Skip to main content
NCBI home page
Medline Book to support NIHPA logoLink to Medline Book to support NIHPA
. 2020 Nov;24(59):1–136. doi: 10.3310/hta24590

An intervention to improve the quality of life in children of parents with serious mental illness: the Young SMILES feasibility RCT.

Kathryn M Abel, Penny Bee, Lina Gega, Judith Gellatly, Adekeye Kolade, Diane Hunter, Craig Callender, Lesley-Anne Carter, Rachel Meacock, Peter Bower, Nicky Stanley, Rachel Calam, Miranda Wolpert, Paul Stewart, Richard Emsley, Kim Holt, Holly Linklater, Simon Douglas, Bryony Stokes-Crossley, Jonathan Green
PMCID: PMC7701992  PMID: 33196410

Abstract

BACKGROUND

Quality of life for children and adolescents living with serious parental mental illness can be impaired, but evidence-based interventions to improve it are scarce.

OBJECTIVE

Co-production of a child-centred intervention [called Young Simplifying Mental Illness plus Life Enhancement Skills (SMILES)] to improve the health-related quality of life of children and adolescents living with serious parental mental illness, and evaluating its acceptability and feasibility for delivery in NHS and community settings.

DESIGN

Qualitative and co-production methods informed the development of the intervention (Phase I). A feasibility randomised controlled trial was designed to compare Young SMILES with treatment as usual (Phase II). Semistructured qualitative interviews were used to explore acceptability among children and adolescents living with their parents, who had serious mental illness, and their parents. A mixture of semistructured qualitative interviews and focus group research was used to examine feasibility among Young SMILES facilitators and referrers/non-referrers.

SETTING

Randomisation was conducted after baseline measures were collected by the study co-ordinator, ensuring that the blinding of the statistician and research team was maintained to reduce detection bias.

PARTICIPANTS

Phase I: 14 children and adolescents living with serious parental mental illness, seven parents and 31 practitioners from social, educational and health-related sectors. Phase II: 40 children and adolescents living with serious parental mental illness, 33 parents, five referrers/non-referrers and 16 Young SMILES facilitators.

INTERVENTION

Young SMILES was delivered at two sites: (1) Warrington, supported by the National Society for the Prevention of Cruelty to Children (NSPCC), and (2) Newcastle, supported by the NHS and Barnardo's. An eight-session weekly group programme was delivered, with four to six children and adolescents living with serious parental mental illness per age-appropriate group (6-11 and 12-16 years). At week 4, a five-session parallel weekly programme was offered to the parents/carers. Sessions lasted 2 hours each and focused on improving mental health literacy, child-parent communication and children's problem-solving skills.

MAIN OUTCOME MEASURES

Phase ll children and parents completed questionnaires at randomisation and then again at 4 and 6 months post randomisation. Quality of life was self-reported by children and proxy-reported by parents using the Paediatric Quality of Life questionnaire and KIDSCREEN. Semistructured interviews with parents (n = 14) and children (n = 17) who participated in the Young SMILES groups gathered information about their motivation to sign up to the study, their experiences of participating in the group sessions, and their perceived changes in themselves and their family members following intervention. Further interviews with individual referrers (n = 5) gathered information about challenges to recruitment and randomisation. Two focus groups (n = 16) with practitioners who facilitated the intervention explored their views of the format and content of the Young SMILES manual and their suggestions for changes.

RESULTS

A total of 35 families were recruited: 20 were randomly allocated to Young SMILES group and 15 to treatment as usual. Of those, 28 families [15/20 (75%) in the intervention group and 13/15 (87%) in the control group] gave follow-up data at the primary end point (4 months post baseline). Participating children had high adherence to the intervention and high completion rates of the questionnaires. Children and adolescents living with their parents, who had serious mental illness, and their parents were mainly very positive and enthusiastic about Young SMILES, both of whom invoked the benefits of peer support and insight into parental difficulties. Although facilitators regarded Young SMILES as a meaningful and distinctive intervention having great potential, referrers identified several barriers to referring families to the study. One harm was reported by a parent, which was dealt with by the research team and the NSPCC in accordance with the standard operating procedures.

LIMITATIONS

The findings from our feasibility study are not sufficient to recommend a fully powered trial of Young SMILES in the near future. Although it was feasible to randomise children and adolescents living with serious parental mental illness of different ages to standardised, time-limited groups in both NHS and non-NHS settings, an intervention like Young SMILES is unlikely to address underlying core components of the vulnerability that children and adolescents living with serious parental mental illness express as a population over time.

CONCLUSIONS

Young SMILES was widely valued as unique in filling a recognised gap in need. Outcome measures in future studies of interventions for children and adolescents living with serious parental mental illness are more likely to capture change in individual risk factors for reduced quality of life by considering their unmet need, rather than on an aggregate construct of health-related quality of life overall, which may not reflect these young people's needs.

FUTURE WORK

A public health approach to intervention might be best. Most children and adolescents living with serious parental mental illness remain well most of the time, so, although their absolute risks are low across outcomes (and most will remain resilient most of the time), consistent population estimates find their relative risk to be high compared with unexposed children. A public health approach to intervention needs to be both tailored to the particular needs of children and adolescents living with serious parental mental illness and agile to these needs so that it can respond to fluctuations over time.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN36865046.

FUNDING

This project was funded by the National Institute of Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 59. See the NIHR Journals Library website for further project information.

Plain language summary

Children and adolescents living with serious parental mental illness are at increased risk of poorer mental, physical and emotional health but few services are available to them. We worked with young people, parents and professionals to co-develop a community-based intervention called Young Simplifying Mental Illness plus Life Enhancement Skills (SMILES). This involves eight children’s sessions over 8 weeks in two age groups (6–11 and 12–16 years) and five separate parent sessions. Each session includes activities designed to improve understanding of mental illness, communication between children and parents, and problem-solving. To assess the feasibility and how acceptable Young SMILES is to those who received (and delivered) the intervention, we recruited 35 families: 20 were offered Young SMILES and 15 continued to receive their usual care. Children and parents completed questionnaires when they entered the research and then after 4 and 6 months. Children and adolescents living with serious parental mental illness assigned to either Young SMILES or usual-care groups reported that their quality of life, mental health, day-to-day functioning and knowledge of mental illness was similar to that of their population peers. Answers to parental questionnaires suggested that overall our participants’ parenting style was positive and their levels of stress were as expected for parents in general. Across questionnaires, parents underestimated their children’s quality of life and overestimated their difficulties. Children and adolescents living with serious parental mental illness and parents were mainly very positive and enthusiastic about Young SMILES. They liked getting together to discuss their experiences with others in similar situations, but some parents felt unprepared to do this. Children liked having something that focused on their own needs separately from those of their parents; they liked the fun activities and valued the time away from their parents, but also wanted their parents to have support. Facilitators and referrers saw great value in Young SMILES. The needs of children with mentally ill parents remain unmet in the current system; a future evaluation of Young SMILES needs to reconsider the primary outcome and start with a pilot trial with clear criteria for progression to a full trial.

