Ignite Creation Date:
2024-10-26 @ 3:40 PM
Last Modification Date:
2025-12-17 @ 6:06 AM
Study NCT ID:
NCT06600139
Status:
None
Last Update Posted:
2024-09-19 00:00:00
First Post:
2024-08-23 00:00:00
Brief Title:
Screening to Identify Parents in Need of Mental Health Support: a Feasibility Study in Child Welfare Services
Sponsor:
None
Organization:
Karolinska Institutet
Study Overview
Official Title:
A Feasibility Study of the Collaboration-Screening-Referral Model - an Approach to Identify Parents in Child Welfare Services Who Need Mental Health Support
Status:
None
Status Verified Date:
2024-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
BACKGROUND:
Parental mental illness is prevalent and associated with several family-related risks. Parental mental illness is more common during circumstances characterized by family-related risk factors and for parents in contact with the child welfare system. Further, children to parents with mental health problems are at increased risk of developing own psychiatric problems in childhood and later adulthood. Additionally, parental mental illness influences parenting ability and is a strong risk factor for child maltreatment (CM). CM strongly increases the risk of children developing a range of psychiatric problems.
Identifying mental illness among parents within the child welfare services (CWS) and referring them to evidence-based treatment in healthcare could be essential for improving children's well-being and reducing the risk of CM. For that, intra-agency collaboration is considered crucial. Collaboration between the CWS and healthcare is however a known issue.
One way to address the lack of knowledge in assessing mental illness and support intra-agency collaboration can be routines for screening and referrals. Screening everyone in a setting can be a non-stigmatizing approach to assess symptoms and risk behaviors. Screening parents for mental health symptoms is widely implemented within pediatric healthcare, e.g., screening for post-natal depression, but is to our knowledge not a common approach within the CWS. Additionally, the lack of evidence-based methods has often been cited as a shortcoming within the CWS. Furthermore, social workers could lack the competence to identify mental illness, as it is not included in their basic education. It is therefore assumed that social workers do not always assess parents' mental health with validated procedures and do not always refer parents in need.
PURPOSE AND RESEARCH QUESTIONS:
The main aim of this project is to improve early identification of mental illness in parents reported for CM and to make treatment accessible for families with additional needs. The feasibility of the Collaboration-Screening-Referral model (in Swedish: Samverkan-Screening-Hänvisning - SSH) will be evaluated - an approach for screening parents for symptoms of mental illness and referring to support. The research questions are:
1. Are parents engaged with CWS willing to undergo screening for symptoms of depression and anxiety?
2. What barriers and facilitators to implementing the SSH have there been?
3. In what ways do parents and social workers experience that the children are influenced by the SSH, and what support the children in these families might need?
4. Do social workers' behaviors relating to assessing and handling mental illness and intra-agency collaboration procedures increase when implementing the SSH?
5. Do social workers' knowledge and perceived competence in assessing and managing mental illness increase after employing the SSH?
6. What strategies have been employed by the CWS agencies in the implementation of the SSH?
7. To what degree is usage of the SSH sustained 12 months after initiation?
METHODS:
SSH is a structured approach for screening and referring parents who need mental health support, designed for use by social workers within CWS. Municipalities will be recruited to take part in the research project and implement the SSH. First, staff will be trained in mental health screening, and a referral routine will be established. Units will also be encouraged to arrange meetings with local mental health clinics. Social workers will then administer the screening to parents. Questionnaires are followed by a discussion about well-being and support needs. The social worker can provide information on available mental health resources and offer support in establishing a contact.
The data collection will include surveys and interviews/focus groups. In connection with the training, staff will respond to a survey (baseline measurement) regarding their work methods and perceived competence in addressing mental health issues. Prior to participation, staff will be given information about the study and provide informed consent via an online platform before they access the survey. The data collection will then be divided into two phases.
Phase 1. After the first municipalities have used the SSH for approximately 3 months, social workers will participate in interviews or focus groups. If necessary, the SSH will be modified before further evaluation.
Phase 2. In the next phase, these and additional municipalities will continue to use the SSH as part of routine work. Approximately 6 months from baseline, staff will answer a follow-up survey and interviews and/or focus groups will be conducted. Further, social workers will be asked to recruit parents who have completed the screening for interviews. They will give oral information and provide a link to where parents can read written information and give informed consent. For parents who consent to participate, a person from the research team will call and inform the parent about the study, give the possibility to ask questions, and book a time for the interview. Interviews/focus groups will be conducted by phone calls or video meetings.
SAMPLE SIZE CALCULATION AND ANALYSES:
Quantitative data in surveys to staff will be presented descriptively and statistically analyzed (e.g., t-tests/non-parametric alternative). Psychometric statistics will be calculated. For a power of 80% to detect a medium sized effect (d = 0.50), the total sample size of participating staff has to be N = 34 (alpha = 0.05). To account for a drop-out rate of approximately 10%, the aim is to recruit 40 participants. Qualitative data will be analyzed employing qualitative methods, e.g., thematic analysis. For interviews, 20-40 social workers and 10-25 parents will be recruited. The specific number will be dependent upon achieving a sufficiently rich dataset according to qualitative methodological standards, e.g., data saturation or information power.
The data from the questionnaire administered to parents to assess symptoms of depression and anxiety is presented in a separate study: \"Identifying Parents in Child Welfare Services Who Need Mental Health Support: Depression and Anxiety Symptoms\". Based on the power calculation for that study, the aim is that 290 parents respond to the questionnaire. In this study, only the questions from parents' questionnaire assessing acceptability of the screening process are included.
Parental mental illness is prevalent and associated with several family-related risks. Parental mental illness is more common during circumstances characterized by family-related risk factors and for parents in contact with the child welfare system. Further, children to parents with mental health problems are at increased risk of developing own psychiatric problems in childhood and later adulthood. Additionally, parental mental illness influences parenting ability and is a strong risk factor for child maltreatment (CM). CM strongly increases the risk of children developing a range of psychiatric problems.
Identifying mental illness among parents within the child welfare services (CWS) and referring them to evidence-based treatment in healthcare could be essential for improving children's well-being and reducing the risk of CM. For that, intra-agency collaboration is considered crucial. Collaboration between the CWS and healthcare is however a known issue.
One way to address the lack of knowledge in assessing mental illness and support intra-agency collaboration can be routines for screening and referrals. Screening everyone in a setting can be a non-stigmatizing approach to assess symptoms and risk behaviors. Screening parents for mental health symptoms is widely implemented within pediatric healthcare, e.g., screening for post-natal depression, but is to our knowledge not a common approach within the CWS. Additionally, the lack of evidence-based methods has often been cited as a shortcoming within the CWS. Furthermore, social workers could lack the competence to identify mental illness, as it is not included in their basic education. It is therefore assumed that social workers do not always assess parents' mental health with validated procedures and do not always refer parents in need.
PURPOSE AND RESEARCH QUESTIONS:
The main aim of this project is to improve early identification of mental illness in parents reported for CM and to make treatment accessible for families with additional needs. The feasibility of the Collaboration-Screening-Referral model (in Swedish: Samverkan-Screening-Hänvisning - SSH) will be evaluated - an approach for screening parents for symptoms of mental illness and referring to support. The research questions are:
1. Are parents engaged with CWS willing to undergo screening for symptoms of depression and anxiety?
2. What barriers and facilitators to implementing the SSH have there been?
3. In what ways do parents and social workers experience that the children are influenced by the SSH, and what support the children in these families might need?
4. Do social workers' behaviors relating to assessing and handling mental illness and intra-agency collaboration procedures increase when implementing the SSH?
5. Do social workers' knowledge and perceived competence in assessing and managing mental illness increase after employing the SSH?
