Prioritising Interventions for Preventing Mental Health Problems for Children Experiencing Adversity: a Modified Nominal Group Technique Australian Consensus Study

Abstract

Background: Despite the well-established link between childhood adversity and mental health problems, there is a dearth of evidence to inform decision making about the most acceptable and feasible interventions for preventing mental health problems for children experiencing adversity. Expert consensus is an important input into evidence-informed policy and practice but is often employed at the national level which misses important local contextual factors shaping decision making. This study aimed to: (1) reach consensus on local priority interventions for preventing mental health problems for children living with adversity in Wyndham, Victoria; and (2) understand the enabling factors and barriers to implementing these interventions. Methods: This study employed six online modified nominal group technique (NGT) workshops with 19 stakeholders; intersectoral service providers from health, social and education sectors and caregivers of children aged 0-8 years. Results: Three interventions reached consensus among the mixed stakeholder groups as being a high or very high priority for implementation in Wyndham: nurse home visiting, parenting programs and community-wide programs. Key rationales were the ability for these interventions to act as a gateway for families to increase their knowledge about topics immediately relevant to them (i.e. parenting), increase their knowledge about available supports and build relationships with service providers.Conclusions: Local priorities for preventing mental health problems for children living with adversity emphasized relational approaches to service provision and were shaped by the availability of existing interventions and supports in the locality. The NGT was found to be an effective method for prioritising evidence-based practice interventions in health settings, engaging local stakeholders, and identifying enablers and barriers to implementation.

Targeted community-based programmes for children’s mental health: A systematic review and meta-analysis of the Australian literature

“…While these interventions may already be delivered across Australia, there is significant need for high-quality evaluations with such cohorts to build their evidence base and inform future practice. Greater implementation and evaluation of community-driven systemic, coordinated and integrated wrap-around approach that intervenes at the child, parent, family and community level are needed (Hall et al, 2021). This approach may better identify, reach and engage vulnerable children and families to address the psychosocial determinants (e.g.…”

“…This approach may better identify, reach and engage vulnerable children and families to address the psychosocial determinants (e.g. adverse childhood experiences) and persistent disadvantage underpinning their emotional and behavioural concerns (Hall et al, 2021;NMHC, 2020;Sahle et al, 2021aSahle et al, , 2021b. These implications align with Australia's first National Children's Mental Health and Wellbeing Strategy for children aged 0-12 years, in which stronger holistic community-driven approaches to children's mental health is a key priority (Australian Government, 2021).…”