Full text of this article can be found in Bookshelf.

References

  1. Castle DJ, Abel KM. Comprehensive Women’s Mental Health. Cambridge: Cambridge University Press; 2016. https://doi.org/10.1017/CBO9781107045132 doi: 10.1017/CBO9781107045132. [DOI]
  2. Abel KM, Hope H, Swift E, Parisi R, Ashcroft DM, Kosidou K, et al. Prevalence of maternal mental illness among children and adolescents in the UK between 2005 and 2017: a national retrospective cohort analysis. Lancet Public Health 2019;4:e291–300. https://doi.org/10.1016/S2468-2667(19)30059-3 doi: 10.1016/S2468-2667(19)30059-3. [DOI] [PMC free article] [PubMed]
  3. Maybery D, Reupert A. Parental mental illness: a review of barriers and issues for working with families and children. J Psychiatr Ment Health Nurs 2009;16:784–91. https://doi.org/10.1111/j.1365-2850.2009.01456.x doi: 10.1111/j.1365-2850.2009.01456.x. [DOI] [PubMed]
  4. Stambaugh LF, Forman-Hoffman V, Williams J, Pemberton MR, Ringeisen H, Hedden SL, Bose J. Prevalence of serious mental illness among parents in the United States: results from the National Survey of Drug Use and Health, 2008–2014. Ann Epidemiol 2017;27:222–4. https://doi.org/10.1016/j.annepidem.2016.12.005 doi: 10.1016/j.annepidem.2016.12.005. [DOI] [PubMed]
  5. Bassani DG, Padoin CV, Philipp D, Veldhuizen S. Estimating the number of children exposed to parental psychiatric disorders through a national health survey. Child Adolesc Psychiatry Ment Health 2009;3:6. https://doi.org/10.1186/1753-2000-3-6 doi: 10.1186/1753-2000-3-6. [DOI] [PMC free article] [PubMed]
  6. Bee P, Berzins K, Calam R, Pryjmachuk S, Abel KM. Defining quality of life in the children of parents with severe mental illness: a preliminary stakeholder-led model. PLOS ONE 2013;8:e73739. https://doi.org/10.1371/journal.pone.0073739 doi: 10.1371/journal.pone.0073739. [DOI] [PMC free article] [PubMed]
  7. Abel KM, Hope H, Swift E, Parisi R, Ashcroft DM, Kosidou K, et al. Prevalence of maternal mental illness among children and adolescents in the UK between 2005 and 2017: a national retrospective cohort analysis. Lancet Public Health 2019;4:e291–e300. doi: 10.1016/S2468-2667(19)30059-3. [DOI] [PMC free article] [PubMed]
  8. Dean K, Stevens H, Mortensen PB, Murray RM, Walsh E, Pedersen CB. Full spectrum of psychiatric outcomes among offspring with parental history of mental disorder. Arch Gen Psychiatry 2010;67:822–9. https://doi.org/10.1001/archgenpsychiatry.2010.86 doi: 10.1001/archgenpsychiatry.2010.86. [DOI] [PubMed]
  9. Siegenthaler E, Munder T, Egger M. Effect of preventive interventions in mentally ill parents on the mental health of the offspring: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry 2012;51:8–17.e8. https://doi.org/10.1016/j.jaac.2011.10.018 doi: 10.1016/j.jaac.2011.10.018. [DOI] [PubMed]
  10. van Santvoort F, Hosman CM, Janssens JM, van Doesum KT, Reupert A, van Loon LM. The impact of various parental mental disorders on children’s diagnoses: a systematic review. Clin Child Fam Psychol Rev 2015;18:281–99. https://doi.org/10.1007/s10567-015-0191-9 doi: 10.1007/s10567-015-0191-9. [DOI] [PubMed]
  11. Olfson M, Marcus SC, Druss B, Alan Pincus H, Weissman MM. Parental depression, child mental health problems, and health care utilization. Med Care 2003;41:716–21. https://doi.org/10.1097/01.MLR.0000064642.41278.48 doi: 10.1097/01.MLR.0000064642.41278.48. [DOI] [PubMed]
  12. Anderson LN, Campbell MK, daSilva O, Freeman T, Xie B. Effect of maternal depression and anxiety on use of health services for infants. Can Fam Physician 2008;54:1718–19.e5. [PMC free article] [PubMed]
  13. Hope H, Abel KM, Evans, Osam S, Swift E, Ashcroft D, et al. The health utilisation and costs of children exposed to parental mental illness in the UK. Unpublished.
  14. Manning C, Gregoire A. Effects of parental mental illness on children. Psychiatry 2006;5:10–12. https://doi.org/10.1383/psyt.2006.5.1.10 doi: 10.1383/psyt.2006.5.1.10. [DOI]
  15. Gladstone BM, Boydell KM, Seeman MV, McKeever PD. Children’s experiences of parental mental illness: a literature review. Early Interv Psychiatry 2011;5:271–89. https://doi.org/10.1111/j.1751-7893.2011.00287.x doi: 10.1111/j.1751-7893.2011.00287.x. [DOI] [PubMed]
  16. Ackerson BJ. Parents with serious and persistent mental illness: issues in assessment and services. Soc Work 2003;48:187–94. https://doi.org/10.1093/sw/48.2.187 doi: 10.1093/sw/48.2.187. [DOI] [PubMed]
  17. Gellatly J, Bee P, Gee L, Hunter D, Abel KM. Health Related Quality of Life Needs and Preferences of Children and Adolescents who have Parents with a Severe mental Illness. In Diggins M, editor. Parental Mental Health and Child Welfare. 2nd edn. Shoreham-by-Sea: Pavilion; 2016. pp. 47–9.
  18. Bakermans-Kranenburg MJ, van IJzendoorn MH. The hidden efficacy of interventions: Gene× environment experiments from a differential susceptibility perspective. Annu Rev Psychol 2015;66:381–409. https://doi.org/10.1146/annurev-psych-010814-015407 doi: 10.1146/annurev-psych-010814-015407. [DOI] [PubMed]
  19. Cattaneo A, Malpighi C, Cattane N, Provencal N, Pariante C. 126. Prenatal depression exposure and enhanced stress responses in the offspring: role of the glucocorticoid-mediated epigenetic changes. Biol Psychiatry 2018;83:S51–2. https://doi.org/10.1016/j.biopsych.2018.02.144 doi: 10.1016/j.biopsych.2018.02.144. [DOI]
  20. Brand SR, Brennan PA. Impact of antenatal and postpartum maternal mental illness: how are the children? Clin Obstet Gynecol 2009;52:441–55. https://doi.org/10.1097/GRF.0b013e3181b52930 doi: 10.1097/GRF.0b013e3181b52930. [DOI] [PubMed]
  21. Field T. Prenatal depression effects on early development: a review. Infant Behav Dev 2011;34:1–14. https://doi.org/10.1016/j.infbeh.2010.09.008 doi: 10.1016/j.infbeh.2010.09.008. [DOI] [PubMed]
