Many autistic young people and/or those with attention deficit hyperactivity disorder (ADHD) have co-occurring mental health conditions. These individuals can experience significant challenges when transitioning from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). However, barriers and enablers to the transition from CAMHS to AMHS are poorly understood for this population. This scoping review sought to synthesise the available evidence on barriers and enablers to the transition from CAMHS to AMHS for autistic young people and/or those with ADHD. Arksey and O'Malley's six-step framework for scoping reviews was used to map out the evidence available and report the findings with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines (PRISMA-ScR). Electronic databases of Medline, PsycINFO, CINAHL, Scopus and ProQuest Central were searched for relevant studies published in English with no date limitations. The review included studies that focused on young people with a primary diagnosis of autism spectrum disorder (ASD) and/or ADHD (population) and their care transition barriers and/or enablers (concept) from CAMHS to AMHS (context). A socioecological framework informed data extraction and narrative synthesis of data on barriers and enablers to transition. This review identified 1677 studies, of which 66 proceeded to full-text screening, and 10 were included. Most studies focused on institutional-level transition barriers, including poor communication between CAMHS and AMHS and lack of clarity about their role in the transition process. Involvement of the neurodivergent young person in decision-making processes about their mental health care and clinicians who tailored their approaches to the needs of the neurodivergent young person emerged as key enablers of a positive transition experience. Studies largely failed to examine community and policy-related barriers to mental health care transitions. Most studies examined the perspectives of providers or carers, with only five representing the perspectives of neurodivergent people. Young people who are autistic and/or have ADHD experience many barriers to their transition from CAMHS to AMHS; however, few studies have examined barriers and enablers to the service transition process.

SUMMARY Children with social communication difficulties or an autism diagnosis and co-occurring mental health needs can struggle to access and engage in psychological treatment. This can have a negative effect on well-being and recovery. A service improvement pilot study investigated the impact of a values-focused intervention on the well-being of this patient group. Here, an anonymised clinical case demonstrates the key phases of the intervention. Reflections highlight the importance of a flexible and person-centred approach for these young people.

ABSTRACT Adolescent depression and suicide remain pressing global health concerns, particularly in low- and middle-income countries where access to mental health services is limited. Digital interventions have emerged as promising, accessible, and stigma-free alternatives for promoting youth mental health. This study aimed to evaluate the impact of the Nyala app on depressive symptoms and suicidal risk among adolescents. A posttest-only control group design was employed involving 40 adolescents aged 12–15 years from a private junior high school in Surakarta. Participants were divided into intervention (n = 20) and control (n = 20) groups. The intervention group used the Nyala app—which integrates psychoeducation, mood tracking, thought diary, and SOS crisis support—for two weeks. Depressive symptoms and suicidal risk were measured using the PHQ-9 and SBQ-R. Data were analyzed using the Mann–Whitney U test. The intervention group showed significantly lower mean scores for depressive symptoms (M = 2.35, SD = 2.64) compared to the control group (M = 8.50, SD = 7.02; p < 0.001). Similarly, suicidal risk scores were lower in the intervention group (M = 4.00, SD = 0.00) than in the control group (M = 4.55, SD = 2.84; p < 0.001). The Nyala app effectively reduced depressive symptoms and suicidal risk among adolescents. These findings support the integration of digital tools like Nyala into adolescent mental health services, especially in resource-limited and stigma-sensitive settings. Keywords: Adolescent Mental Health, Depression, Suicide Risk, Digital Intervention, Mobile Health, Nyala App.