6. What strategies have been employed by the CWS agencies in the implementation of the SSH?
7. To what degree is usage of the SSH sustained 12 months after initiation?
METHODS:
SSH is a structured approach for screening and referring parents who need mental health support, designed for use by social workers within CWS. Municipalities will be recruited to take part in the research project and implement the SSH. First, staff will be trained in mental health screening, and a referral routine will be established. Units will also be encouraged to arrange meetings with local mental health clinics. Social workers will then administer the screening to parents. Questionnaires are followed by a discussion about well-being and support needs. The social worker can provide information on available mental health resources and offer support in establishing a contact.
The data collection will include surveys and interviews/focus groups. In connection with the training, staff will respond to a survey (baseline measurement) regarding their work methods and perceived competence in addressing mental health issues. Prior to participation, staff will be given information about the study and provide informed consent via an online platform before they access the survey. The data collection will then be divided into two phases.
Phase 1. After the first municipalities have used the SSH for approximately 3 months, social workers will participate in interviews or focus groups. If necessary, the SSH will be modified before further evaluation.
Phase 2. In the next phase, these and additional municipalities will continue to use the SSH as part of routine work. Approximately 6 months from baseline, staff will answer a follow-up survey and interviews and/or focus groups will be conducted. Further, social workers will be asked to recruit parents who have completed the screening for interviews. They will give oral information and provide a link to where parents can read written information and give informed consent. For parents who consent to participate, a person from the research team will call and inform the parent about the study, give the possibility to ask questions, and book a time for the interview. Interviews/focus groups will be conducted by phone calls or video meetings.
SAMPLE SIZE CALCULATION AND ANALYSES:
Quantitative data in surveys to staff will be presented descriptively and statistically analyzed (e.g., t-tests/non-parametric alternative). Psychometric statistics will be calculated. For a power of 80% to detect a medium sized effect (d = 0.50), the total sample size of participating staff has to be N = 34 (alpha = 0.05). To account for a drop-out rate of approximately 10%, the aim is to recruit 40 participants. Qualitative data will be analyzed employing qualitative methods, e.g., thematic analysis. For interviews, 20-40 social workers and 10-25 parents will be recruited. The specific number will be dependent upon achieving a sufficiently rich dataset according to qualitative methodological standards, e.g., data saturation or information power.
The data from the questionnaire administered to parents to assess symptoms of depression and anxiety is presented in a separate study: \"Identifying Parents in Child Welfare Services Who Need Mental Health Support: Depression and Anxiety Symptoms\". Based on the power calculation for that study, the aim is that 290 parents respond to the questionnaire. In this study, only the questions from parents' questionnaire assessing acceptability of the screening process are included.
Detailed Description:
BACKGROUND
Parental mental illness is prevalent and associated with several family-related risks Parental mental illness is more common during circumstances characterized by family-related risk factors and for parents in contact with the child welfare system Further children to parents with mental health problems are at increased risk of developing own psychiatric problems in childhood and later adulthood Additionally parental mental illness influences parenting ability and is a strong risk factor for child maltreatment CM CM strongly increases the risk of children developing a range of psychiatric problems
Identifying mental illness among parents within the child welfare services CWS and referring them to evidence-based treatment in healthcare could be essential for improving childrens well-being and reducing the risk of CM For that intra-agency collaboration is considered crucial Collaboration between the CWS and healthcare is however a known issue
One way to address the lack of knowledge in assessing mental illness and support intra-agency collaboration can be routines for screening and referrals Screening everyone in a setting can be a non-stigmatizing approach to assess symptoms and risk behaviors Screening parents for mental health symptoms is widely implemented within pediatric healthcare eg screening for post-natal depression but is to our knowledge not a common approach within the CWS Additionally the lack of evidence-based methods has often been cited as a shortcoming within the CWS Furthermore social workers could lack the competence to identify mental illness as it is not included in their basic education It is therefore assumed that social workers do not always assess parents mental health with validated procedures and do not always refer parents in need
PURPOSE AND RESEARCH QUESTIONS
