Effectiveness of mental health and wellbeing interventions for children and young people in foster, kinship, and residential care: systematic review and meta-analysis

Trubey, Robert, Evans, Rhiannon ORCID: https://orcid.org/0000-0002-0239-6331, Macdonald, Sarah ORCID: https://orcid.org/0000-0002-8245-2347, Noyes, Jane, Robling, Michael ORCID: https://orcid.org/0000-0002-1004-036X, Willis, Simone ORCID: https://orcid.org/0000-0003-3949-7651, Boffey, Maria, Wooders, Charlotte, Vinnicombe, Soo and Melendez-Torres, G.J. 2024. Effectiveness of mental health and wellbeing interventions for children and young people in foster, kinship, and residential care: systematic review and meta-analysis. Trauma, Violence, and Abuse 10.1177/15248380241227987

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Abstract

The mental health and wellbeing of children and young people who have been in care, primarily foster care, kinship care or residential care, remains a public health priority. The Care-experienced cHildren and young people’s Interventions to improve Mental health and wEll-being outcomes Systematic review (CHIMES) synthesized evidence for the effectiveness of interventions targeting: subjective wellbeing; mental, behavioral and neurodevelopmental disorders; and suicide-related outcomes. Searches were conducted in 16 bibliographic databases and 22 websites between 1990 and 2022. This was supplemented by citation tracking, screening of relevant systematic reviews, and expert recommendation. We identified 35 interventions, with 44 evaluations via randomized controlled trials. Through meta-analyses, we found that interventions have a small beneficial impact on a variety of mental health outcomes in the short term (0–6 months). Interventions improved total social, emotional, and behavioral problems (d = −0.15, 95% CI [−0.28, −0.02]), social-emotional functioning difficulties (d = −0.18, 95% CI [−0.31, −0.05]), externalizing problem behaviors (d = −0.30, 95% CI [−0.53, −0.08]), internalizing problem behaviors (d = −0.35, 95% CI [−0.61, −0.08]); and depression and anxiety (d = −0.26, 95% CI [−0.40, −0.13]). Interventions did not demonstrate any effectiveness for outcomes assessed in the longer term (>6 months). Certainty of effectiveness was limited by risk of bias and imprecision. There was limited available evidence for interventions targeting subjective wellbeing and suicide-related outcomes. Future intervention design and delivery must ensure that programs are sufficient to activate causal mechanisms and facilitate change. Evaluation research should use a robust methodology.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Centre for Trials Research (CNTRR) Social Sciences (Includes Criminology and Education) Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Subjects:	H Social Sciences > H Social Sciences (General) H Social Sciences > HV Social pathology. Social and public welfare
Publisher:	SAGE Publications
ISSN:	1552-8324
Funders:	National Institute for Health and Care Research | NIHR
Date of First Compliant Deposit:	8 April 2024
Date of Acceptance:	2 January 2024
Last Modified:	02 Jul 2024 10:05
URI:	https://orca.cardiff.ac.uk/id/eprint/167819

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