  22. Howe D, Batchelor S, Bochynska K. Estimating consumer parenthood within mental health services: a census approach. AeJAMH 2009;8:231–41. https://doi.org/10.5172/jamh.8.3.231 doi: 10.5172/jamh.8.3.231. [DOI]
  23. Hall A. Parental Psychiatric Disorder and the Developing Child. In Göpfert M, Webster J, Seeman MV, editors. Parental Psychiatric Disorder: Distressed Parents and their Families. Cambridge: Cambridge University Press; 2004. pp. 22–49. https://doi.org/10.1017/CBO9780511543838.005 doi: 10.1017/CBO9780511543838.005. [DOI]
  24. Rutter M, Quinton D. Parental psychiatric disorder: effects on children. Psychol Med 1984;14:853–80. https://doi.org/10.1017/s0033291700019838 doi: 10.1017/s0033291700019838. [DOI] [PubMed]
  25. Kim-Cohen J, Caspi A, Rutter M, Tomás MP, Moffitt TE. The caregiving environments provided to children by depressed mothers with or without an antisocial history. Am J Psychiatry 2006;163:1009–18. https://doi.org/10.1176/ajp.2006.163.6.1009 doi: 10.1176/ajp.2006.163.6.1009. [DOI] [PubMed]
  26. Steer S, Reupert A, Maybery D. Programs for children of parents who have a mental illness: referral and assessment practices. ‘One size fits all’? Aust Soc Work 2011;64:502–14. https://doi.org/10.1080/0312407X.2011.594901 doi: 10.1080/0312407X.2011.594901. [DOI]
  27. Kinsella MT, Monk C. Impact of maternal stress, depression and anxiety on fetal neurobehavioral development. Clin Obstet Gynecol 2009;52:425–40. https://doi.org/10.1097/GRF.0b013e3181b52df1 doi: 10.1097/GRF.0b013e3181b52df1. [DOI] [PMC free article] [PubMed]
  28. Murray L, Cooper P, Hipwell A. Mental health of parents caring for infants. Arch Womens Ment Health 2003;6(Suppl. 2):71–7. https://doi.org/10.1007/s00737-003-0007-7 doi: 10.1007/s00737-003-0007-7. [DOI] [PubMed]
  29. Smith M. Parental mental health: disruptions to parenting and outcomes for children. Child Fam Soc Work 2004;9:3–11. https://doi.org/10.1111/j.1365-2206.2004.00312.x doi: 10.1111/j.1365-2206.2004.00312.x. [DOI]
  30. Weissman MM, Warner V, Wickramaratne P, Moreau D, Olfson M. Offspring of depressed parents. 10 years later. Arch Gen Psychiatry 1997;54:932–40. https://doi.org/10.1001/archpsyc.1997.01830220054009 doi: 10.1001/archpsyc.1997.01830220054009. [DOI] [PubMed]
  31. Weissman MM, Wickramaratne P, Nomura Y, Warner V, Pilowsky D, Verdeli H. Offspring of depressed parents: 20 years later. Am J Psychiatry 2006;163:1001–8. https://doi.org/10.1176/ajp.2006.163.6.1001 doi: 10.1176/ajp.2006.163.6.1001. [DOI] [PubMed]
  32. Riebschleger J, Grove C, Costello S, Cavanaugh D. Mental health literacy for children with a parent with a mental illness. J Parent Fam Ment Health 2018;3:1006. https://doi.org/10.7191/parentandfamily.1006 doi: 10.7191/parentandfamily.1006. [DOI]
  33. Havinga PJ, Boschloo L, Hartman CA, Schoevers RA. Paternal and maternal depression and offspring risk: additive effects or worse? Lancet Psychiatry 2018;5:107–8. https://doi.org/10.1016/S2215-0366(18)30013-0 doi: 10.1016/S2215-0366(18)30013-0. [DOI] [PubMed]
  34. Lewis G, Neary M, Polek E, Flouri E, Lewis G. Paternal and maternal depression and offspring risk: additive effects or worse? – Authors’ reply. Lancet Psychiatry 2018;5:108. https://doi.org/10.1016/S2215-0366(18)30014-2 doi: 10.1016/S2215-0366(18)30014-2. [DOI] [PubMed]
  35. Fudge E, Mason P. Consulting with young people about service guidelines relating to parental mental illness. AeJAMH 2004;3:50–8. https://doi.org/10.5172/jamh.3.2.50 doi: 10.5172/jamh.3.2.50. [DOI]
  36. Reupert A, Maybery D. Families affected by parental mental illness: a multiperspective account of issues and interventions. Am J Orthopsychiatry 2007;77:362–9. https://doi.org/10.1037/0002-9432.77.3.362 doi: 10.1037/0002-9432.77.3.362. [DOI] [PubMed]
  37. Wilson S, Durbin CE. Effects of paternal depression on fathers’ parenting behaviors: a meta-analytic review. Clin Psychol Rev 2010;30:167–80. https://doi.org/10.1016/j.cpr.2009.10.007 doi: 10.1016/j.cpr.2009.10.007. [DOI] [PubMed]
  38. Fisher SD, Brock RL, O’Hara MW, Kopelman R, Stuart S. Longitudinal contribution of maternal and paternal depression to toddler behaviors: interparental conflict and later depression as mediators. Couple Family Psychol 2015;4:61. https://doi.org/10.1037/cfp0000037 doi: 10.1037/cfp0000037. [DOI]
  39. Flouri E. Fathers’ behaviors and children’s psychopathology. Clin Psychol Rev 2010;30:363–9. https://doi.org/10.1016/j.cpr.2010.01.004 doi: 10.1016/j.cpr.2010.01.004. [DOI] [PubMed]
  40. Ramchandani P, Stein A, Evans J, O’Connor TG, ALSPAC study team. Paternal depression in the postnatal period and child development: a prospective population study. Lancet 2005;365:2201–5. https://doi.org/10.1016/S0140-6736(05)66778-5 doi: 10.1016/S0140-6736(05)66778-5. [DOI] [PubMed]
  41. Jacobs RH, Talati A, Wickramaratne P, Warner V. The influence of paternal and maternal major depressive disorder on offspring psychiatric disorders. J Child Fam Stud 2015;24:2345–51. https://doi.org/10.1007/s10826-014-0037-y doi: 10.1007/s10826-014-0037-y. [DOI] [PMC free article] [PubMed]
  42. Connell AM, Goodman SH. The association between psychopathology in fathers versus mothers and children’s internalizing and externalizing behavior problems: a meta-analysis. Psychol Bull 2002;128:746–73. https://doi.org/10.1037/0033-2909.128.5.746 doi: 10.1037/0033-2909.128.5.746. [DOI] [PubMed]
  43. Rutter M. Resilience as a dynamic concept. Dev Psychopathol 2012;24:335–44. https://doi.org/10.1017/S0954579412000028 doi: 10.1017/S0954579412000028. [DOI] [PubMed]
  44. Rutter M. Implications of resilience concepts for scientific understanding. Ann NY Acad Sci 2006;1094:1–12. https://doi.org/10.1196/annals.1376.002 doi: 10.1196/annals.1376.002. [DOI] [PubMed]
  45. Cicchetti D, Curtis WJ. Multilevel perspectives on pathways to resilient functioning. Dev Psychopathol 2007;19:627–9. https://doi.org/10.1017/s0954579407000314 doi: 10.1017/s0954579407000314. [DOI] [PubMed]
  46. Santos IS, Matijasevich A, Domingues MR, Barros AJ, Barros FC. Long-lasting maternal depression and child growth at 4 years of age: a cohort study. J Pediatr 2010;157:401–6. https://doi.org/10.1016/j.jpeds.2010.03.008 doi: 10.1016/j.jpeds.2010.03.008. [DOI] [PMC free article] [PubMed]
  47. Giallo R, Bahreinian S, Brown S, Cooklin A, Kingston D, Kozyrskyj A. Maternal depressive symptoms across early childhood and asthma in school children: findings from a longitudinal Australian population based study. PLOS ONE 2015;10:e0121459. https://doi.org/10.1371/journal.pone.0121459 doi: 10.1371/journal.pone.0121459. [DOI] [PMC free article] [PubMed]
  48. Letourneau NL, Kozyrskyj AL, Cosic N, Ntanda HN, Anis L, Hart MJ, et al. Maternal sensitivity and social support protect against childhood atopic dermatitis. Allergy Asthma Clin Immunol 2017;13:26. https://doi.org/10.1186/s13223-017-0199-4 doi: 10.1186/s13223-017-0199-4. [DOI] [PMC free article] [PubMed]
  49. Pierce M, Hope H, Kolade A, Gellatly J, Osman SO, Abel KM. The Physical Health of Children with Parental Mental Illness: A Systematic Review and Meta-analysis. Manchester: University of Manchester; 2019.
  50. Diggins M. Think Child, Think Parent, Think Family: A Guide to Parental Mental Health and Child Welfare. London: Social Care Institute for Excellence; 2011.
  51. Tabak I, Zabłocka-Żytka L, Ryan P, Poma SZ, Joronen K, Viganò G, et al. Needs, expectations and consequences for children growing up in a family where the parent has a mental illness. Int J Ment Health Nurs 2016;25:319–29. https://doi.org/10.1111/inm.12194 doi: 10.1111/inm.12194. [DOI] [PubMed]
  52. Farahati F, Marcotte DE, Wilcox-Gök V. The effects of parents’ psychiatric disorders on children’s high school dropout. Econ Educ Rev 2003;22:167–78. https://doi.org/10.1016/S0272-7757(02)00031-6 doi: 10.1016/S0272-7757(02)00031-6. [DOI]
  53. Stanley N, Penhale B, Riordan D, Barbour RS, Holden S. Working on the interface: identifying professional responses to families with mental health and child-care needs. Health Soc Care Community 2003;11:208–18. https://doi.org/10.1046/j.1365-2524.2003.00428.x doi: 10.1046/j.1365-2524.2003.00428.x. [DOI] [PubMed]
  54. Hipwell AE, Murray L, Ducournau P, Stein A. The effects of maternal depression and parental conflict on children’s peer play. Child Care Health Dev 2005;31:11–23. https://doi.org/10.1111/j.1365-2214.2005.00448.x doi: 10.1111/j.1365-2214.2005.00448.x. [DOI] [PubMed]
  55. Feurer C, Hammen CL, Gibb BE. Chronic and episodic stress in children of depressed mothers. J Clin Child Adolesc Psychol 2016;45:270–8. https://doi.org/10.1080/15374416.2014.963859 doi: 10.1080/15374416.2014.963859. [DOI] [PMC free article] [PubMed]
  56. Breslend NL, Parent J, Forehand R, Peisch V, Compas BE. Children of parents with a history of depression: the impact of a preventive intervention on youth social problems through reductions in internalizing problems. Dev Psychopathol 2019;31:219–31. https://doi.org/10.1017/S0954579417001821 doi: 10.1017/S0954579417001821. [DOI] [PMC free article] [PubMed]
  57. Beardselee WR, Versage EM, Giadstone TR. Children of affectively ill parents: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 1998;37:1134–41. https://doi.org/10.1097/00004583-199811000-00012 doi: 10.1097/00004583-199811000-00012. [DOI] [PubMed]
  58. Compas BE, Forehand R, Thigpen JC, Keller G, Hardcastle EJ, Cole DA, et al. Family group cognitive-behavioral preventive intervention for families of depressed parents: 18- and 24-month outcomes. J Consult Clin Psychol 2011;79:488–99. https://doi.org/10.1037/a0024254 doi: 10.1037/a0024254. [DOI] [PMC free article] [PubMed]
  59. Dodge KA, Bates JE, Pettit GS. Mechanisms in the cycle of violence. Science 1990;250:1678–83. https://doi.org/10.1126/science.2270481 doi: 10.1126/science.2270481. [DOI] [PubMed]
  60. Zahnâ Waxler C, Cummings EM, Iannotti RJ, Radkeâ Yarrow M. Young offspring of depressed parents: a population at risk for affective problems. New Dir Child Adolesc Dev 1984;1984:81–105. https://doi.org/10.1002/cd.23219842607 doi: 10.1002/cd.23219842607. [DOI]
  61. Hammen C, Brennan PA. Depressed adolescents of depressed and nondepressed mothers: tests of an interpersonal impairment hypothesis. J Consult Clin Psychol 2001;69:284–94. https://doi.org/10.1037//0022-006x.69.2.284 doi: 10.1037//0022-006x.69.2.284. [DOI] [PubMed]
  62. Sullivan PF, Magnusson C, Reichenberg A, Boman M, Dalman C, Davidson M, et al. Family history of schizophrenia and bipolar disorder as risk factors for autism. Arch Gen Psychiatry 2012;69:1099–103. https://doi.org/10.1001/archgenpsychiatry.2012.730 doi: 10.1001/archgenpsychiatry.2012.730. [DOI] [PMC free article] [PubMed]
  63. Shen H, Magnusson C, Rai D, Lundberg M, Lê-Scherban F, Dalman C, Lee BK. Associations of parental depression with child school performance at age 16 years in Sweden. JAMA Psychiatry 2016;73:239–46. https://doi.org/10.1001/jamapsychiatry.2015.2917 doi: 10.1001/jamapsychiatry.2015.2917. [DOI] [PubMed]
  64. Reupert AE, Cuff R, Drost L, Foster K, van Doesum KT, van Santvoort F. Intervention programs for children whose parents have a mental illness: a review. Med J Aust 2013;199(Suppl. 3):18–22. https://doi.org/10.5694/mja11.11145 doi: 10.5694/mja11.11145. [DOI] [PubMed]
  65. Garber J, Little S. Predictors of competence among offspring of depressed mothers. J Adolesc Res 1999;14:44–71. https://doi.org/10.1177/0743558499141004 doi: 10.1177/0743558499141004. [DOI]
  66. Fraser E, Pakenham KI. Resilience in children of parents with mental illness: relations between mental health literacy, social connectedness and coping, and both adjustment and caregiving. Psychol Health Med 2009;14:573–84. https://doi.org/10.1080/13548500903193820 doi: 10.1080/13548500903193820. [DOI] [PubMed]
