Highlights in child mental health research: June 2025

This month’s highlights include:

Digital mental health interventions for social anxiety in children

This systematic review and meta-analysis examines the efficacy of digital mental health interventions (DMHIs) for treating social anxiety in children and young people. The study found some forms of DMHIs, such as those using cognitive behavioural therapy or human support, can provide effective short-term treatment of social anxiety symptoms. The research found various DMHI formats can provide support for anxiety symptoms at different developmental stages.

The intersection of neighbourhood environments, adverse childhood experiences and health equity

This article identifies the role that neighbourhood environments and adverse childhood experiences (ACEs) play in the health outcomes of children and their families. Neighbourhood environments include factors such as poverty, green spaces, pollution and healthy food availability. The authors discuss how both neighbourhood environments and ACEs may lead to the development and increased severity of mental health disorders and chronic health conditions such as obesity. The authors’ recommendations include the suggestion that practitioners working with families and children screen for ACES and social determinants of health related to neighbourhood factors when determining what services and supports may best meet young people’s needs.

Interventions to support the mental health of parents with autistic and/or ADHDer adolescents

This systematic review examines the effectiveness of interventions that aim to improve the mental health and wellbeing of parents with adolescents who have a diagnosis of autism spectrum disorder (ASD) and/or attention-deficit hyperactivity disorder (ADHD). Interventions are grouped into three different categories: mindfulness-based, psychoeducation-based and therapeutic approach-based interventions. The authors found that most studies assessed the effectiveness of mindfulness-based interventions, which were shown to be effective at reducing stress levels and increasing mindfulness. Psychoeducation-based interventions were shown to be effective at increasing self-efficacy and reducing depressive symptoms. There were no conclusive results for therapeutic-based interventions.

Kinship in Australian foster care

This paper discusses policy and practice recommendations for encouraging kinship care for children in out-of-home care. Kinship care has historically been viewed as ‘high risk’; however, this view is changing as the potential benefits of kinship are increasingly recognised. These include the greater possibility of maintaining a child’s connection to their family, community and culture. The paper discusses the challenges associated with kinship care, including the need to navigate complex systems and administrative requirements, the additional financial cost of caring for a child, and a lack of support for kinships carers supporting children trauma-based behaviours.

Why is this important?

• Social anxiety disorder can significantly affect a young person’s social and academic functioning. Digital mental health interventions (DMHIs) can provide an accessible and effective treatment option.

What did they do?

• This systematic literature review aims to evaluate the efficacy of DHMIs for children and young people with social anxiety symptoms.
• DHMIs are aimed at treating or managing mental health symptoms through digital technology such as the internet, phone apps or text messaging. They can include human support through online chats or phone calls, or unguided online self-help.
• The authors reviewed 22 studies and conducted a meta-analysis that included 21 studies. These studies used randomised control trials and investigated the use of DMHIs for social anxiety in young people under the age of 25 years.

What did they find?

• Some types of DMHIs worked better than others. Interventions that used cognitive behavioural therapy, that included tools specific to symptoms of social anxiety or that had support from a person (such as a therapist or coach) were more effective than self-help tools with no guidance.
• The age of the participants or whether parents were involved in the intervention did not have a significant effect on the efficacy of DMHIs.
• The effects of the interventions decreased significantly 12 months after the initial interventions.

What does this mean for practice?

• DMHIs that involve human guidance, such as with a professional psychologist, can be an effective form of temporary support but have limited evidence to support use for long-term treatment.
• Different DMHIs may be useful for different developmental stages. For example, DMHIs requiring parental involvement may be more effective for young children, whereas self-guided DMHIs may be better for adolescents.

Why is this important?

• Neighbourhood environmental characteristics (such as poverty, a lack of green spaces, pollution, limited or lack of healthy food options) are associated with poorer child health.
• Although adverse childhood experiences (ACEs) and neighbourhoods are both known to contribute to health inequities, there is limited research on the intersection between the two.

What did they do?

• The article outlines ways that practitioners and policymakers can consider the intersection between neighbourhood environments and ACEs. For example, they discuss how both neighbourhood environments and ACEs may lead to the development and increased severity of mental health disorders and chronic health conditions such as obesity.

What did they find?

• The article found that less than 1% of studies into ACEs have focused on neighbourhood-level variables.
• The article includes data that shows the spatial distribution of health outcomes in particular areas of the US. The figures show there is a correlation between neighbourhood location, various health outcomes and ACEs.

