Reviewing the evidence - parental support / child mental health

Research questions: RQ1) What are the needs of parents/carers of young people who are receiving mental health services? RQ2) What intervention approaches have been used to address those needs? RQ3) What evidence is there for the effectiveness of interventions to improve parents own wellbeing, family wellbeing, and child and young person (CYP) mental health service utilisation? Background: Having a CYP with mental health problems can have a major impact on parents/carers, including depression, anxiety, lost productivity, and poor family relationships. Synthesis of evidence is urgently required to guide better support for these parents/carers, as this is a policy priority and vital with increasing CYP mental health difficulties. Aims and objectives: To provide a timely and comprehensive review of the literature, using stakeholder engagement, to provide practical recommendations. Methods: Specialised databases and registers of protocols and trials will be searched to identify potentially relevant studies for all three research questions. Two reviewers will screen titles/abstracts, review full-text articles for inclusion, and extract data. Studies must relate to parent/carer needs, and/or interventions to address needs, arising from having a CYP with a mental health problem. Specifically: RQ1: Qualitative data or validated quantitative measures that describe parents /carers needs will be extracted. Quantitative data will be summarised, and synthesised with the qualitative data. Quality of the studies will be appraised using Newcastle Ottawa Scale or JBI Critical Appraisal Checklist. RQ2: Data will be extracted from any study that describes the details of an intervention with at least one component specifically designed to support parents/carers, for example dose, content, underpinning theory, and parents /carers need(s) addressed. The Template for intervention description and replication will be used as a checklist. Content analysis will summarise the findings, and identify any needs identified for RQ1 that are not covered by the interventions. RQ3: Cochrane systematic reviewing methods will be used to extract data from only randomised controlled trials that compare an intervention to support parents/carers to either active or inactive control group. The Cochrane tool will be used to assess Risk of Bias. Narrative synthesis is likely, owing to expected heterogeneity across studies. If possible, subgroup analysis will be conducted examining CYP s diagnosis and identity/gender of the parent/carer. A system-based logic model will summarise interventions used and outcomes, noting wider contextual factors relevant to implementation. A process-based logic model will detail what needs are addressed, and potential mechanisms of action linking interventions to outcomes. Stakeholder input from health professionals, academics, and parents/carers will input into our synthesis, recommendations and output. Timeline: 15 months. Anticipated impact and dissemination: Routes to impact are via recommendations relating to 1) any further research to specify parents/carers needs, 2) intervention content development to address unmet needs, 3) further trials where high quality evidence not available or populations not included, 4) implementation, if sufficient evidence, of supported interventions. This builds towards improving availability of empirically-grounded support for parents/carers. Dissemination will include roundtable discussion with policy makers; academic outputs; video and policy briefing summaries to be share via our collaborators to a broad audience.