The wellbeing of children with imprisoned parents is known to be challenged by various stressors related to parental incarceration; it is imperative that these are addressed appropriately to allow children to reach their potential. This scoping review aims to specifically explore children’s experiences during the time of parental incarceration. The databases Scopus, Web of Science, PSYCINFO and Academic Search Complete were searched; 59 peered-reviewed articles presenting the narratives of 904 children and young people are reviewed. The findings indicate that these children have a range of unmet needs: for, maintaining meaningful contact with incarcerated parents, having a childhood, sharing feelings, community awareness and education, and agency. Understanding and valuing children’s lived experience of parental incarceration help to make more appropriate recommendations for future research and social interventions.
• Food insecurity is consistently associated with worse child mental health in sub-Saharan Africa. • The causal relationship between food insecurity and child mental health is poorly understood. • No intervention studies investigated the effect of reducing food insecurity on mental health. • Measures of food insecurity lacked validity and reliability. • Included observational studies were of acceptable quality. Food insecurity and mental health conditions are important public health problems among children and adolescents in sub-Saharan Africa (SSA). Many potential biological, psychological and social mechanisms may explain the association between food insecurity and mental health among children and adolescents. Experiences of food insecurity are known to affect an individual’s psychological state resulting in anxiety, isolation, stress, and sadness. To systematically review the literature on the association between food insecurity and child and adolescent mental health (CAMH) and the impact of food insecurity reduction interventions on CAMH outcomes in SSA. A systematic search of eight databases (APA PsycINFO, CINAHL, EconLit, Embase, MEDLINE, Scopus, PubMed and Cochrane Library) was conducted to identify relevant studies. Included studies were assessed for quality and correlations between food insecurity and CAMH reported. 9547 published articles were retrieved during literature search. Seventeen observational studies met the inclusion criteria and were included in the review. No articles of intervention studies were identified. Positive significant associations were found between food insecurity and worse CAMH outcomes. Included articles of observational studies were of acceptable quality. Experiencing food insecurity is associated with both internalising and externalizing problems among children and adolescents in SSA. While no interventions reducing food insecurity were found, there is a need to design and conduct intervention studies to assess the impact of such interventions on CAMH. Although cross-sectional evidence for the association between food insecurity and mental health conditions is well established, there is a need for longitudinal studies to assess the bi-directional, temporal associations, and unpack mechanisms through which food insecurity affects mental health (social causation) and through which mental health conditions affect food insecurity (social drift). Reducing food insecurity and improving CAMH is needed to break the cycle of food insecurity and to achieve the United Nations 2030 Sustainable Development Goals.
Ibrahim Kasujja, Crick Lund, Tatiana Taylor Salisbury
• This study privileges the lived experiences of young people in therapeutic residential care. • We use the dual lens of recognition theory and the theory of practice architectures. • Young people highlight what needs to change to improve their relationships and connections. • ‘Recognitional practice’ is conceptualised based on the voices of young people. Young people living in therapeutic residential care face major challenges that can prevent them from forming healthy relationships and connections within the community, which are critical building blocks for their wellbeing and safety. To address these challenges, Australia has introduced ‘therapeutic residential care’ (TRC) models in a number of states and territories. TRC in Australia is designed to respond to high levels of complexity of need, for those young people who are unable to live in a home-based care arrangement. This research sought to explore whether and how relational practices in TRC enable the experience of positive, trusting relationships for young people. Young interviewees between the ages of 12 and 18 years ( N = 38) reported experiencing trust when staff members genuinely invested time in their wellbeing, demonstrated care and respect, and made them feel valued. Conversely the lack of these practices and/or particular organisational and systemic conditions were often considered barriers that could lead to ‘misrecognition.’ Drawing directly from the lived experience as recounted by the young people currently living in residential care, the researchers conceptualise and introduce a new dimension of relational practice in residential care settings.
Lynne McPherson, Antonia Canosa, Robbie Gilligan et al.
