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Theme: Mental Health & Dementia
This review was led by the Evidence Synthesis Team.
“Living with a long term medical condition is often much harder than many people think it
is. Not only do you have to cope with the health condition itself, but you also have to tackle all
the other issues it brings along with it, such as psychological disorders or simply chronic pain,
and in a young teenager’s normal life of long, tiring days and constantly fluctuating moods, these
are enough to really push you over the edge."
Excerpt from Afterword of the Final Report – written by a member of our Children and Young People Advisory Group
The burden of suffering with a long term physical condition can cause feelings of anxiety and depression in many young people and children. This can hinder the treatment and management of their condition, reduce quality of life and influence their development. Often services aimed at supporting young people with long term conditions can find it difficult to support any concurrent mental health problems they may be experiencing. Children with mental and physical illness need effective integrated healthcare, yet it has not been established whether, or which, interventions for mental health disorders are effective in children with chronic physical illness.
The project consisted of two systematic reviews that addressed the following research questions:
We conducted a systematic review of quantitative research evidence about the effectiveness and cost-effectiveness of relevant interventions and a review of qualitative research that explored the attitudes to, and experiences of, receiving interventions, from the perspectives of the children and young people, their parents and families and those involved in delivering interventions. We then brought together the findings from the two reviews to map out the links between the treatments and their effects on mental health, gaps in the evidence and factors that seem to enhance or limit the success of interventions.
We wanted to ensure that our findings make sense to end users. Therefore, we discussed the findings with a group of children and young people who have long term conditions, and their families, and practitioners who work with them. This was done via a mixture of face to face discussions with individuals and groups and also email to achieve a widespread distribution of different views and experiences. We hope that by bringing together all the results in a single piece of work we will be able to make a helpful contribution to knowledge in this area.
It is important that the findings are readily available to the people for whom they are relevant. This includes: mental and physical health clinicians, commissioners of health services, other researchers and children and young people and their families. We are using different methods of dissemination to target different audiences.
We co-created plain language summaries with the parents, children and young people who were involved throughout the project. They also helped us to record two podcasts which describe the results and also reflect on our experiences of working with children and young people on this project. The plain language summaries and podcasts will make available to patient groups and charities, as well as to practitioners and clinicians when the main report is published.
We place a lot of value on working with childeren and younger people, and recently attended INVOLVE (read more about this on our blog) to share our results, and presented at the Cochrane Colloquium in Edinburgh.
The main report will be available in the NIHR HTA Monograph series (expected date of publication is Spring 2018).
We are also preparing papers for publication in respected journals and presenting the findings at appropriate national and international scientific conferences, including the MQ conference in London, February 2017 and Global Evidence Summit in Cape Town, September 2017.
"Watching a child suffer from a long-term health condition is awful. They may be in
pain, feel ill and be unable to do the things that other young people do. They may need
surgery and lengthy stays in hospital. They need medication and side effects can be a
challenge all by themselves. Watching a child cope with all this, and then put their fist
through their bedroom door in anger, or refuse to leave the house for weeks through social
isolation, or be unable to sleep at night/eat properly due to anxiety, is heart-breaking...
... In looking at the effectiveness of the various strategies, it is hoped that excellent
practice can be identified and used to improve all mental health provision for our young
people with long-term physical conditions. They deserve nothing less."
Excerpt from the Foreword of the Final Report – written by a member of our Parent Advisory Group
“Before my diagnosis of SLE at the age of 9 (I am now 17), my life was relatively normal. For the past 9 years I have battled with having to take daily medications; continual check-ups; and various mental health problems mainly around anxiety and depression.
Over the years my biggest struggles have been the lack of control I have felt over my physical and mental health. Both these things affected my ability to socialise; go to school and college consistently; and take part in activities that other teenagers of my age might do. At times this has made life difficult and isolating, with professionals around me not really listening to me.
Being part of this research project has been important, because over the years I have used mental health services with varying affect and they have felt forced rather than a choice. I hope the findings in the research will enable future interventions to be more creative for all young people but particularly for those like me who have long term illnesses. It felt good to think that my experiences and contributions can make a difference.”
The project team have made a number of podcasts discussing their experiences of the systematic review including their recommendations for further work in this area. You can listen below:
In this podcast, the project team talk about the value and importance of working with young people living with long-term health conditions when carrying out this review:
The following posters were presented at the Global Evidence Summit in Cape Town in September 2017 and are available to download here:
The following posters were presented at the MQ Mental Health Science Meeting in London in Feb 2017:
The Evidence Synthesis Team have written the following blog posts about the project:
Full details of the project are available on the NIHR project page.
You can also view the project's protocol.