Children and young people’s mental health in the English-speaking Caribbean: a scoping review and evidence map

Abstract

Internationally, there is a wealth of research suggesting that many children and young people experience mental health problems. However, the evidence from low- and middle-income countries and developing nations is generally limited. This scoping review aimed to add to the body of evidence by providing an overview of the available research literature on children and young people’s (CYP’s) mental health in the English-speaking Caribbean region. Seven key online academic databases and grey literature sources were searched until January 2021. Records were screened against predefined criteria and suitable articles retrieved. Relevant information was then charted and summarized. All stages of the review were informed by expert consultations. Ninety-six articles from 7901 records met the inclusion criteria. Most of the studies were conducted in Jamaica, Trinidad and Tobago and Barbados while fewer studies reported findings from St Lucia, The Bahamas and St Kitts and Nevis. Research funding was not frequently reported, and participants were predominantly recruited in education settings. There was a substantial focus on depressive symptoms and behaviour problems. Little or no research was available for younger children (< 12), complex clinical cases or commonly under-represented groups. Four unique interventions were identified of which one intervention showed no significant impact on CYP. Among the commonly used outcome measures only the Jamaican Youth Checklist (teacher-reported), Beck Depression Inventory-II, Brief Screen for Depression, Trinidad and Tobago Youth Survey and Minnesota Multiphasic Personality Inventory had evidence for psychometric validity within this population. We discuss future directions, implications and recommendations for research, practice, policy and training.

Factors associated with children and young people’s mental health in the English-speaking Caribbean region: Systematic review and narrative synthesis

“…Further cross-disciplinary research focusing on possible interactions among these factors would also be useful since the evidence reviewed did not always provide a consistent narrative of the risk profiles. The absence of some key factors (e.g., impact of natural disasters), presenting problems (e.g., psychosis), and countries (e.g., Belize) also reinforces recent appeals for more research in this area [27]. Despite the gradual increase in research activity in the last 40 years, there was also a lack of diversity in research methods used in the included studies and variation in the quality of the evidence, suggesting a need for a wider range of high-quality rigorous research activity.…”

“…The search strategy was developed and piloted through an iterative process with a research librarian. Further details of the literature search have been published as part of the initial scoping review [27].…”

“…Population statistics suggest that this region consists mainly of families of African, mixed-race, Indian or indigenous origins [25,26]. Studies conducted in the English-speaking Caribbean region also reported high rates of mental health problems and a limited number of evidence-based interventions [27]. A recent report also highlighted a scarcity of appropriate mental health policies and funding [6].…”

“…Between the two reviews the authors identified gender, age, family, home environment, school, religion and engagement in risk behaviours as important factors associated with adolescent's mental health. Since those studies were conducted there have been an exponential increase in research as well as a growing interest and need for CYP mental health support [27,31]. There have also been increased attention and advocacy to focus on a wider age range up to 24 years to capture the key transition periods from childhood to adulthood [32].…”

“…There have also been increased attention and advocacy to focus on a wider age range up to 24 years to capture the key transition periods from childhood to adulthood [32]. Therefore, based on recommendations and consensus from academic, practice and lived experience experts, an updated systematic review was deemed appropriate [27,33].…”