ABSTRACT Objectives Adolescents transitioning from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) may face challenges in accurately identifying and reporting their mental health symptoms, often leading to discrepancies between clinician and patient evaluations. Using data from the MILESTONE project, this study aims to assess clinician‐adolescent concordance over 24 months and identify domains of psychopathology with the highest disparities. Methods Participants were assessed at baseline, 9, 15, and 24 months using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) scale and were categorized in four diagnostic groups. Hierarchical cluster analysis identified symptom‐based subgroups of patients based on clinician and patient‐rated HoNOSCA scores. Concordance was evaluated through multilevel linear regression models, while Bland–Altman plots examined agreement between scores across time points. Results Two clusters of patients were identified: one characterized by lower severity and greater prevalence, the other by higher complexity and fewer individuals. Clinician–patient concordance increased over time, rising from 77% to 83% by the second time point and stabilizing. Concordance varied across diagnostic categories, with anxiety showing the highest agreement and ADHD the lowest. Conclusions Improved communication, psychoeducation, and tailored interventions may facilitate greater patient–clinician alignment, thereby supporting more favorable outcomes during this critical developmental period. Trial Registration: ISRCTN83240263; NCT03013595

Objective: This study aims to examine the impact of the COVID-19 pandemic on inpatient treatment processes in child and adolescent psychiatry by comparing three distinct periods: pre-pandemic, during the pandemic, and post-pandemic. Methods: Clinical data of a total of 768 patients who were hospitalized in the child and adolescent psychiatry inpatient unit of a university hospital between April 1, 2018, and January 31, 2024, were retrospectively reviewed. Sociodemographic variables (age, sex) and clinical variables (diagnosis, length of stay, number of admissions, history of suicide attempts, presence of comorbid diagnoses) were compared across three time periods. Results: During the pandemic period, a statistically significant increase was observed in the hospitalization rates of patients diagnosed with neurodevelopmental disorders, particularly attention-deficit/hyperactivity disorder (p < 0.05). Although hospitalization rates for patients diagnosed with depressive disorder, post-traumatic stress disorder, bipolar disorder, obsessive-compulsive disorder, substance use disorder, and anxiety disorders increased during the pandemic period, these increases were not statistically significant. The mean age of patients increased during the pandemic period, and the rate of comorbid diagnoses was markedly higher compared to previous periods. Additionally, the length of hospital stay was significantly shorter during the pandemic and post-pandemic periods (p < 0.05). Conclusion: The COVID-19 pandemic adversely affected the mental health of children and adolescents, particularly increasing the need for inpatient treatment among individuals with neurodevelopmental disorders. The findings highlight the necessity of maintaining the sustainability of child and adolescent mental health services world wide even under extraordinary circumstances such as a pandemic. Therefore, strengthening child mental health services and developing supportive policies targeted at vulnerable groups are crucial for preparedness in future similar crises.

Teenage pregnancy is a persistent public health concern in low- and middleincome countries, including Nigeria, where socio-economic and gender-based vulnerabilities increase adolescent risk. This study assessed the prevalence, contributing factors, consequences, and prevention strategies of teenage pregnancy among adolescents attending the Sexual and Gender-Based Violence (SGBV) Unit at General Hospital Gusau, Zamfara State. A descriptive cross-sectional study was conducted from June 2023 to May 2024. Using purposive sampling, 74 adolescent girls aged 13–19 years were recruited. Data were collected through structured questionnaires and hospital records. Descriptive statistics were applied, and prevalence was estimated with 95% confidence intervals (CIs). The prevalence of teenage pregnancy was 4.1% (95% CI: 0.1%–11.6%), with most cases among late adolescents (16–19 years). Contributing factors included poverty (24.3%), low educational attainment (18.9%), and sexual abuse (16.2%). Reported psychosocial consequences were stigma (48.6%) and maternal depression (31.1%). Healthcare providers recommended strengthening adolescent health services, early identification of high-risk behaviours, and improving access to family planning, though resistance to comprehensive sexuality education was noted. Despite the relatively low prevalence, teenage pregnancy in this setting is linked with significant psychosocial and socio-economic burdens. Addressing this issue requires integrated, culturally sensitive interventions that reduce poverty, expand educational opportunities, prevent sexual abuse, and improve adolescent-friendly reproductive health services. Greater community acceptance of sexuality education and protection of adolescent reproductive rights are critical to sustainable prevention.