  67. Vakrat A, Apter-Levy Y, Feldman R. Fathering moderates the effects of maternal depression on the family process. Dev Psychopathol 2018;30:27–38. https://doi.org/10.1017/S095457941700044X doi: 10.1017/S095457941700044X. [DOI] [PubMed]
  68. Bee P, Bower P, Byford S, Churchill R, Calam R, Stallard P, et al. The clinical effectiveness, cost-effectiveness and acceptability of community-based interventions aimed at improving or maintaining quality of life in children of parents with serious mental illness: a systematic review. Health Technol Assess 2014;18(8). https://doi.org/10.3310/hta18080 doi: 10.3310/hta18080. [DOI] [PMC free article] [PubMed]
  69. Perera DN, Short L, Fernbacher S. There is a lot to it: being a mother and living with a mental illness. Adv Ment Health 2014;12:167–81. https://doi.org/10.1080/18374905.2014.11081895 doi: 10.1080/18374905.2014.11081895. [DOI]
  70. Angermeyer MC, Matschinger H. The stigma of mental illness: effects of labelling on public attitudes towards people with mental disorder. Acta Psychiatr Scand 2003;108:304–9. https://doi.org/10.1034/j.1600-0447.2003.00150.x doi: 10.1034/j.1600-0447.2003.00150.x. [DOI] [PubMed]
  71. Reupert A, Maybery D. What do we know about families where parents have a mental illness? A systematic review. Child Youth Serv 2016;37:98–111. https://doi.org/10.1080/0145935X.2016.1104037 doi: 10.1080/0145935X.2016.1104037. [DOI]
  72. Braddick F, Carral V, Jenkins R, Jané-Llopis E. Child and Adolescent Mental Health in Europe: Infrastructures, Policy and Programmes. Luxembourg: European Communities; 2009. URL: https://ec.europa.eu/health/ph_determinants/life_style/mental/docs/camhee_infrastructures.pdf (accessed 15 July 2020).
  73. National Institute for Health and Care Excellence (NICE). Social and Emotional Wellbeing for Children and Young People. London: NICE; 2013.
  74. Crossroads Caring for Carers and Princess Royal Trust for Carers. Economic Evaluation of Young Carers’ Interventions. Crossroads Caring for Carers; 2008. URL: https://pdfs.semanticscholar.org/d956/a899ff65378adad55f462ef7c2e3f53d804e.pdf (accessed 15 July 2020).
  75. Thanhäuser M, Lemmer G, de Girolamo G, Christiansen H. Do preventive interventions for children of mentally ill parents work? Results of a systematic review and meta-analysis. Curr Opin Psychiatry 2017;30:283–99. https://doi.org/10.1097/YCO.0000000000000342 doi: 10.1097/YCO.0000000000000342. [DOI] [PubMed]
  76. Bee P. Community preventive interventions for children of parents with serious mental illness: a commentary on the evidence base. Adv Ment Health 2015;13:165–7. https://doi.org/10.1080/18387357.2015.1066945 doi: 10.1080/18387357.2015.1066945. [DOI]
  77. Barry MM, Zissi A. Quality of life as an outcome measure in evaluating mental health services: a review of the empirical evidence. Soc Psychiatry Psychiatr Epidemiol 1997;32:38–47. https://doi.org/10.1007/bf00800666 doi: 10.1007/bf00800666. [DOI] [PubMed]
  78. Nicholson J, Sweeney EM, Geller JL. Mothers with mental illness: II. Family relationships and the context of parenting. Psychiatr Serv 1998;49:643–9. https://doi.org/10.1176/ps.49.5.643 doi: 10.1176/ps.49.5.643. [DOI] [PubMed]
  79. van der Zanden R, Kramer J, Gerrits R, Cuijpers P. Effectiveness of an online group course for depression in adolescents and young adults: a randomized trial. J Med Internet Res 2012;14:e86. https://doi.org/10.2196/jmir.2033 doi: 10.2196/jmir.2033. [DOI] [PMC free article] [PubMed]
  80. Lucksted A, McFarlane W, Downing D, Dixon L. Recent developments in family psychoeducation as an evidence-based practice. J Marital Fam Ther 2012;38:101–21. https://doi.org/10.1111/j.1752-0606.2011.00256.x doi: 10.1111/j.1752-0606.2011.00256.x. [DOI] [PubMed]
  81. Compas BE, Forehand R, Keller G, Champion JE, Rakow A, Reeslund KL, et al. Randomized controlled trial of a family cognitive-behavioral preventive intervention for children of depressed parents. J Consult Clin Psychol 2009;77:1007–20. https://doi.org/10.1037/a0016930 doi: 10.1037/a0016930. [DOI] [PMC free article] [PubMed]
  82. Muñoz RF, Beardslee WR, Leykin Y. Major depression can be prevented. Am Psychol 2012;67:285–95. https://doi.org/10.1037/a0027666 doi: 10.1037/a0027666. [DOI] [PMC free article] [PubMed]
  83. Loechner J, Starman K, Galuschka K, Tamm J, Schulte-Körne G, Rubel J, Platt B. Preventing depression in the offspring of parents with depression: a systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev 2018;60:1–14. https://doi.org/10.1016/j.cpr.2017.11.009 doi: 10.1016/j.cpr.2017.11.009. [DOI] [PubMed]
  84. Compas BE, Forehand R, Thigpen J, Hardcastle E, Garai E, McKee L, et al. Efficacy and moderators of a family group cognitive-behavioral preventive intervention for children of parents with depression. J Consult Clin Psychol 2015;83:541–53. https://doi.org/10.1037/a0039053 doi: 10.1037/a0039053. [DOI] [PMC free article] [PubMed]
  85. Stice E, Shaw H, Bohon C, Marti CN, Rohde P. A meta-analytic review of depression prevention programs for children and adolescents: factors that predict magnitude of intervention effects. J Consult Clin Psychol 2009;77:486–503. https://doi.org/10.1037/a0015168 doi: 10.1037/a0015168. [DOI] [PMC free article] [PubMed]
  86. NHS England. Implementing the Five Year Forward View for Mental Health. London: NHS England; 2016.
  87. Cabinet Office. Reaching Out: Think Family. London: Social Exclusion Task Force; 2007.
  88. HM Goverment. Working with Troubled Families: A Guide to the Evidence and Good Practice. London: Ministry of Housing, Communities and Local Government; 2012.