What does this mean for practice?

• Policy makers and practitioners should aim to connect families with resources related to their needs that consider experiences of both ACEs and their neighbourhood contexts.
• Practitioners looking to address health and wellbeing outcomes of families and young people should consider screening for both ACEs and social determinants of health that are related to neighbourhood environments. This can help practitioners to provide more targeted services and supports to families.

Why is this important?

• Parents of adolescents with a diagnosis of autism spectrum disorder (ASD) and/or attention-deficit hyperactivity disorder (ADHD) tend to experience higher stress levels and more mental health challenges than parents with adolescents who do not have an ASD and/or ADHD diagnosis.
• Existing research on the effectiveness of interventions for parents of autistic and/or ADHDer children tends to focus on parents of younger children. Less is known about how effective these interventions are for parents of autistic and/or ADHDer adolescents.

What did they do?

• The authors conducted a systematic review of 31 studies (published between 2008 to 2023) that focused on the effectiveness of interventions aiming to improve the mental health and wellbeing of parents of adolescents who have been diagnosed with a neurodevelopmental condition.
• Studies were grouped into three different categories:
  • mindfulness-based interventions, which included interventions that used mindfulness or relaxation techniques (e.g. breathing, relaxation, mind-body connection activities)
  • psychoeducation-based interventions, which included interventions that provided education about health and mental health, and aimed to increase knowledge about mental health awareness and coping strategies
  • therapeutic approach-based interventions, which included interventions such as acceptance and commitment therapy and cognitive behavioural therapy.
• The reviewed studies used standardised assessment measures to report mental health and wellbeing outcomes, included a control group or pre-post test comparison groups, and included parents of an adolescent aged 10 to 19 years old with a neurodevelopmental condition.

What did they find?

• The authors found that most of the studies examined mindfulness-based interventions (n=23), with fewer focusing on psychoeducation (n=5) and therapeutic interventions (n=4).
• Overall, 19 different interventions were identified. Although the reviewed studies used several search terms for neurodevelopmental conditions, almost all 19 interventions identified focused on parents of autistic and/or ADHDer children.
• Mindfulness-based interventions saw a reduction in parental stress levels and an increase in an individual’s capacity to practice mindfulness in their everyday lives but had mixed results for depressive symptoms and anxiety.
• Psychoeducation-based interventions showed an increase in self-efficacy and a reduction in depressive symptoms.
• There were no conclusive results for therapeutic-based interventions.

What does this mean for practice?

• Support for the parents of autistic and/or ADHDer adolescents is important to aid their own mental health and wellbeing and that of their adolescent children.
• Practitioners who work with these parents may want to recommend mindfulness and psychoeducation interventions as these show some promise.

Why is this important?

• Kinship and foster care are the most common forms of out-of-home care (OOHC) for children who are unable to live with their parents.
• Foster carer numbers have either remained the same or declined in some Australian jurisdictions due to several challenges (e.g. increasing compliance demands, cost of living).
• With the decline in foster carers, there are increasing numbers of children being cared for in residential care. This form of care was previously reserved for the most complex cases.
• Kinship care has historically been viewed as ‘high risk’, but this view is changing as there is increasing recognition of its benefits, such as maintaining a child’s connection to their family, community and culture.

What did they do?

• The paper discusses some key policy and practice recommendations. These recommendations focus on how to encourage kinship care for children in OOHC in preference to foster care or residential care.
• The key themes of the recommendations were the desirability of shifting from foster to kinship care, identifying the needs of kinship carers and ensuring the sustainability of kinship care models.

What did they find?

• Kinship carers are faced with processes and applications that are often confusing, intensive and intrusive.
• Administrative requirements and the challenges of navigating the system can create additional challenges for kinship carers. This includes being subject to statutory regulations that restrict behaviours that may be standard in their homes (e.g. smoking), being required to hold a Working with Children Check, and a lack of understanding and support from care team professionals.
• The cost-of-living crisis has put additional financial stress on kinship carers. The extra cost of caring for children often increases financial stress on kinship carers, many of whom are grandparents and have low incomes.
• Kinship carers may benefit from one-on-one training. For example, some carers feel ill-equipped to support children with trauma-based behaviours. Participating in individualised trauma-informed training may help in managing these behaviours.

What does this mean for practice?

• Greater attention on the challenges that kinship carers face is needed to encourage more kinship care and to make it more sustainable. This includes understanding that kinship carers require different assessment, training and support.