This study compared 5 years of admission data at the only active Adolescent Psychiatric Inpatient Unit in all the U.S. government's military hospitals to national databases to investigate the similarities and disparities between the two populations. Data for this study were collected from the Adolescent Inpatient Behavioral Health Service (AIBHS) at the Alexander T. Augusta Military Medical Center and were compared with national databases. Descriptive statistics were performed to analyze the relationships between the primary outcome variable (length of stay, LOS), secondary outcome variable (Risk-Standardized Readmission Rate, RSRR) and each independent predictor variable (age, LOS, sex, fiscal year, diagnosis type, and risk of mortality). Comparing the AIBHS data to national database data showed a similar protective effect in LOS for age (i.e., for each additional year of age, the LOS decreased) and an increased LOS based on increasing risk for self-harm and having an admission diagnosis of a psychotic disorder. There was also agreement between datasets that an increased LOS was predictive of increased RSRR. On average, the AIBHS LOS was longer (11 vs 6 days) but the RSRR was lower (3% vs 8%) when compared to national databases. While the similarities of predictors of LOS and RSRR indicate a common driving force between the two different populations, the marked differences in LOS and RSRR warrant further research to help determine if they are related or if there is some other factor that explains the difference.

Background: While the positive relationship between mental health and physical activity (PA) is well established, numerous barriers are reported. This study analyzed PA levels and associated barriers in young people attending a national child and adolescent mental health service using a quantitatively driven mixed methods design. Methods: From contacted patient families (n = 1284) meeting inclusion criteria, 23.67% (n = 304; age 12 to 18 years) completed a questionnaire (quantitative component/supplementary qualitative component). Statistical tests and thematic analysis were used to interpret data. Results: 57.24% (n = 174) of participants practiced PA/sport. Those in a sporting discipline did more PA overall, and males were almost twice as likely (OR = 1.98) to do PA/sports than females. PA levels were significantly different across mental disorder groups (highest in personality disorders and related traits, and lowest in disruptive behavioral or dissocial disorders). Participants supported the positive association between mental health and athletic performance, including the use of exercise prescriptions. Barriers to PA included excessive screentime, reduced mental health support/awareness, lack of appropriate facilities, financial difficulties, etc. Conclusion: Further research is needed. However, such results will serve to inform the development of the first documented sport mental health clinic for young people.

BackgroundDialectical Behavior Therapy – Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A) is a 30-week program adapted from the comprehensive DBT protocol for adolescents, to be delivered in schools, by school staff. This novel approach takes a preventative position wherein adolescents (aged 11–18) are taught social and emotional skills from DBT to equip them to navigate challenging situations with the premise that this may prevent the development of more severe psychological difficulties. Few studies exist evaluating the “real world delivery” of STEPS-A, and less so outside the United States of America. This protocol outlines the planned evaluation of the effectiveness of the STEPS-A program, as delivered by Marinoto Child and Adolescent Mental Health Service (Health New Zealand|Te Whatu Ora - Waitematā) in Aotearoa New Zealand.MethodThis research will use a mixed-methods approach. Specifically, the evaluation of the program will be based on: (i) completed psychometrics pre- and post- program completion, (ii) perceived acceptability as expressed by participants, their families and the schools running the STEPS-A program during semi-structured interviews and focus groups, and (iii) the feasibility of the STEPS-A program in terms of the ability of participating schools to deliver it in an ongoing manner and (iv) any adaptations required to run the program in New Zealand in a culturally responsive manner. The proposed protocol has been peer reviewed by two independent academics and approved by a national health and disability ethics committee. A power analysis has also indicated that the estimated number of program participants will likely yield a sample that will be adequately powered for data analysis.DiscussionThis research will evaluate the effectiveness, acceptability and feasibility of the STEPS-A program. Findings will highlight the challenges of implementation in a public health system and the suitability for use with an indigenous population.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40359-025-02694-0.

Purpose Although substantial evidence exists on how peer social networks influence adolescent sexual and reproductive health service utilisation behaviours, most studies focus on the general population and overlook migrant adolescents. This paper sought to fill this knowledge gap by exploring how migrant peer social networks shape adolescents’ sexual and reproductive health service utilisation behaviours in an urban slum community (Old Fadama/Agbogbloshie) in Accra, Ghana. Design/methodology/approach A qualitative descriptive design was employed to provide accounts of participants’ experiences, using the theory of planned behaviour (TPB). Peer network groups of migrant adolescents and their gatekeepers residing in the urban slum community of Old Fadama/Agbogbloshie in Accra were recruited for the study. Using purposive and convenience sampling techniques, a total of 22 participants were selected to represent the population after data saturation was reached. Findings The study highlights poor attitudes among migrant adolescents toward ASRH service utilisation due to the lack of culturally sensitive services. It also reveals that social networks strongly influence adolescents’ decisions to use ASRH services. Furthermore, the study suggests that inadequate outreach programs compel many migrant adolescents to rely on peer-shared information, which often reinforces misconceptions and undermines their confidence in navigating the healthcare system. Research limitations/implications This study’s findings may be limited by its focus on a single urban slum in Accra, which may limit generalisability to other migrant adolescent populations in Ghana, although the community studied is typical of urban migrant slums. Additionally, reliance on participants’ self-reported accounts may have introduced reporting biases, especially given the sensitive nature of sexual and reproductive health topics. However, to minimise potential bias, the research team built rapport and trust through community entry by engaging local leaders and youth organisers who facilitated introductions, and participants were assured of the study’s ethical integrity. Practical implications Interventions could leverage peer social networks and group leaders as effective entry points for disseminating accurate information and countering misconceptions about ASRH utilisation. Additionally, fostering sustainable partnerships with youth groups can help ensure that interventions remain context-specific and responsive to adolescents’ lived realities. Strengthening these structures has the potential to build self-efficacy among migrant adolescents, enhance trust in the healthcare system and improve overall utilisation of ASRH services. Originality/value This paper provides valuable insight into how migrant peer social networks shape adolescents’ sexual and reproductive health service utilisation behaviours. It argues that understanding these social dynamics is essential for informing the design and implementation of targeted behaviour change strategies aimed at improving service uptake.

Emotional disorders are common in children and young people and can significantly impair their quality of life. Evidence-based treatments require a timely and appropriate diagnosis. The utility of standardised diagnostic assessment tools may aid the detection of emotional disorders, but there is limited evidence of their clinical value. To assess the clinical effectiveness and cost effectiveness of a standardised diagnostic assessment for children and young people with emotional difficulties referred to Child and Adolescent Mental Health Services. A nested qualitative process evaluation aimed to identify the barriers and facilitators to using a standardised diagnostic assessment tool in Child and Adolescent Mental Health Services. A United Kingdom, multicentre, two-arm, parallel-group randomised controlled trial with a nested qualitative process evaluation. Eight National Health Service Trusts providing multidisciplinary specialist Child and Adolescent Mental Health Services. Children and young people aged 5-17 years with emotional difficulties referred to Child and Adolescent Mental Health Services, excluding emergency/urgent referrals that required an expedited assessment. In the qualitative process evaluation, 15 young people aged 16-17 years, 38 parents/carers and 56 healthcare professionals participated in semistructured interviews. Participants were randomly assigned (1 : 1) following referral receipt to intervention (the development and well-being assessment) and usual care, or usual care only. Primary outcome was a clinician-made diagnosis decision about the presence of an emotional disorder within 12 months of randomisation, collected from Child and Adolescent Mental Health Services clinical records. Secondary outcomes collected from clinical records included referral acceptance, time to offer and start treatment/interventions and discharge. Data were also self-reported from participants through online questionnaires at baseline, 6 and 12 months post randomisation, and the cost effectiveness of the intervention was investigated. One thousand two hundred and twenty-five (1225) children and young people were randomly assigned (1 : 1) to study groups between 27 August 2019 and 17 October 2021; 615 were assigned to the intervention and 610 were assigned to the control group. Adherence to the intervention (full/partial completion of the development and well-being assessment) was 80% (494/615). At 12 months, 68 (11%) participants in the intervention group received an emotional disorder diagnosis versus 72 (12%) in the control group [adjusted risk ratio 0.94 (95% confidence interval 0.70 to 1.28); p = 0.71]. Child and Adolescent Mental Health Services acceptance of the index referral [intervention 277 (45%) vs. control 262 (43%); risk ratio: 1.06 (95% confidence interval: 0.94 to 1.19)] or any referral by 18 months [intervention 374 (61%) vs. control 352 (58%); risk ratio: 1.06 (95% confidence interval: 0.97 to 1.16)] was similar between groups. There was no evidence of any differences between groups for any other secondary outcomes. The qualitative nested process evaluation identified a number of barriers and facilitators to the use of the development and well-being assessment during the trial, particularly at the assessment and diagnosis stages of the Child and Adolescent Mental Health Services pathway. It was not possible to mask participants, clinicians or site researchers collecting source data to treatment allocation. We found no evidence that completion of the development and well-being assessment aided the detection of emotional disorders in this study. Using the development and well-being assessment in this way cannot be recommended for clinical practice. To determine longer-term service use outcomes and to investigate whether receipt of a clinical diagnosis makes a difference to clinical outcomes and care/intervention receipt. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 16/96/09.

