACT FROM AUTHOR]

Aims Design and Methods Findings Conclusion Impact Reporting Method Patient or Public Contribution To explore youth, caregiver and staff perspectives on their vision of trauma‐informed care, and to identify and understand potential considerations for the implementation of a trauma‐informed care programme in an inpatient mental health unit within a paediatric hospital.We applied the Interpretive Description approach, guided by complexity theory and the Implementation Roadmap, and used Applied Thematic Analysis methods.Twenty‐five individuals participated in individual or group interviews between March and June 2022, including 21 healthcare professionals, 3 youth and 1 caregiver. We identified two overarching themes. The first theme, ‘Understanding and addressing the underlying reasons for distress’, related to participants’ understanding and vision of TIC in the current setting comprising: (a) ‘Participants’ understanding of TIC’; (b) ‘Trauma screening and trauma processing within TIC’; (c) ‘Taking “a more individualized approach”’; (d) ‘Unit programming’; and (e) “Connecting to the community”. The second theme, ‘Factors that support or limit successful TIC implementation’ comprises: (a) ‘The need for a broad “cultural shift”’; (b) ‘The physical environment on the unit’; and (c) ‘Factors that may limit successful implementation’.We identified five key domains to consider within trauma‐informed care implementation: (a) the centrality of engagement with youth, caregivers and staff in trauma‐informed care delivery and implementation, (b) trauma‐informed care core programme components, (c) factors that may support or limit success in implementing trauma‐informed care within the mental health unit and (d) hospital‐wide and (e) the importance of intersectoral collaboration (partnering with external organizations and sectors). When implementing TIC, there is an ongoing need to increase clarity regarding TIC interventions and implementation initiatives. Youth, caregiver and healthcare professional participants shared considerations important for planning the delivery and implementation of trauma‐informed care in their setting. We identified five key domains to consider within trauma‐informed care implementation: (a) the centrality of relational engagement, (b) trauma‐informed care programme components, (c) factors that may support or limit successful implementation of trauma‐informed care within the mental health unit and (d) hospital‐wide and (e) the importance of intersectoral collaboration. Organizations wishing to implement trauma‐informed care should consider ongoing engagement with all relevant knowledge user groups throughout the process. Standards for Reporting Qualitative Research (SRQR).The local hospital research institute's Patient and Family Advisory Committee reviewed the draft study methods and provided feedback. [ABSTRACT FROM AUTHOR]

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Individuals experiencing non-suicidal self-injurious (NSSI) thoughts only are greatly overlooked by current research. This investigation aimed at determining how three groups of university students differed in their reported quality of childhood relationships with parents, and histories of physical and sexual abuses. These groups included students experiencing only NSSI thoughts (n = 126), students engaging in NSSI actions (n = 90), and students exhibiting neither (n = 1,080). Results showed that individuals experiencing NSSI thoughts only, and those engaging in NSSI actions reported poorer relationships with parents and more physical abuse than the No NSSI group; however, NSSI thoughts and NSSI action groups had similar outcomes to one another for most variables. These findings suggest that individuals experiencing only NSSI thoughts share similar negative childhood environments associated with engagement in NSSI action and that they should be included in future research, particularly investigations aimed at identifying protective factors that could prevent them from engaging in NSSI.

An innovative crisis intervention programme was created at the Children's Hospital of Eastern Ontario in Canada in order to provide emergency assessments for youth presenting with mental health crises. The current investigation presents an overview of the programme and examines the emergency staff's perception and satisfaction with it. Eighty-seven emergency department medical staff completed a survey. Overall, emergency department staff place high value on having access to emergency mental health services, are pleased with the quality of service and appreciate that the crisis intervention worker's presence allows them to spend more time with other patients. (Contains 4 tables.)

During the potentially tumultuous adolescent period, non-suicidal self-injury (NSSI) and suicide attempts are relatively common, particularly amongst youth who present to mental health services. These phenomena frequently co-occur but their relationship is unclear. This study evaluated clinical data from 468 youth between the ages of 12 and 17 years (63.5% female) to determine the incidence of NSSI 24 h prior to presentation at emergency crisis services, evaluated the overlap between NSSI and suicide attempt, and examined the characteristics of different types of self-harm. Half of the adolescents presenting to emergency crisis services had self-harmed within the previous 24 h, with most of these (91%) classified as NSSI only. The percentage of youth with a suicide attempt was 5% and the co-occurrence of these two behaviours was 4%. Group differences in depressive symptoms, suicidal ideation and impulsivity were identified, with the co-occurring NSSI and suicide attempt group presenting with the highest level of psychopathology. This study underscores the necessity of assessing suicidal ideation and NSSI in all youth presenting to mental health services.

Couples with chronically ill children are particularly at risk for experiencing marital distress. The study presented here is a 2-year follow-up of a randomized control trial that assessed the efficacy of Emotionally Focused Therapy (EFT) in decreasing marital distress in a sample of couples with a chronically ill child. Thirteen couples with chronically ill children who received treatment were assessed to determine if the significant improvement in relationship distress observed at posttreatment and 5-month follow-up would be maintained at 2-year follow-up. Results demonstrated that improvements in marital functioning were not only maintained but, in some cases, enhanced at the 2-year follow-up. This uncontrolled follow-up study provides initial evidence of the longer-term benefits of EFT.

A study evaluated the emotional and behavioral adjustment of 92 parents and 56 children within three months and one year after the discovery of extrafamilial sexual abuse. Parents and children experienced clinically significant effects, both initially and at 12 months' post-disclosure. Children's self-blame and extent of traumatization predicted self-reported symptomatology. (Author/CR)

Introduction: Suicidal Ideation (SI) is common in adolescents and increases the risk of completed suicide. Few brief interventions have been shown to reduce SI in adolescents. The objective of this study was to evaluate the feasibility of a novel brief group intervention, building resilience and attachment in vulnerable adolescents (BRAVA), designed for adolescents and their caregivers to reduce adolescent SI. Methods: The study was a pre–post, noncontrolled trial in which 46 adolescents were enrolled in the BRAVA intervention. Adolescents and caregivers completed an intake assessment, six BRAVA group sessions, and an exit assessment 1‐week post‐BRAVA. Results: Adolescents' SI decreased significantly after completing the BRAVA treatment (pre–post difference = 18.1, 95% CI = 10.01–26.12). Significant improvements in associated symptoms of depression, anxiety, and perceived stress were also observed. Caregivers had reduced perceived stress (pre–post difference = 2.7, 95% CI = 0.30–5.16) and reduction in attachment avoidance (difference = 1.6, 95% CI = 0.29–2.91). Treatment satisfaction was high across the six modules. The rolling entry feature of the intervention allowed participants to begin treatment approximately 2 weeks sooner compared to waiting for the next group cycle. Conclusions: Study results demonstrate that the BRAVA intervention has the potential to reduce SI among adolescents who present to hospital services in crisis. Further studies are required to establish BRAVA's efficacy in a randomized controlled trial. [ABSTRACT FROM AUTHOR]