Despite increasing numbers of adolescents experiencing poor mental wellbeing, adolescents are often reluctant to seek help for mental health problems. In response, there is increasing interest in the development of evidence-based interventions to increase help-seeking behavior. However, the evidence base may lack validity if help-seeking measures used in adolescent research contain age-inappropriate language or content such as seeking help from a spouse; no previous review has assessed this. A review of adolescent mental health help-seeking research was conducted to identify help-seeking measures used, assess their psychometric properties and linguistic appropriateness in adolescent populations, and organize measures by facet of help-seeking for ease of future use. We found 14 help-seeking measures used in adolescent research, but only 17/72 (24%) studies found used one of the identified measures. Help-seeking measures identified were categorized into one of four help-seeking facets: attitudes toward help-seeking, intentions to seek help, treatment fears regarding help-seeking, and barriers to help-seeking. The content and language of measures were deemed appropriate for all but one help-seeking measure. Recommendations for future research include greater utilization of identified measures, particularly in researching help-seeking behavior in different cultures, subcultures and between stages of adolescence.

Background Poor transitions to adult care from child and adolescent mental health services may increase the risk of disengagement and long-term negative outcomes. However, studies of transitions in mental health care are commonly difficult to administer and little is known about the determinants of successful transition. The persistence of health inequalities related to access, care, and outcome is now well accepted including the inverse care law which suggests that those most in need of services may be the least likely to obtain them. We sought to examine the pathways and determinants of transition, including the role of social class. Method A retrospective systematic examination of electronic records and case notes of young people eligible to transition to adult care over a 4-year period across five Health and Social Care NHS Trusts in Northern Ireland. Results We identified 373 service users eligible for transition. While a high proportion of eligible patients made the transition to adult services, very few received an optimal transition process and many dropped out of services or subsequently disengaged. Clinical factors, rather than social class, appear to be more influential in the transition pathway. However, those not in employment, education or training (NEET) were more likely (OR 3.04: 95% CI 1.34, 6.91) to have been referred to Adult Mental Health Services (AMHS), as were those with a risk assessment or diagnosis (OR 4.89: 2.45, 9.80 and OR 3.36: 1.78, 6.34), respectively. Conclusions Despite the importance of a smoother transition to adult services, surprisingly, few patients experience this. There is a need for stronger standardised policies and guidelines to ensure optimal transitional care to AMHS. The barriers between different arms of psychiatry appear to persist. Joint working and shared arrangements between child and adolescent and adult mental health services should be fostered.

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ObjectivesIn this study, we seek to explore the relationship between adolescent mental well-being, religion and family activities among a school-based adolescent sample from Northern Ireland.SettingThe Northern Ireland Schools and Wellbeing Study is a cross-sectional study (2014–2016) of pupils in Northern Ireland aged 13–18 years.Participants1618 adolescents from eight schools participated in this study.Outcomes measuresOur primary outcome measure was derived using the Warwick-Edinburgh Mental Wellbeing Scale. We used hierarchical linear regression to explore the independent effects of a range of personal/social factors, including religious affiliation, importance of religion and family activities.ResultsIn fully adjusted models, older adolescents and females reported lower mental well-being scores—for the year-on-year increase in age β=−0.45 (95% CI=−0.84, –0.06), and for females (compared with males) β=−5.25 (95% CI=−6.16, –4.33). More affluent adolescents reported better mental well-being. No significant differences in mental well-being scores across religious groups was found: compared with Catholics, Protestant adolescents recorded β=−0.83 (95% CI=−2.17, 0.51), other religious groups β=−2.44 (95% CI=−5.49, 0.62) and atheist adolescents β=−1.01 (95% CI=−2.60, 0.58). The importance of religion in the adolescents’ lives was also tested: (compared with those for whom it was not important) those for whom it was very important had better mental well-being (β=1.63: 95% CI=0.32, 2.95). Higher levels of family activities were associated with higher mental well-being: each unit increase in family activity produced a 1.45% increase in the mental well-being score (β=0.78: 95% CI=0.67, 0.90).ConclusionsThis study indicates that non-religious adolescents may have lower mental well-being scores when compared with their more religious peers, irrespective of religious denomination. This may relate to both a sense of lack of firm identity and perceived marginalisation. Additionally, adolescents with poor family cohesion are more vulnerable to poor mental well-being.

ObjectivesAsthma is the most common chronic disease in childhood, yet little is known about rates of asthma and wheezing in children with congenital anomalies. This study explored the prevalence and risk of receiving anti-asthmatic prescriptions in children with congenital anomalies compared to children without anomalies in six European regions/countries. ApproachThis was a EUROlinkCAT population-based linkage cohort study involving children from 0-9 years of age born between 2000-2014. Congenital anomaly data from six EUROCAT registries were linked to births data in national/vital statistics and to electronic prescription databases. Prescription/pharmacy dispensing records across regions were standardised to a Common Data Model. Anatomical Therapeutic Chemical classification codes beginning with R03 were used to identify anti-asthmatic prescriptions. Random-effects meta-analyses were performed to identify both the relative risk (RR) of receiving >1 anti-asthmatic prescription in a year relative to the reference group, and the heterogeneity of prevalence rates across registries and age group. ResultsA total of 5.1% of children with congenital anomalies and 4.9% of reference children were dropped from the study as they were not linked. Children with congenital anomalies (n=60,662) had a higher prevalence of >1 anti-asthmatic prescription and a significantly higher risk of being prescribed anti-asthmatics (RR=1.41, 95% CI 1.35-1.48) compared to reference children (n=1,722,912). The increased risk was consistent across all age groups. Children with congenital anomalies were more likely to be prescribed beta-2 agonists (RR=1.71, 95% CI 1.60-1.83) and inhaled corticosteroids (RR=1.74, 95% CI 1.61-1.87). Children with oesophageal atresia, diaphragmatic hernia, genetic syndromes and chromosomal anomalies had over twice the risk of being prescribed anti-asthmatics compared to reference children. Regional differences in prevalence and risk of anti-asthmatic prescriptions were identified. ConclusionChildren aged <10 years with congenital anomalies consistently had higher prevalence and risk of receiving >1 anti-asthmatic prescription across age group and across European regions. This study demonstrates that information on the prevalence of anti-asthmatic prescriptions issued/dispensed can be obtained through data linkage to monitor changes in prevalence over time.