Attachment and Psychological Distress in Adolescents from Schools and Care Practices During and After the Covid-19 Pandemic The COVID-19 pandemic had a substantial impact on the mental health of children and adolescents. Internalizing symptoms such as anxiety and depression emerged early on, particularly among those with high pre-pandemic vulnerability. This study investigates the development of psychological difficulties (internalizing, externalizing, and social problems) among adolescents in rural areas after returning to in-person schooling, comparing a non-clinical school-based sample with a clinical sample from child and adolescent mental health services. The study examines whether symptoms persist over time, the role of attachment quality, and the potential buffering effect of early therapeutic intervention. At two time points, 46 adolescents (M_T1age = 14.65 years, SD = 1.08; M_T2age = 16.05 years, SD = 1.24) were assessed using the Adolescent Separation Anxiety Interview (ASAI) and the Youth Self Report (YSR/ 11-18). Findings indicate that participants were highly affected by pandemic-related measures such as lockdowns, homeschooling, and social isolation. Adolescents with insecure-preoccupied attachment reported the highest symptoms. Symptoms persisted beyond the end of public health restrictions. In contrast, connection to a care network emerged as a resilience factor. These results underscore the urgent need for expanded and more targeted support for youth in coping with crisis-related stress.

IntroductionForcibly displaced children and adolescents in the WHO European Region have high mental health needs, yet few manage to access mental health services and even fewer receive high-quality care. Addressing this gap is crucial, as inadequate mental health support has profound and lasting negative effects on individuals, families and communities. This scoping review aims to identify and synthesise the available evidence on the barriers and facilitators to quality mental healthcare for forcibly displaced children and adolescents in the WHO European Region.Methods and analysisQuantitative, qualitative and mixed-method studies that examine barriers and facilitators of quality mental healthcare for forcibly displaced children and adolescents in the WHO European Region will be included. Eligible participants include forcibly displaced children and adolescents, mental healthcare providers, policymakers and humanitarian actors in the mental health and psychosocial support field. We will adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews) guidelines. A comprehensive search of databases, including Embase, Medline, PsycINFO, Scopus and Web of Science, will be conducted. We will systematically search for relevant studies published between January 2004 and December 2024. At least two reviewers will independently screen titles, abstracts and full texts. Data extraction will involve systematically charting relevant information from included studies. We will use the WHO Quality Standards for Child and Adolescent Mental Health Services as an analytical lens to map the evidence. Our study will provide a comprehensive overview of the barriers and facilitators to quality mental healthcare for forcibly displaced children and adolescents, and identify knowledge gaps and areas for potential quality improvement.Ethics and disseminationEthical approval will not be required since this study will retrieve data from already published research and no new data will be collected. The results of this study will be published in a peer-reviewed journal and presented at international conferences in order to disseminate to academic and non-academic stakeholders such as non-governmental organisations, government bodies and community organisations involved in mental healthcare for forcibly displaced persons.Review registration detailshttps://doi.org/10.17605/OSF.IO/AK74F.