  89. Scottish Government. Towards a Mentally Flourishing Scotland: Policy and Action Plan 2009–11. Edinburgh: Scottish Government; 2009.
  90. Dearden C, Becker S. Young Carers in the UK: The 2004 Report. London: Carers UK; 2004.
  91. Afzelius M, Plantin L, Östman M. Families living with parental mental illness and their experiences of family interventions. J Psychiatr Ment Health Nurs 2018;25:69–77. https://doi.org/10.1111/jpm.12433 doi: 10.1111/jpm.12433. [DOI] [PubMed]
  92. Social Exclusion Unit. Mental Health and Social Exclusion. Social Exclusion Unit Report R2089. London: Office of the Deputy Prime Minister; 2004.
  93. Department of Health, Social Services and Public Safety. Families Matter: Supporting Families in Northern Ireland: Regional Family and Parenting Strategy. Belfast: Department of Health, Social Services and Public Safety; 2009.
  94. Department of Health and Social Care (DHSC). Future in Mind. London: DHSC; 2015.
  95. Public Health Wales. Adverse Childhood Experiences. 2018. URL: www.wales.nhs.uk/sitesplus/888/page/88524 (accessed 7 March 2019).
  96. Bush M. Addressing Adversity: Prioritising Adversity and Trauma-informed Care for Children and Young People in England. Addressing Adversity. URL: https://youngminds.org.uk/media/2142/ym-addressing-adversity-book-web.pdf (accessed 15 July 2020).
  97. Department for Education. Working Together to Safeguard Children: A Guide to Inter-agency Working to Safeguard and Promote the Welfare of Children. London: HM Government; 2018.
  98. Puras D, Kolaitis G, Tsiantisn J. Child and adolescent mental health in the enlarged European Union: overview of the CAMHEE Project. Int J Mental Health Promot 2010;12:3–9 https://doi.org/10.1080/14623730.2010.9721821 doi: 10.1080/14623730.2010.9721821. [DOI]
  99. Finnish Government. Child Welfare Act. Ministry of Social Affairs and Health; 2007. URL: http://www.finlex.fi/en/laki/kaannokset/2007/en20070417 (accessed 15 July 2020).
  100. NSW Government. NSW Children of Parents with a Mental Illness (COPMI) Framework for Mental Health Services 2010–15. New South Wales; 2010. URL: www.wslhd.health.nsw.gov.au/Redbank-House/Redbank-Services/Children-of-Parents-with-a-Mental-Illness--COPMI- (accessed 15 July 2020).
  101. Government of Ireland. Children First: National Guidance for the Protection and Welfare of Children. Dublin: Department of Children and Youth Affairs; 2011.
  102. Northern Ireland Executive. Children and Young People’s Strategy 2017–2027. Belfast: Department of Education; 2016.
  103. Fonagy P, Pugh K, O’Herlihy A. The Children and Young People’s Improving Access to Psychological Therapies (CYP IAPT) Programme in England. In Skuse D, Bruce H, Dowdney L, editors. Child Psychology and Psychiatry: Frameworks for Clinical Training and Practice. 3rd edn. Hoboken, NJ: John Wiley & Sons; 2017. pp. 429–35. https://doi.org/10.1002/9781119170235.ch48 doi: 10.1002/9781119170235.ch48. [DOI]
  104. NHS England. Children and Young People’s Improving Access to Psychological Therapies Programme. London: NHS England; 2019. URL: www.england.nhs.uk/mental-health/cyp/iapt/ (accessed 7 March 2019).
  105. Gellatly J, Bee P, Gega L, Bower P, Hunter D, Stewart P, et al. A community-based intervention (Young SMILES) to improve the health-related quality of life of children and young people of parents with serious mental illness: randomised feasibility protocol. Trials 2018;19:550. https://doi.org/10.1186/s13063-018-2935-6 doi: 10.1186/s13063-018-2935-6. [DOI] [PMC free article] [PubMed]
  106. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and Evaluating Complex Interventions: Following Considerable Development in the Field Since 2006, MRC and NIHR have Jointly Commissioned an Update of this Guidance to be Published in 2019. Southampton: Medical Research Council Lifecourse Epidemiology Unit; 2006. URL: https://mrc.ukri.org/documents/pdf/complex-interventions-guidance/ (accessed 1 March 2020).
  107. Gellatly J, Bee P, Kolade A, Hunter D, Gega L, Callender C, et al. Developing an intervention to improve the health related quality of life in children and young people with serious parental mental illness. Front Psychiatry 2019;10:155. https://doi.org/10.3389/fpsyt.2019.00155 doi: 10.3389/fpsyt.2019.00155. [DOI] [PMC free article] [PubMed]
  108. Varni JW, Seid M, Kurtin PS. PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in healthy and patient populations. Med Care 2001;39:800–12. https://doi.org/10.1097/00005650-200108000-00006 doi: 10.1097/00005650-200108000-00006. [DOI] [PubMed]
  109. The KIDSCREEN Group Europe. The KIDSCREEN Questionnaires. Quality of Life Questionnaires for Children and Adolescents. Lengerich: Pabst Science Publishers 2006.
  110. Strengths and Difficulties Questionnaire (SDQ). 2017. URL: https://theshapesystem.com/resource-assessments/4118/SDQ_FINAL_11.29.17.pdf (accessed 16 February 2019).
  111. Chorpita BF, Ebesutani C, Spence S. Revised Children’s Anxiety and Depression Scale: User’s Guide 2015. URL: www.childfirst.ucla.edu/wp-content/uploads/sites/163/2018/03/RCADSUsersGuide20150701.pdf (accessed 7 March 2019).
  112. Campos L, Dias P, Palha F. Finding space to mental health – promoting mental health in adolescents: pilot study. Educ Health 2014;32:23–9.
  113. Campos L, Dias P, Palha F. Finding space to mental health – promoting mental health in adolescents: pilot study. Educ Health 2014;32:23–9.
  114. Arnold DS, O’Leary SG, Wolff LS, Acker MM. The Parenting Scale: a measure of dysfunctional parenting in discipline situations. Psychol Assess 1993;5:137–44. https://doi.org/10.1037/1040-3590.5.2.137 doi: 10.1037/1040-3590.5.2.137. [DOI]
  115. Abidin RR. Parenting Stress Index: A Measure of the Parent–Child System. In Zalaquett CP, Wood RJ, editors. Evaluating Stress: A Book of Resources. Lanham, MD: Scarecrow Education; 1997. pp. 277–91.
