How many children with LTCs and poor mental health receive access to primary care, paediatrics or child and adolescent mental health services?
June 2021-Aug 2021
University of Cambridge
During my summer internship I will be using epidemiological data to look at the proportion of children and young people with poor mental health, and in some cases additional long term conditions, who receive access to primary health care, paediatrics and CAMHS. I will also consider the barriers and predictors of service access.
What actually is public health research? My 7-week whirlwind tour.
Public health research was a mystery to me. It had never once been mentioned at school or University. Indeed, I would love to be proven wrong, but I feel this is the case for many social and medicinal science students. I hate to bring the pandemic into this article (!) but I believe it really has shed a new light on the practicalities and importance of public health and indeed the research that guides its practice. Public health professionals have been on our TV screens almost every day talking about measures to tackle the pandemic. Furthermore, the efficiency of public health research in producing safe coronavirus vaccines in such a short space of time has been frankly astonishing. It is amazing to see how the work of a handful of researchers can inform policy and improve the lives and baseline health of a whole population. I was lucky enough to get a 7-week research placement through the National Institute of Health Research School of Public Health Research (NIHR SPHR) internship scheme (1) to allow me to experience public health research first-hand. Through this blog I hope to communicate my newfound understanding of what public health research entails through my personal experience.
My research project
My research project aimed to determine factors which could predict whether children with mental health problems and physical long-term health conditions in the population would access GPs, paediatric services or child and adolescent mental health services for their mental health problems. My schedule consisted of a 35-hour working week and as my placement was online, the hours were flexible which meant I could fit my work around meeting friends and family. This made it a really nice summer job! I had one supervisor whom I met weekly to discuss the progress of the project and decide on the aims of the coming week.
I began my project by scouting through previous research papers which brought to light some startling facts. First, the prevalence of mental health problems in children and adolescents is increasing dramatically, with one study finding that 10% of children and young people (aged 5-16 years) in the UK have a clinically diagnosable mental health problem (2). Even more worrying is that a current problem faced by healthcare professionals is that less than two thirds of these young people with mental health problems are accessing professional help (3). Furthermore, an estimated 30% of individuals of all ages with long term physical health conditions also have a mental health condition (4).
My reading also informed me of certain factors, highlighted by previous researchers which were shown to predict whether children and adolescents were accessing healthcare services for their mental health condition. This was useful as I could also compare my findings, which were focused, for the first time, on children and young people with comorbid long-term physical health conditions and mental health problems, with previous studies in children without physical health conditions.
After this, I analysed quantitative data from the 1999 and 2004 British Child and Adolescent Mental Health Surveys using a statistical software program called SPSS. It swiftly became clear that seven weeks was a relatively short time to complete a public health research project using data from thousands of families so there is still more statistical analysis to be done before we can make any concrete conclusions from my results. However my research indicated that when a child has more contact with their teachers about their mental health symptoms and when the parent recognises the severity of their child’s mental health condition, children are more likely to access professional health services. If after further analysis, these preliminary conclusions are confirmed, then I hope that these results will inform policy and encourage more contact between teachers and children and the production of accessible material for parents to help identify their child’s issue.
I also learnt that an equally vital part of public health research is actively engaging and involving the public with your work. This holds researchers accountable for their methods and also affords them an insight into whether the public are engaging in their work. It is hugely important to bring your output to the attention of people who have the influence to change policy, be it by public demonstrations, crowdfunding or further cooperation in trials. The NIHR SPHR interns had a workshop where we were taught how to write a blog post and research briefing (which are much more accessible to the general public than scientific articles) and encouraged to write one to accompany our respective research projects.
I have learnt so much during these seven weeks and I have now experienced the lifestyle of a public health researcher and what public health research
entails. I would say that public health is best defined by its purpose; to provide services and interventions which improve the baseline health level of the whole population. Therefore the role of public health research is to provide evidence to show what factors influence population health and what methods we can employ to promote optimal health.
- Reardon, T., Harvey, K., Baranowska, M., O’Brien, D., Smith, L., & Creswell, C. (2017). What do parents perceive are the barriers and facilitators to accessing psychological treatment for mental health problems in children and adolescents? A systematic review of qualitative and quantitative studies. Eur Child Adolesc Psychiatry, 26(6), 623-647. https://doi.org/10.1007/s00787-016-0930-6
- Radez, J., Reardon, T., Creswell, C., Lawrence, P. J., Evdoka-Burton, G., & Waite, P. (2021). Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. Ibid.,30(2), 183-211. https://doi.org/10.1007/s00787-019-01469-4