There are numerous measures available demonstrating characteristics, which make them suitable for continued use. Future research is needed to examine the more holistic measurement of family functioning using integration of multi-informant data.

General practitioner and senior research fellow.Section of general practice and primary care, University of Glasgow, 1 Horselethill Rd, Glasgow, G12 9LX. email: Abstract:Aim This paper is a report of a study to describe the workload of health visitors and school nurses in relation to children and young people with psychological, emotional or behavioural problems, and to identify perceived challenges, obstacles and sources of satisfaction associated with this aspect of their work. Background There is little published information on the work done by non-specialist community nurses with children and young people who have psychological, emotional and behavioural problems. Method We analysed data from a survey of 1049 Scottish professionals working with children and young people. Data included quantitative responses and free text describing the cases seen by respondents. Responses from a sub-sample of 71 health visitors and 100 school nurses were analysed using a combination of descriptive statistics and analysis of themes emerging from the text. Findings Although community-based nurses saw a relatively small number of children with psychological, emotional or behavioural problems each week, dealing with these problems took up a disproportionate amount of time. The commonest types of problem were self-harm, externalising behaviours and family difficulties. Few respondents had received specific training in child and adolescent mental health but most expressed a wish to receive such training. ConclusionThe work of health visitors and school nurses in caring for children with mental health problems is substantial and important. Development of their public health role should not be at the expense of this important contribution. There is a need for rigorous evaluation of nursing mental health interventions among children and young people. KEYWORDSHealth visitors, school nurses, questionnaire, empirical research report, children, psychological problems, behavioural problems SUMMARY STATEMENT What is already known on this topic• There is some evidence that input by community-based nurses can have a major impact on the mental well-being of children and young people• Policy documents acknowledge the important role of both school nurses and health visitors, who are responsible for providing professional support for children and young people with psychological and behavioural problems.• Detailed information on the precise nature of school nurses' and health visitors' involvement -workload, demands, and satisfaction -is not available. 'What this study adds'• Health visitors and school nurses have substantial, but different, mental health caseloads • Nurses reported that a lack of training and support limited their ability to provide good quality care to children and young people• Self-harm, externalising behaviours and family difficulties were the commonest problems described.

The Sound Sense™ hearing conservation program improved earplug use practices in elementary school children in the short and long term. The development, implementation and evaluation of a community-based health promotion project around hearing loss can serve as a tremendous opportunity for students to develop their knowledge and skills in health advocacy.

This paper describes the use of family therapy with adolescent school refusers. School refusal is assessed and formulated from a family systems perspective, and therapy proceeds with the crisis precipitated by insisting on the adolescent's early return to school. Some of the common problems encountered in this approach are considered along with its results.