  116. Stevens K. Valuation of the Child Health Utility 9D Index. PharmacoEconomics 2012;30:729–47. https://doi.org/10.2165/11599120-000000000-00000 doi: 10.2165/11599120-000000000-00000. [DOI] [PubMed]
  117. Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res 2017;17:88. https://doi.org/10.1186/s12913-017-2031-8 doi: 10.1186/s12913-017-2031-8. [DOI] [PMC free article] [PubMed]
  118. Martinsen KD, Kendall PC, Stark K, Neumer S-P. Prevention of anxiety and depression in children: acceptability and feasibility of the transdiagnostic EMOTION program. Cogn Behav Pract 2016;23:1–13. https://doi.org/10.1016/j.cbpra.2014.06.005 doi: 10.1016/j.cbpra.2014.06.005. [DOI]
  119. Kulier R, Helmerhorst FM, Maitra N, Gülmezoglu AM. Effectiveness and acceptability of progestogens in combined oral contraceptives – a systematic review. Reprod Health 2004;1:1. https://doi.org/10.1186/1742-4755-1-1 doi: 10.1186/1742-4755-1-1. [DOI] [PMC free article] [PubMed]
  120. Brooke-Sumner C, Petersen I, Asher L, Mall S, Egbe CO, Lund C. Systematic review of feasibility and acceptability of psychosocial interventions for schizophrenia in low and middle income countries. BMC Psychiatry 2015;15:19. https://doi.org/10.1186/s12888-015-0400-6 doi: 10.1186/s12888-015-0400-6. [DOI] [PMC free article] [PubMed]
  121. Muftin Z, Thompson AR. A systematic review of self-help for disfigurement: effectiveness, usability, and acceptability. Body Image 2013;10:442–50. https://doi.org/10.1016/j.bodyim.2013.07.005 doi: 10.1016/j.bodyim.2013.07.005. [DOI] [PubMed]
  122. El-Den S, O’Reilly CL, Chen TF. A systematic review on the acceptability of perinatal depression screening. J Affect Disord 2015;188:284–303. https://doi.org/10.1016/j.jad.2015.06.015 doi: 10.1016/j.jad.2015.06.015. [DOI] [PubMed]
  123. Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res 2016;26:1753–60. https://doi.org/10.1177/1049732315617444 doi: 10.1177/1049732315617444. [DOI] [PubMed]
  124. Lancaster GA, Dodd S, Williamson PR. Design and analysis of pilot studies: recommendations for good practice. J Eval Clin Pract 2004;10:307–12. https://doi.org/10.1111/j.2002.384.doc.x doi: 10.1111/j.2002.384.doc.x. [DOI] [PubMed]
  125. Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, Lancaster GA, PAFS consensus group. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. Pilot Feasibility Stud 2016;2:64. https://doi.org/10.1186/s40814-016-0105-8 doi: 10.1186/s40814-016-0105-8. [DOI] [PMC free article] [PubMed]
  126. Ravens-Sieberer U, Gosch A, Rajmil A, Erhart M, Bruil J, Duer W, et al. KIDSCREEN-52 quality of life measure for children and adolescents. Expert Rev Pharmacoecon Res 2005;5:353–64. https://doi.org/10.1586/14737167.5.3.353 doi: 10.1586/14737167.5.3.353. [DOI] [PubMed]
  127. Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambul Pediatr 2003;3:329–41. https://doi.org/10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2 doi: 10.1367/1539-4409(2003)003&#x0003c;0329:TPAAPP&#x0003e;2.0.CO;2. [DOI] [PubMed]
  128. Hilliard ME, Lawrence JM, Modi AC, Anderson A, Crume T, Dolan LM, et al. Identification of minimal clinically important difference scores of the PedsQL in children, adolescents, and young adults with type 1 and type 2 diabetes. Diabetes Care 2013;36:1891–7. https://doi.org/10.2337/dc12-1708 doi: 10.2337/dc12-1708. [DOI] [PMC free article] [PubMed]
  129. Rhoades KA, O’Leary SG. Factor structure and validity of the parenting scale. J Clin Child Adolesc Psychol 2007;36:137–46. https://doi.org/10.1080/15374410701274157 doi: 10.1080/15374410701274157. [DOI] [PubMed]
  130. Byford S, Barrett B, Roberts C, Wilkinson P, Dubicka B, Kelvin RG, et al. Cost-effectiveness of selective serotonin reuptake inhibitors and routine specialist care with and without cognitive behavioural therapy in adolescents with major depression. Br J Psychiatry 2007;191:521–7. https://doi.org/10.1192/bjp.bp.107.038984 doi: 10.1192/bjp.bp.107.038984. [DOI] [PubMed]
  131. Byford S, Harrington R, Torgerson D, Kerfoot M, Dyer E, Harrington V, et al. Cost-effectiveness analysis of a home-based social work intervention for children and adolescents who have deliberately poisoned themselves. Results of a randomised controlled trial. Br J Psychiatry 1999;174:56–62. https://doi.org/10.1192/bjp.174.1.56 doi: 10.1192/bjp.174.1.56. [DOI] [PubMed]
  132. Yi-Frazier JP, Hilliard ME, Fino NF, Naughton MJ, Liese AD, Hockett CW, et al. Whose quality of life is it anyway? Discrepancies between youth and parent health-related quality of life ratings in type 1 and type 2 diabetes. Qual Life Res 2016;25:1113–21. https://doi.org/10.1007/s11136-015-1158-5 doi: 10.1007/s11136-015-1158-5. [DOI] [PMC free article] [PubMed]
  133. Qadeer RA, Ferro MA. Child–parent agreement on health-related quality of life in children with newly diagnosed chronic health conditions: a longitudinal study. Int J Adolesc Youth 2018;23:99–108. https://doi.org/10.1080/02673843.2017.1297242 doi: 10.1080/02673843.2017.1297242. [DOI]
  134. Oltean II, Ferro MA. Agreement of child and parent-proxy reported health-related quality of life in children with mental disorder. Qual Life Res 2019;28:703–12. https://doi.org/10.1007/s11136-018-2026-x doi: 10.1007/s11136-018-2026-x. [DOI] [PubMed]
  135. Varni JW, Setoguchi Y. Screening for behavioral and emotional problems in children and adolescents with congenital or acquired limb deficiencies. Am J Dis Child 1992;146:103–7. https://doi.org/10.1001/archpedi.1992.02160130105030 doi: 10.1001/archpedi.1992.02160130105030. [DOI] [PubMed]
  136. Wei Y, McGrath PJ, Hayden J, Kutcher S. Mental health literacy measures evaluating knowledge, attitudes and help-seeking: a scoping review. BMC Psychiatry 2015;15:291. https://doi.org/10.1186/s12888-015-0681-9 doi: 10.1186/s12888-015-0681-9. [DOI] [PMC free article] [PubMed]
