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New research from the Evidence Based Practice Unit

The Anna Freud National Centre for Children and Families' Evidence-Based Practice Unit has published several new articles.

Vostanis, P., Martin, P., Davies, R., De Francesco, D., Jones, M., Sweeting, R., Ritchie, B., Allen, P., & Wolpert, M. (2015). Development of a framework for prospective payment for child mental health services. Journal of Health Services Research and Policy.

This paper reports on the initial stages of the child and adolescent mental health services payment project, which aims to develop a system for payment that can be tailored to the different clinical resources needed by children and young people accessing services. Using three studies – consultation with CAMHS stakeholders, disorders and resource use data analysis, and review of clinical guidelines – a framework for subsequent work was developed. This suggests a broader definition of need than only diagnosis is required and the complexity of service activities and evidence-based guidelines should be carefully considered.

Lead author Professor Panos Vostanis said: “This is the first study in the UK and internationally to integrate existing evidence and guidelines in developing a methodology for the evaluation of payment systems in CAMHS.”

The paper is available at the following link:

Patalay, P., Fonagy, P., Deighton, J., Belsky, J., Vostanis, P. & Wolpert, M. (2015). A general psychopathology factor in early adolescence. BJPsych. 

Are there common aspects among symptoms of psychiatric disorders in adolescents? This paper takes a research question that has only been considered in relation to adults and investigates through young people’s reports of their own symptoms. Research indicated that a general factor, equal across genders, could be identified for young people. This general dimension better predicted future functioning both in terms of mental health and also academic attainment. The findings, if replicated, will help increase our understanding of risk factors that lead to mental health difficulties in young people.

Professor Peter Fonagy, an author of the paper, said: “These findings underscore the limitations of diagnoses as predictors of future mental health problems in young people; instead vulnerability to mental health problems may be a single dimension, better captured by the number of different problems a young person has than by any one of those difficulties”.

The paper can be found at:

Wolpert, M., Humphrey, N., Deighton, J., Patalay, P., Fugard, A.J.B., Fonagy, P., Belsky, J. & Vostanis, P. (2015). An evaluation of the implementation and impact of England's mandated school-based mental health initiative in elementary schools. School Psychology Review, 44, 117-138

This paper presents our findings from a large scale randomised controlled trial involving 8,480 children (aged 8-9 years) from 266 primary schools, that evaluated a government initiative: Targeted Mental Health in Schools (TaMHS) (2008-11) whereby schools were given funding specifically to support targeted mental health provision. The research found that children in TaMHS schools with, or at risk of, behavioural difficulties reported significant reductions in behavioural difficulties compared to control school students at one year follow up. No difference was found in relation to emotional difficulties. (NB no difference was found for either emotional or behavioural difficulties in secondary schools though these results are not presented in detail in this publication). TaMHS implementation was associated with increased school provision of a range of mental health interventions and also with enhanced collaboration between schools and NHS child and adolescent mental health services (CAMHS).

Dr Jessica Deighton, an author of the paper, said: “These findings show that investment in mental health support for children in primary school can make a real difference to young people’s behavioural problems.”

Patalay, P., Sharpe, H. & Wolpert, M. (2015). Internalising symptoms and body dissatisfaction: untangling temporal precedence using cross-lagged models in two cohorts. The Journal of Child Psychology and Psychiatry. Online first. 

This study aimed to explore age and gender differences in how body dissatisfaction and emotional wellbeing are related over time. Unlike previous work, which focused on teenagers, this study also considered children under 12 years to take into account the importance of pubertal change in links between body dissatisfaction and emotional problems. The authors found that for all children aged 8-11 and for boys aged 11-14, having emotional problems was linked with later body dissatisfaction. However, for girls aged 11-14, the reverse was true: those who felt unhappy about their appearance went on to have more emotional problems three years later.

Dr Helen Sharpe, an author of the paper, said: "Targeting emotional problems in primary school and early in secondary school for boys may have an impact on later levels of body dissatisfaction. In contrast, it may be important to tackle body dissatisfaction directly for early adolescent girls."

Read the article: