Highlights in child mental health research: October 2025

This month’s highlights include:

Participatory systems modelling workshops for youth mental health

This paper evaluates participatory systems modelling (PSM) workshops to support youth mental health in Brisbane, Queensland. PSM is a method that aims to understand complex systems, in this case the local mental health system, to support decision-making. The PSM workshops in this research incorporated lived experience and local practitioner expertise to co-design a decision-support tool to guide mental health policy and investment that reflected the complexity of the local health system.

The use of ChatGPT-4o in child and adolescent mental health settings

This mixed methods study explored child and adolescent psychiatrists’ and psychologists’ attitudes toward ChatGPT-4o across seven domains including clinical use, ethical concerns, bias and therapeutic potential. The study found that AI tools like ChatGPT-4o may support practitioners in clinical settings but need to be tailored to clinician’s ability and acceptance of the technology. There is also a need to minimise risks when using the tool for patient-facing interventions.

Physical exercise intervention to support children and adolescents with neurodevelopmental disorders (NDD)

This paper reports on a systematic review and meta-analysis on the evidence of physical exercise (PE) interventions aimed at supporting wellbeing outcomes for children and adolescents with neurodevelopmental disorders (NDD). PE interventions were found to reduce negative emotions in children and adolescents with NDD. Regular exercise and a diversity of activities (e.g. aerobic and skill-based activities) were found to be especially useful in reducing negative emotions such as anxiety.

How inter-parental conflict can impact mental health outcomes in children and adolescents

This study was the first to use longitudinal Australian data to examine how inter-parental conflict (IPC) is experienced from childhood to adolescence and the association between IPC and mental health difficulties in adolescence. Based on the population included in this study, approximately 15% of adolescents experienced very high interparental conflict at some point during their childhood. The study found that the level, timing and consistency of IPC affects how it impacts the mental health of children and adolescents.

Why is this important?

• The mental health of young Australians is a growing concern, with high rates of psychological distress among young people and increasing demand for services.
• Mental health planning and funding decisions often rely on static, published research that may not reflect the complexity of local health systems. In addition, a lack of ongoing program evaluations can hinder evidence-based decision-making.
• Participatory systems modelling (PSM) is based on the idea of ‘system dynamics modelling’, which is a method to understand complex systems over time and explores different scenarios and potential outcomes to support decision-making. PSM extends on this idea by placing more emphasis on involving a range of stakeholders within the community to understand the complexity of local systems – in this case, the local mental health system.
• PSM workshops incorporate lived experience and local practitioner expertise to co-design decision-support tools that can guide mental health policy and investment.
• This paper evaluates PSM workshops as a method of workshop facilitation to support youth mental health.

What did they do?

• The researchers conducted three interactive PSM workshops in Brisbane, Queensland, to build a youth mental health decision-support tool tailored to the local context. The workshops included service providers, policymakers and young people.
• The authors evaluated the experiences of workshop participants using semi-structured interviews at three time points to understand their motivations and expectations in participating in the PSM process, engagement in the process and openness to sharing their knowledge.

What did they find?

• Diversity among workshop participants was essential if the PSM workshop – and the tools it developed – were to accurately reflect the local community and mental health system. This included diversity in background (age, gender, sexual orientation or cultural identity) and what cohorts or groups the participants represented (lived experience, professional or non-professional). This diversity also helped create an environment where everyone felt they could contribute to the workshop by bringing their particular perspective and experience.
• Flexible workshop formats and different data collection methods, such as anonymous feedback, breakout groups and roving facilitators, improved participants’ engagement and the perceived inclusivity of the workshop.
• Clear communication throughout the workshop about the goal of the workshop was important. This provided clarity about the participants’ role in the process of developing the decision-support tool, which increased their confidence to contribute.

What does this mean for practice?

• PSM workshops provide practitioners and lived experience advocates in the community with a meaningful opportunity to contribute and influence youth mental health planning and funding in their local areas. PSM workshops can be used as a process to support the production of decision-making tools that policymakers can use for program and funding decision-making.
• For PSM to be successful, participant recruitment should include diverse stakeholders, workshop facilitation should be flexible and responsive to the group dynamics, and there should be clear ongoing communication about the value of PSM and end goals of the workshop.

Why is this important?

• Child and adolescent mental health professionals are facing increasing demand, with more young people requiring, and being referred to, mental health support.
• Artificial intelligence (AI) tools like ChatGPT-4o may streamline some tasks in a clinical setting and are increasingly being used in child and adolescent mental health care. However, empirical evidence on the ethics, safety and effectiveness of their use in this setting is limited.
• Understanding clinicians’ perspectives on AI use is essential for shaping responsible, profession-specific guidelines that ensure safe and ethical AI use in clinical contexts.

What did they do?

• The authors conducted a mixed-methods study of 96 child and adolescent psychiatrists and 70 psychologists in Turkey.
• They explored attitudes toward ChatGPT-4o across seven domains including clinical use, ethical concerns, bias and therapeutic potential.
• They compared responses between groups (psychiatrists and psychologists) to determine discipline-specific views and priorities for AI’s clinical use.

What did they find?

• Of the group, nearly half of the psychiatrists and 40% of psychologists had prior experience using ChatGPT-4o.
• Psychiatrists were more optimistic about ChatGPT-4o’s use in diagnosis, treatment planning and crisis prevention. Psychologists were more cautious and prioritised ethics and oversight.
• Both groups expressed significant concern about the ethical issues of ChatGPT-40’s use, especially data safety, privacy and lack of clear guidelines.

What does this mean for practice?

• With tailored training and institutional protocols, AI tools such as ChatGPT-4o have the potential to assist child and adolescent mental health care practitioners in a clinical setting.
• Clear guidelines and training are needed to address practitioners’ ethical concerns about the use of AI tools.
• Use of AI tools like ChatGPT-4o should consider clinician’s ability to use, and acceptance of, the technology. They should also prioritise clinician-facing applications over patient-facing interfaces (i.e. those where the patient directly engages with the AI tool). When patient-facing applications are used, these should be low-intensity and low-risk.

Why is this important?

• There has been an increase in neurodevelopment disorders (NDD) – conditions resulting in limitations in autonomy, social integration and academic/occupational functioning – in the last two decades.
• Evidence suggests that physical exercise (PE) can enhance mental wellbeing and ease emotional distress in both children with NDD and typically developing children. This review aims to bring together the evidence of PE interventions aimed at supporting wellbeing outcomes for children and adolescents with NDD.

What did they do?

• The authors conducted a systematic review and meta-analysis (a method where outcome findings across multiple findings are combined) on the effects of PE interventions on negative emotions, specifically depression and anxiety, in children and adolescents with NDD.
• Ten studies were included across a variety of country contexts, including Australia. To be included in the review, the study needed to include a randomised control trial (RCT) and have a population group (those that undertook the PE intervention) and a control group (those that did not undertake the intervention).
• The most common NDD in the populations included in the review were attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

What did they find?

• PE interventions were found to reduce negative emotions in children and adolescents with NDD. This result was statistically significant, which means that the researchers were confident that the results were not due to chance.
• There was stronger evidence to suggest that PE interventions can reduce anxiety symptoms, compared with depression symptoms.
• Factors that supported better outcomes for children included engaging in mixed forms of PE (combining aerobic, motor skills and conditioning) for a minimum of 60 minutes per session, once a week for at least a 12-week period.

What does this mean for practice?

• There is promising evidence for the value and effectiveness of incorporating PE interventions as part of plans to support the emotional wellbeing of children and adolescents with NDD.
• Regular exercise and a diversity of activities (e.g. aerobic and skill-based activities) may have particular value for reducing experiences of anxiety.

Why is this important?

• Conflict between parents can be a stressful experience for children and adolescents and has been associated with poor mental health outcomes for young people later in life.
• This is the first time that longitudinal Australian data has been used to examine how inter-parental conflict (IPC) is experienced from childhood to adolescence. It also allows for examination of the association between IPC and mental health difficulties in adolescence.

What did they do?

• Researchers used a sample of over 8,000 children, a subset from the Longitudinal Study of Australian Children (LSAC), which follows over 10,000 Australian children and families over time.
• Within LSAC, IPC is assessed using a scale that measures the frequency of verbal and physical conflict (according to the mother). For this study, IPC was measured across six timepoints spanning 10 years (from ages 4 to 15 years). Adolescent mental health (depression and anxiety) and anti-social behaviour were assessed with self-report measures using the same data.

What did they find?

• Based on the population included in this study, approximately 15% of adolescents experienced very high IPC at some point during their childhood.
• Four IPC trajectories were identified: consistently low (85.8%), increasing (2.7%), decreasing (2%) and persistently elevated (9.6%).
• Children and adolescents with persistently elevated IPC levels over time were associated with higher mental health difficulties and anti-social behaviour than those with consistently low IPC. Decreasing levels of IPC were associated with fewer symptoms of anxiety.
• Adolescents exposed to high levels of IPC in early childhood, but which decreased over time, had lower anxiety but higher anti-social behaviour at 15 years of age than both adolescents with increasing levels of IPC and adolescents with consistently low levels of IPC.
• IPC is more strongly linked to mental health outcomes associated with ‘hyperarousal’ (e.g. anxiety, anti-social behaviour) than low arousal (e.g. depression).
• A limitation of the study is that it did not test for mediating mechanisms (i.e. how other factors could explain changes in child outcomes).

What does this mean for practice?

• There is evidence that IPC can negatively affect the mental health of children and adolescents. It is not just the presence of IPC that matters but the level, timing and consistency of IPC.
• Identifying and mitigating IPC, especially in early childhood, can support better mental health outcomes for children and adolescents.
• The authors suggest that clinicians working with adolescents should enquire about IPC history to inform how they support the adolescent’s mental health.
• When working with children and adolescents exposed to IPC, practitioners can use therapeutic interventions that target internalising difficulties (such as anxiety) and externalising symptoms (such as anti-social behaviour) and that promote downregulation (e.g. emotional regulation and conflict resolution).