Background Nationally and internationally, researchers and practitioners are increasingly expressing concerns regarding the number of babies removed by child protection systems soon after birth and how child protection processes in the perinatal period (conception to one year following birth) impact families. Aim This systematic review synthesises qualitative studies to gain an understanding of the experiences and needs of pregnant women, mothers, and fathers involved in perinatal child protection processes that occur in health, welfare, and legal systems. Methods Multi-disciplinary electronic databases (13) were searched for relevant peer-reviewed journal articles written in English and published since 2000. Twenty-four articles met the inclusion criteria. Analysis adopted a socio-ecological approach and thematic synthesis. An expert advisory group comprised of lived experience advisors, service providers, and academics contributed to development of the thematic framework. Results Although the reviewed studies were conducted between 2005 and 2023 with diverse participants from six countries, they highlight parents’ similar experiences of perinatal child protection processes. Parents’ experiences were synthesised according to spheres of the socio-ecological model: (i) At the individual level, parents described their love, hope, confusion, fear, agency, and anguish. (ii) Within relationships parents recounted broken parent-baby bonds, limited personal and professional support, and the implications of trauma and trust for parent-professional relationships. (iii) When engaging with organisations parents reported pervasive surveillance and harmful processes, inadequate communication and support, and power imbalances. (iv) At policy and societal levels parents’ experiences pointed to dominant Western norms and values, increased poverty and homelessness, compromised rights, and prejudicial perinatal policies. Also synthesised are parents’, professionals’, and researchers’ recommendations for improving perinatal child protection processes and supporting families. Conclusions Over the last 20 years, qualitative studies from around the globe have consistently reported the adverse biopsychosocial impacts of removing babies from their families. Addressing poverty and trauma, redressing power imbalances, and mitigating the enduring impact of perinatal child protection processes is critical for parents’ to be able to keep or be reunified with their babies. Shifts at institutional, policy, and societal levels are needed to: prioritise prevention and early intervention; enable relational practice and cross-sector collaboration; and move beyond traditional Western notions of family. Centring parents’ voices in efforts to improve child protection processes before and after birth will help inform the delivery of early and appropriate support to meet parents’ identified needs and promote family wellbeing.
Samantha Burrow, Lisa Jane Wood, Colleen M. Fisher et al.
Service-level factors that influence father engagement within child and family services are not well understood due to diversity in research studies and evidence from different contexts. Accordingly, the aim of this systematic review was to identify and synthesise available qualitative evidence across contexts to identify the common service-level barriers and facilitators of father engagement in child and family services. The following six databases were systematically searched from database inception in February 2022: Medline, EMBASE, AMED, PsycINFO, CAB Abstracts, and Global Health. Studies were considered eligible if they described service-level factors impacting father engagement in healthcare services and interventions aimed at improving child and family well-being. The screening and selection processes were conducted by two independent reviewers to reduce the risk of bias. Selected studies were quality assessed using the CASP appraisal tool. Results from the included studies were synthesised thematically. Twenty-three eligible qualitative studies were included in the analysis. All studies were published between 2005-2022 Thematic synthesis identified seven main themes encompassing service-level barriers and facilitators to father engagement: practitioners; environment; marketing; resources; staff education; policy and practice guidelines; and evaluation. The findings show that improving father engagement is dependent on a combination of individual practitioner competence, and service environment that provides the necessary structure, processes, and resources to enable effective work with fathers. Addressing the barriers and prioritizing facilitators therefore requires strengthening of both the organizational and practitioner capacity for father-inclusive practice.
Intra-familial child sexual abuse is acknowledged to have wide-reaching impacts within the family environment; impacts that can affect both non-abusing family members’ own wellbeing and their capacity to support the child who has been abused. Yet research also demonstrates the important role that can be played by family members, in the aftermath of the identification of abuse, when appropriately supported. This article builds on this existing evidence base (that is primarily drawn from research with parents/carers and professionals) through analysing a unique qualitative data set, developed using interviews and a creative ‘toolkit’ approach with 53 children and young people (aged 6–19 years), who had experienced sexual abuse in the family environment. The article explores their perspectives on the wider family impacts of identification of abuse, their perceptions of the associated support needs of other family members and their understanding of how this relates to their own recovery. The findings firstly suggest the need to recognise children’s relationships with non-abusing family members as a fundamental and interdependent aspect of their recovery in the aftermath of sexual abuse in the family environment. Secondly, they demonstrate the need to recognise the high levels of (self-perceived) responsibility that child victims experience for impacts on their non-abusing family members. Finally, they highlight how professional support to non-abusing family members is explicitly identified as an unmet need by children themselves, and how crucial it is to alleviate what children describe as the ‘ripple effect’ of additional challenges and harms emanating after abuse is identified. The article concludes by considering the implications of these findings, further strengthening arguments around the importance of viewing children’s needs relationally and the unique and critical insights to be gained from involving children in research addressing child sexual abuse.
Camille Warrington, Helen Beckett, Debra Sue Allnock et al.
Placement instability in residential youth care is an important issue. Youth in residential care have the highest number of previous placements compared to youth in other types of out-of-home care (e.g., foster care), and the high number of previous placements can be experienced as traumatic events. Placement instability is associated with negative outcomes for youth, such as mental health problems. However, there is no review of the factors associated with placement instability in residential care. In this study, we reviewed research (qualitative and quantitative) on factors related to placement instability in residential youth care. A search in four databases (PsycINFO, ERIC, SocINDEX, and Medline) resulted in 10,299 hits. After selecting on the inclusion criteria, we included fifteen articles in our analysis. We identified several youth, family, decision-making, care, and, organizational factors associated with placement instability in residential care. In general, the number of studies focusing on placement instability is small. Most studies focused on static (i.e., unchangeable) youth factors, such as sex and age. We found some indications that dynamic (i.e., changeable) family, care, and organizational factors, such as poor parenting skills, low staff competence and turnover of professionals are positively associated with placement instability. It is striking that most of the included studies focused mainly on static youth factors. We need more knowledge about dynamic factors to reduce placement instability in residential youth care. Future research should focus on elements that might prevent placement instability.
