A general psychopathology factor, which is equal across genders, can be identified in young people. Its associations with correlates and future functioning indicate that investigating this factor can increase our understanding of the aetiology, risk and correlates of psychopathology.

ObjectivesExplore how patient-reported experience measures (PREMs) are collected, communicated and used to inform quality improvement (QI) across healthcare settings.DesignSystematic review.SettingVarious primary and secondary care settings, including general practice, and acute and chronic care hospitals.ParticipantsA full range of patient populations from (children through to the elderly) and staff (from healthcare practitioners to senior managers).MethodsScientific databases were searched (CINAHL, PsycINFO, MEDLINE and Cochrane Libraries) as was grey literature. Qualitative and quantitative studies describing collection of PREM data and subsequent QI actions in any healthcare setting were included. Risk of bias was assessed using established criteria. Of 5312 initial hits, 32 full texts were screened, and 11 were included.ResultsPatient experience data were most commonly collected through surveys and used to identify small areas of incremental change to services that do not require a change to clinician behaviour (eg, changes to admission processes and producing educational materials). While staff in most studies reported having made effective improvements, authors struggled to identify what those changes were or the impact they had.ConclusionsFindings suggest there is no single best way to collect or use PREM data for QI, but they do suggest some key points to consider when planning such an approach. For instance, formal training is recommended, as a lack of expertise in QI and confidence in interpreting patient experience data effectively may continue to be a barrier to a successful shift towards a more patient-centred healthcare service. In the context of QI, more attention is required on how patient experience data will be used to inform changes to practice and, in turn, measure any impact these changes may have on patient experience.

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The increased prevalence of emotional problems in girls mirrors a trend found in other similar studies, and the results are discussed in the context of recent economic and societal changes. The small decrease in total difficulties in boys, although promising, clearly warrants further research.

There is a growing appetite for mental health and wellbeing outcome measures that can inform clinical practice at individual and service levels, including use for local and national benchmarking. Despite a varied literature on child mental health and wellbeing outcome measures that focus on psychometric properties alone, no reviews exist that appraise the availability of psychometric evidence and suitability for use in routine practice in child and adolescent mental health services (CAMHS) including key implementation issues. This paper aimed to present the findings of the first review that evaluates existing broadband measures of mental health and wellbeing outcomes in terms of these criteria. The following steps were implemented in order to select measures suitable for use in routine practice: literature database searches, consultation with stakeholders, application of inclusion and exclusion criteria, secondary searches and filtering. Subsequently, detailed reviews of the retained measures’ psychometric properties and implementation features were carried out. 11 measures were identified as having potential for use in routine practice and meeting most of the key criteria: 1) Achenbach System of Empirically Based Assessment, 2) Beck Youth Inventories, 3) Behavior Assessment System for Children, 4) Behavioral and Emotional Rating Scale, 5) Child Health Questionnaire, 6) Child Symptom Inventories, 7) Health of the National Outcome Scale for Children and Adolescents, 8) Kidscreen, 9) Pediatric Symptom Checklist, 10) Strengths and Difficulties Questionnaire, 11) Youth Outcome Questionnaire. However, all existing measures identified had limitations as well as strengths. Furthermore, none had sufficient psychometric evidence available to demonstrate that they could reliably measure both severity and change over time in key groups. The review suggests a way of rigorously evaluating the growing number of broadband self-report mental health outcome measures against standards of feasibility and psychometric credibility in relation to use for practice and policy.

Early detection of child mental health problems in schools is critical for implementing strategies for prevention and intervention. The development of an effective measure of mental health and well-being for this context must be both empirically sound and practically feasible. This study reports the initial validation of a brief self-report measure for child mental health suitable for use with children as young as 8 years old (“Me & My School” [M&MS]). After factor analysis, and studies of measurement invariance, 2 subscales emerged: emotional difficulties and behavioral difficulties. These 2 subscales were highly correlated with corresponding constructs of the Strengths and Difficulties Questionnaire (SDQ) and showed correlations with attainment, deprivation, and educational needs similar to ones obtained between these demographic measures and the SDQ. Results suggest that this school-based self-report measure is psychometrically sound, and has the potential of contributing to school mental health surveys, evaluation of interventions, and recognition of mental health problems within schools.

Facilitators and barriers to person-centered care in child and young people mental health services: A systematic review. AbstractImplementation of person-centered care has been widely advocated across various health settings and patient populations, including recent policy for child and family services.Nonetheless, evidence suggests that service users are rarely involved in decision making, whilst their preferences and goals may be often unheard. The aim of the present research was to systematically review factors influencing person-centered care in mental health services for children, young people and families examining perspectives from professionals, service users, and carers. This was conducted according to best practice guidelines, and seven academic databases were searched. Overall, 23 qualitative studies were included. Findings from the narrative synthesis of the facilitators and barriers are discussed in light of a recently published systematic review examining person-centered care in mental health services for adults. Facilitators and barriers were broadly similar across both settings. Training professionals in person-centered care, supporting them to use it flexibly to meet the unique needs of service users whilst also being responsive to times when it may be less appropriate, and improving both the quantity and quality of information for service users and carers, are key recommendations to facilitate person-centered care in mental health services with children, young people and families.Facilitators and barriers to person-centered care 2 2 Acknowledgments

The present research addressed gaps in our current understanding of validity and quality of measurement provided by patient reported experience measures. We established the psychometric properties of a freely available experience of service questionnaire (ESQ), based on responses from 7,067 families of patients across 41 UK providers of child and adolescent mental health services, using the two-level latent trait modeling. Responses to the ESQ were subject to strong 'halo' effects, which were thought to represent the overall positive or negative affect towards one's treatment. Two strongly related constructs measured by the ESQ were interpreted as specific aspects of global satisfaction, namely satisfaction with care, and with environment. The Care construct was sensitive to differences between less satisfied patients, facilitating individual and service-level problem evaluation. The effects of nesting within service providers were strong, with parental reports being the most reliable source of data for the between-provider comparisons. We provide a scoring protocol for converting the hand-scored ESQ to the model-based population-referenced scores with supplied standard errors, which can be used for benchmarking services as well as individual evaluations.