Evaluation of a mental health drop-in centre offering brief transdiagnostic psychological assessment and treatment for children and adolescents with long-term physical conditions and their families: a single-arm, open, non-randomised trial

Abstract

BackgroundChildren and young people with long-term physical conditions have significantly elevated mental health needs. Transdiagnostic, brief psychological interventions have the potential to increase access to evidence-based psychological treatments for patients who attend health services primarily for physical health needs.ObjectiveA non-randomised study was conducted to assess the impact of brief, transdiagnostic psychological interventions in children and young people presenting at a drop-in mental health centre in the reception area of a paediatric hospital.Methods186 participants attending a transdiagnostic mental health drop-in centre were allocated to assessment and psychological intervention based on a clinical decision-making algorithm. Interventions included signposting, guided self-help based on a modular psychological treatment and referral to the hospital’s paediatric psychology service. The primary transdiagnostic mental health outcome measure was the parent-reported Strengths and Difficulties Questionnaire (SDQ), which was given at baseline and 6 months post-baseline.FindingsThere was a significant positive impact of attending the drop-in mental health centre on the SDQ (Cohen’s d=0.22) and on the secondary outcome measure of Paediatric Quality of life (Cohen’s d=0.55).ConclusionsA mental health drop-in centre offering brief, transdiagnostic assessment and treatment may reduce emotional and behavioural symptoms and improve quality of life in children and young people with mental health needs in the context of long-term physical conditions. A randomised controlled trial to investigate the specificity of any effects is warranted.Clinical implicationsDrop-in centres for mental health needs may increase access and have beneficial effects for children and young people with physical conditions.

A Mental Health Drop-In Centre Offering Brief Transdiagnostic Psychological Assessment and Treatment in a Paediatric Hospital Setting: A One-Year Descriptive Study

“…This cross-sectional analysis undertaken at a single time-point was designed to evaluate feasibility and accessibility, and no data are presented with respect to the impact of interventions provided, e.g., treatment outcome and participant satisfaction. However, this was not the remit of this particular study, and follow-up data have been presented in a separate publication [ 31 ]. We did not use validated measures of service use, as it was felt that questionnaire burden was already high.…”

“…This evaluation is part of a broader project to examine the acceptability, feasibility and impact of the Lucy Project: a “Mental Health and Psychological Wellbeing Drop-in Centre” in a tertiary paediatric hospital setting [ 31 ]. The Lucy Project was primarily designed to address common mental health problems such as anxiety, depression and challenging behaviour, for which a low intensity guided self-help intervention may be suitable [ 31 ]. The project was named after the character Lucy in the cartoon Peanuts who had a drop-in psychiatric clinic and was decided upon in consultation with children and young people at the hospital.…”

A survey of mental health professionals in a paediatric hospital during COVID-19

“…This may involve APs delivering evidence-based low intensity interventions to ensure CPs have the capacity to address more severe needs. This has been shown to be feasible in a paediatric setting during COVID-19 ( Batchelor et al, 2020 ) with good patient outcomes ( Catanzano et al, 2021 ).…”

Cost-effectiveness of a mental health drop-in centre for young people with long-term physical conditions

“…The ‘Lucy Project’ aimed to fill this gap by testing and evaluating an easily accessible mental health intervention for children with LTCs and their families at Great Ormond Street Hospital [ 29 , 30 ]. The project was distinguished by a proactive approach to patient enrolment, including dissemination of recruitment leaflets, referrals of patients to the project by physicians, signposting, and a booth physically located at the reception of the national paediatric hospital where patients and family members could drop in and enquire about enrolment and receive treatment.…”

“…The trial outcome was associated with a significant improvement in the outcome scores suggesting that this transdiagnostic treatment can reduce emotional and behavioural symptoms and improve quality of life in children with long-term physical condition. More detailed findings of the evaluation are presented in the paper by Catanzano [ 29 ]. The objective of this paper is to estimate the costs and cost effectiveness of the intervention to informing important resource allocation decisions for these crucial services.…”