Ymke Riemersma, Annemiek T. Harder, Elianne A. Zijlstra et al.
Care-experienced children and young people are more likely to experience poorer mental health relative to the general population. Some of the most highly cited literature in this area is becoming increasingly outdated, however, and as the gap between mental health service availability and provision is steadily growing, it is imperative that we understand the scale and nature of the mental health needs of this group. A systematic review of all literature published from the UK was conducted in March 2022 using APA PsycINFO, ASSIA, Cochrane Library, Medline, PubMed, Scopus, Social Policy and Practice, Social Services Abstracts, and Web of Science. Papers were included if they sampled young people (aged 0-18 years) with care experience used either a standard or non-standardised measurement tool, or health records to assess mental health prevalence rates (reported as a percentage). Risk of bias assessed used the QuADS tool (Harrison et al., 2021), and data was extracted. Thirty-nine studies were included and summarised. The estimated prevalence of mental health disorders of young people in care ranged from 1-82%. The most frequently used tool to assess mental health was the Strengths and Difficulties Questionnaire (Goodman, 1997) and, while over half of studies utilised prevalence information from a comparator group, this was most commonly young people in the general population. The results of the systematic review demonstrate that estimates of mental health disorders among care-experienced young people in the UK vary considerably. Further consideration should be given toward what measures are used to assess mental health in this population and how we can optimally assess and characterise their support needs.
As the discussion of Chinese left-behind children (LBC) continues, intervention programs dedicated to this population increase and diversify. While reviews have summarized intervention programs promoting LBC’s health and psychological wellbeing, there is no synthesis depicting a comprehensive picture. This scoping review systematically examines interventions tackling LBC’s various issues and identifies their design and foci. We performed a systematic literature search to extract intervention studies from four English (i.e., Web of Science, Scopus, Embase, & PsycINFO) and one Chinese (i.e., CNKI) database. The quality of the studies was assessed using the Mixed Methods Assessment Tool (MMAT). Two main rounds of deductive coding were performed on Nvivo 12 plus to identify the design and foci of the interventions. Thirty-three articles were identified for our final review. Twenty-six were published in Chinese and seven in English. Existing interventions have tackled multiple psychological, social, physical, developmental, and sexual problems or needs of Chinese rural left-behind children. Among them, LBC’s psychological wellbeing has drawn the most attention. The majority of the reviewed studies performed a randomized controlled trial (N=20). Quantitative evaluation is prevalent, with only one study applying a purely qualitative evaluation. In addition, only two studies adopted validated interventions, while the others are self-designed. The review results indicate several gaps in intervention studies for LBC. First, many existing interventions have considered LBC’s psychological and social wellbeing, while little effort has been paid to address their educational and intellectual development. Further, while existing interventions are concerned with LBC’s temporary needs, their long-term life planning, as well as their current self-efficacy and self-concept driving their actions towards future self, were neglected. As for the intervention design, empirically validated interventions are recommended for future studies for their verified efficacy and evidence-based standardized practice. In addition, a qualitative evaluation should be considered because it might be more powerful in eliciting realistic and viable solutions to improve the effectiveness and reliability of the interventions from the participants.
State and local educational agencies are grappling with growing mental health needs among school-aged children that intensified during the COVID-19 pandemic. We undertake a case study of the experiences of one state, Tennessee, to examine the landscape of mental health interventions that are being deployed and to illuminate contextual factors that can support their implementation or exacerbate state and local challenges in addressing children's fast-rising mental health needs. We begin with an examination of the knowledge base on interventions and approaches that are commonly employed in K-12 schools to address children's mental health needs, including in Tennessee, with the aim to identify notable gaps in what we understand about their implementation and impacts on student outcomes. We find a lack of rigorous research that can inform efforts to improve the implementation and effectiveness of school-based mental health interventions. We bring this insight to our case-study analysis, which shows that this lack of guidance from research is compounded by inadequate, time-limited and fluctuating public funding that hinders local efforts to establish strong, ongoing programs that provide or connect K-12 students to essential mental health services. We call for more federal funding to support state and local implementation of proven and promising interventions for addressing children's mental health needs and more rigorous evaluations to strengthen the evidence base on their implementation and impacts.
Carolyn J. Heinrich, Ann Colomer, Matthew Hieronimus