The main aim of this project is to improve early identification of mental illness in parents reported for CM and to make treatment accessible for families with additional needs The feasibility of the Collaboration-Screening-Referral model in Swedish Samverkan-Screening-Hänvisning - SSH will be evaluated - an approach for screening parents for symptoms of mental illness and referring to support The research questions are
1 Are parents engaged with CWS willing to undergo screening for symptoms of depression and anxiety
2 What barriers and facilitators to implementing the SSH have there been
3 In what ways do parents and social workers experience that the children are influenced by the SSH and what support the children in these families might need
4 Do social workers behaviors relating to assessing and handling mental illness and intra-agency collaboration procedures increase when implementing the SSH
5 Do social workers knowledge and perceived competence in assessing and managing mental illness increase after employing the SSH
6 What strategies have been employed by the CWS agencies in the implementation of the SSH
7 To what degree is usage of the SSH sustained 12 months after initiation
METHODS
SSH is a structured approach for screening and referring parents who need mental health support designed for use by social workers within CWS Municipalities will be recruited to take part in the research project and implement the SSH First staff will be trained in mental health screening and a referral routine will be established Units will also be encouraged to arrange meetings with local mental health clinics Social workers will then administer the screening to parents Questionnaires are followed by a discussion about well-being and support needs The social worker can provide information on available mental health resources and offer support in establishing a contact
The data collection will include surveys and interviewsfocus groups In connection with the training staff will respond to a survey baseline measurement regarding their work methods and perceived competence in addressing mental health issues Prior to participation staff will be given information about the study and provide informed consent via an online platform before they access the survey The data collection will then be divided into two phases
Phase 1 After the first municipalities have used the SSH for approximately 3 months social workers will participate in interviews or focus groups If necessary the SSH will be modified before further evaluation
Phase 2 In the next phase these and additional municipalities will continue to use the SSH as part of routine work Approximately 6 months from baseline staff will answer a follow-up survey and interviews andor focus groups will be conducted Further social workers will be asked to recruit parents who have completed the screening for interviews They will give oral information and provide a link to where parents can read written information and give informed consent For parents who consent to participate a person from the research team will call and inform the parent about the study give the possibility to ask questions and book a time for the interview Interviewsfocus groups will be conducted by phone calls or video meetings
SAMPLE SIZE CALCULATION AND ANALYSES
Quantitative data in surveys to staff will be presented descriptively and statistically analyzed eg t-testsnon-parametric alternative Psychometric statistics will be calculated For a power of 80 to detect a medium sized effect d 050 the total sample size of participating staff has to be N 34 alpha 005 To account for a drop-out rate of approximately 10 the aim is to recruit 40 participants Qualitative data will be analyzed employing qualitative methods eg thematic analysis For interviews 20-40 social workers and 10-25 parents will be recruited The specific number will be dependent upon achieving a sufficiently rich dataset according to qualitative methodological standards eg data saturation or information power
The data from the questionnaire administered to parents to assess symptoms of depression and anxiety is presented in a separate study 34Identifying Parents in Child Welfare Services Who Need Mental Health Support Depression and Anxiety Symptoms34 Based on the power calculation for that study the aim is that 290 parents respond to the questionnaire In this study only the questions from parents questionnaire assessing acceptability of the screening process are included
Parental mental illness is prevalent and associated with several family-related risks Parental mental illness is more common during circumstances characterized by family-related risk factors and for parents in contact with the child welfare system Further children to parents with mental health problems are at increased risk of developing own psychiatric problems in childhood and later adulthood Additionally parental mental illness influences parenting ability and is a strong risk factor for child maltreatment CM CM strongly increases the risk of children developing a range of psychiatric problems
Identifying mental illness among parents within the child welfare services CWS and referring them to evidence-based treatment in healthcare could be essential for improving childrens well-being and reducing the risk of CM For that intra-agency collaboration is considered crucial Collaboration between the CWS and healthcare is however a known issue
One way to address the lack of knowledge in assessing mental illness and support intra-agency collaboration can be routines for screening and referrals Screening everyone in a setting can be a non-stigmatizing approach to assess symptoms and risk behaviors Screening parents for mental health symptoms is widely implemented within pediatric healthcare eg screening for post-natal depression but is to our knowledge not a common approach within the CWS Additionally the lack of evidence-based methods has often been cited as a shortcoming within the CWS Furthermore social workers could lack the competence to identify mental illness as it is not included in their basic education It is therefore assumed that social workers do not always assess parents mental health with validated procedures and do not always refer parents in need
PURPOSE AND RESEARCH QUESTIONS
The main aim of this project is to improve early identification of mental illness in parents reported for CM and to make treatment accessible for families with additional needs The feasibility of the Collaboration-Screening-Referral model in Swedish Samverkan-Screening-Hänvisning - SSH will be evaluated - an approach for screening parents for symptoms of mental illness and referring to support The research questions are
1 Are parents engaged with CWS willing to undergo screening for symptoms of depression and anxiety
2 What barriers and facilitators to implementing the SSH have there been
3 In what ways do parents and social workers experience that the children are influenced by the SSH and what support the children in these families might need
4 Do social workers behaviors relating to assessing and handling mental illness and intra-agency collaboration procedures increase when implementing the SSH
5 Do social workers knowledge and perceived competence in assessing and managing mental illness increase after employing the SSH
6 What strategies have been employed by the CWS agencies in the implementation of the SSH
7 To what degree is usage of the SSH sustained 12 months after initiation
METHODS
SSH is a structured approach for screening and referring parents who need mental health support designed for use by social workers within CWS Municipalities will be recruited to take part in the research project and implement the SSH First staff will be trained in mental health screening and a referral routine will be established Units will also be encouraged to arrange meetings with local mental health clinics Social workers will then administer the screening to parents Questionnaires are followed by a discussion about well-being and support needs The social worker can provide information on available mental health resources and offer support in establishing a contact
The data collection will include surveys and interviewsfocus groups In connection with the training staff will respond to a survey baseline measurement regarding their work methods and perceived competence in addressing mental health issues Prior to participation staff will be given information about the study and provide informed consent via an online platform before they access the survey The data collection will then be divided into two phases
Phase 1 After the first municipalities have used the SSH for approximately 3 months social workers will participate in interviews or focus groups If necessary the SSH will be modified before further evaluation
Phase 2 In the next phase these and additional municipalities will continue to use the SSH as part of routine work Approximately 6 months from baseline staff will answer a follow-up survey and interviews andor focus groups will be conducted Further social workers will be asked to recruit parents who have completed the screening for interviews They will give oral information and provide a link to where parents can read written information and give informed consent For parents who consent to participate a person from the research team will call and inform the parent about the study give the possibility to ask questions and book a time for the interview Interviewsfocus groups will be conducted by phone calls or video meetings
SAMPLE SIZE CALCULATION AND ANALYSES
Quantitative data in surveys to staff will be presented descriptively and statistically analyzed eg t-testsnon-parametric alternative Psychometric statistics will be calculated For a power of 80 to detect a medium sized effect d 050 the total sample size of participating staff has to be N 34 alpha 005 To account for a drop-out rate of approximately 10 the aim is to recruit 40 participants Qualitative data will be analyzed employing qualitative methods eg thematic analysis For interviews 20-40 social workers and 10-25 parents will be recruited The specific number will be dependent upon achieving a sufficiently rich dataset according to qualitative methodological standards eg data saturation or information power
The data from the questionnaire administered to parents to assess symptoms of depression and anxiety is presented in a separate study 34Identifying Parents in Child Welfare Services Who Need Mental Health Support Depression and Anxiety Symptoms34 Based on the power calculation for that study the aim is that 290 parents respond to the questionnaire In this study only the questions from parents questionnaire assessing acceptability of the screening process are included
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None