  137. Riebschleger J, Grové C, Cavanaugh D, Costello S. Mental health literacy content for children of parents with a mental illness: thematic analysis of a literature review. Brain Sci 2017;7:E141. https://doi.org/10.3390/brainsci7110141 doi: 10.3390/brainsci7110141. [DOI] [PMC free article] [PubMed]
  138. Moffatt S, Mackintosh J, White M, Howel D, Sandell A. The acceptability and impact of a randomised controlled trial of welfare rights advice accessed via primary health care: qualitative study. BMC Public Health 2006;6:163. https://doi.org/10.1186/1471-2458-6-163 doi: 10.1186/1471-2458-6-163. [DOI] [PMC free article] [PubMed]
  139. Thomas KS, Bradshaw LE, Sach TH, Cowdell F, Batchelor JM, Lawton S, et al. Randomised controlled trial of silk therapeutic garments for the management of atopic eczema in children: the CLOTHES trial. Health Technol Assess 2017;21(16). https://doi.org/10.3310/hta21160 doi: 10.3310/hta21160. [DOI] [PMC free article] [PubMed]
  140. Grønning K, Bratås O, Steinsbekk A. Patients’ perceptions of having a good life one year after arthritis patient education: a qualitative study nested within a randomized controlled trial. Nurse Media J Nurs 2017;7:1–14. https://doi.org/10.14710/nmjn.v7i1.15123 doi: 10.14710/nmjn.v7i1.15123. [DOI]
  141. Jibb LA, Stevens BJ, Nathan PC, Seto E, Cafazzo JA, Johnston DL, et al. Perceptions of adolescents with cancer related to a pain management app and its evaluation: qualitative study nested within a multicenter pilot feasibility study. JMIR Mhealth Uhealth 2018;6:e80. https://doi.org/10.2196/mhealth.9319 doi: 10.2196/mhealth.9319. [DOI] [PMC free article] [PubMed]
  142. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol 2006;3:77–101. https://doi.org/10.1191/1478088706qp063oa doi: 10.1191/1478088706qp063oa. [DOI]
  143. Hilal AH, Alabri SS. Using NVivo for data analysis in qualitative research. Int Interdiscip J Educ 2013;2:181–6. https://doi.org/10.12816/0002914 doi: 10.12816/0002914. [DOI]
  144. May CR, Mair F, Finch T, MacFarlane A, Dowrick C, Treweek S, et al. Development of a theory of implementation and integration: Normalization Process Theory. Implement Sci 2009;4:29. https://doi.org/10.1186/1748-5908-4-29 doi: 10.1186/1748-5908-4-29. [DOI] [PMC free article] [PubMed]
  145. May CR, Cummings A, Girling M, Bracher M, Mair FS, May CM, et al. Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions: a systematic review. Implement Sci 2018;13:80. https://doi.org/10.1186/s13012-018-0758-1 doi: 10.1186/s13012-018-0758-1. [DOI] [PMC free article] [PubMed]
  146. Margolis R, Fernandes P. Building Children’s Confidence and Improving Parents’ Protective Skills: Final Evaluation of the NSPCC Family SMILES Service. London: NSPCC; 2017. URL: https://learning.nspcc.org.uk/media/1133/family-smiles-final-evaluation.pdf (accessed 15 July 2020).
  147. Nevriana A, Pierce M, Dalman C, Wicks S, Hasselberg M, Hope H, et al. Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden. BMJ 2020;369:m853. https://doi.org/10.1136/bmj.m853 doi: 10.1136/bmj.m853. [DOI] [PMC free article] [PubMed]
  148. Young Minds. A New Era for Young People’s Mental Health. 2019. URL: https://youngminds.org.uk/blog/nhs-long-term-plan-commits-to-young-peoples-mental-health/ (accessed 13 March 2019).
  149. House of Commons Committee of Public Accounts. Mental Health Services for Children and Young People. London: House of Commons; 2019.
  150. Early Intervention Foundation. Realising the Potential of Early Intervention. London: Early Intervention Foundation; 2018.
  151. Bower P, Grigoroglou C, Anselmi L, Kontopantelis E, Sutton M, Ashworth M, et al. Is health research undertaken where the burden of disease is greatest? Observational study of geographical inequalities in recruitment to research in England 2013–2018. BMC Med 2020;18:133. https://doi.org/10.1186/s12916-020-01555-4 doi: 10.1186/s12916-020-01555-4. [DOI] [PMC free article] [PubMed]
  152. Knapp M, McDaid D, Parsonage M. Mental Health Promotion and Mental Illness Prevention: The Economic Case. London: Department of Health and Social Care; 2011. URL: https://eprints.lse.ac.uk/32311/1/Knapp_et_al__MHPP_The_Economic_Case.pdf (accessed 14 March 2019).
  153. Upton P, Eiser C, Cheung I, Hutchings HA, Jenney M, Maddocks A, et al. Measurement properties of the UK–English version of the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales. Health Qual Life Outcomes 2005;3:22. https://doi.org/10.1186/1477-7525-3-22 doi: 10.1186/1477-7525-3-22. [DOI] [PMC free article] [PubMed]
  154. Ravens-Sieberer U, Erhart M, Torsheim T, Hetland J, Freeman J, Danielson M, Thomas C, HBSC Positive Health Group. An international scoring system for self-reported health complaints in adolescents. Eur J Public Health 2008;18:294–9. https://doi.org/10.1093/eurpub/ckn001 doi: 10.1093/eurpub/ckn001. [DOI] [PubMed]
  155. Chen G, Flynn T, Stevens K, Brazier J, Huynh E, Sawyer M, et al. Assessing the health-related quality of life of Australian adolescents: an empirical comparison of the child health utility 9D and EQ-5D-Y instruments. Value Health 2015;18:432–8. https://doi.org/10.1016/j.jval.2015.02.014 doi: 10.1016/j.jval.2015.02.014. [DOI] [PubMed]
  156. Drummond M. Introducing economic and quality of life measurements into clinical studies. Ann Med 2001;33:344–9. https://doi.org/10.3109/07853890109002088 doi: 10.3109/07853890109002088. [DOI] [PubMed]
  157. Chorpita BF, Moffitt CE, Gray J. Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behav Res Ther 2005;43:309–22. https://doi.org/10.1016/j.brat.2004.02.004 doi: 10.1016/j.brat.2004.02.004. [DOI] [PubMed]
  158. Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 2001;40:1337–45. https://doi.org/10.1097/00004583-200111000-00015 doi: 10.1097/00004583-200111000-00015. [DOI] [PubMed]

RESOURCES