IntroductionPhysical activity improves physical and psychosocial outcomes in healthy children and in children with a range of chronic health conditions. Unfortunately, children with chronic health conditions have lower levels of physical activity compared to their healthy peers due to multiple restrictions in physical activities and therefore tend to have lower levels of physical activity compared with their peers. This paper describes the protocol for Move to Improve, a pragmatic trial of an individualised physical activity intervention for children with chronic health conditions.Methods and analysisUsing the RE-AIM framework, this study aims to test the feasibility of Move to Improve, an 8-week hospital-based individualised physical activity intervention. We will recruit 100 children aged 5–17 years who are diagnosed with type 1 diabetes, cancer, postburn injuries and cerebral palsy to a single-arm, pragmatic feasibility trial. The primary outcomes (objective moderate to vigorous physical activity, quality of life and goal attainment) and secondary outcomes (including aerobic capacity, body composition, motor function, grip strength and psychosocial outcomes) will be assessed at baseline, post intervention and at 6-month and 12-month follow-ups. We will conduct semistructured interviews with participants and their primary caregiver at a 2-month follow-up to capture aspects of feasibility. Quantitative data will be reported descriptively, and qualitative data will be analysed using thematic analysis. Data gathered from this study will inform service decision-making and future trials.Ethics and disseminationThe study has received ethics approval from the Government of Western Australia Child and Adolescent Health Service Human Research Ethics Committee (RGS6677). Findings of this research will be communicated to the public through peer-reviewed publications, conference presentations, reports, infographics and information sheets. Modifications to the protocol will be outlined in the trial registry and journal publications. Authorship will be in accordance with the International Committee of Medical Journal Editors.Trial registration numberAustralian and New Zealand Clinical Trials Registry Number: ACTRN12624000836538.

HIV, syphilis, and hepatitis B infections are infectious diseases that remain a global health problem, including in Indonesia. Mother-to-child transmission rates are the highest among these three diseases. HIV transmission from mother to child is 20-45%, syphilis transmission from mother to child is 69-80%, and hepatitis B transmission from pregnant women to children is 90-95%. Diseases that should be screened for in mothers during pregnancy include HIV, syphilis, and hepatitis B. These infections in children occur as a result of transmission from the mother during pregnancy, childbirth, and breastfeeding. Programs to prevent mother-to-child transmission of HIV, integrated with efforts to eliminate HIV, congenital syphilis, and hepatitis B, are highly effective interventions to prevent mother-to-child transmission of HIV, syphilis, and hepatitis B. HIV, Syphilis and Hepatitis B screening for pregnant women is carried out in an integrated antenatal care package and supported by promotive and preventive efforts in adolescent reproductive health and family planning services and supports the National Program for Eliminating the Transmission of these three diseases or often called "Triple Elimination". The government's efforts to break the chain of transmission of HIV, syphilis, and hepatitis B infections from mother to child are carried out through the Triple Elimination program, which aims to reduce the risk of transmission of these three diseases from pregnant women to their babies during pregnancy, childbirth, or through breastfeeding. The goal is to prevent these diseases in newborns and provide protection to mothers during pregnancy. This includes testing and counseling for early detection of HIV, syphilis, and hepatitis B, antiretroviral therapy (ARV), syphilis treatment, hepatitis B vaccination and immunization, infant monitoring and care, safe breastfeeding, education, and support. Factors influencing the success of the Triple Elimination program include knowledge, attitudes, and support from health workers.

BackgroundWhile recovery orientation is national policy in many countries, evidence remains limited for the effectiveness at a service level. This paper describes the protocol for implementing a pro-recovery training intervention (REFOCUS-RETAFORM) in specialist mental health services across France. The aim is to evaluate whether REFOCUS-RETAFORM plus usual care leads to improved outcomes for adolescent and adult mental health service users compared with usual care alone.MethodsA two-step stepped wedge cluster randomised controlled trial will be conducted, with a nested qualitative sub-study exploring stakeholders’ views on changes in staff-user relationships and implementation influences. The REFOCUS-RETAFORM intervention is a training intervention for mental health staff, to develop recovery-promoting relationships and pro-recovery working practices. Clusters are services, which transition sequentially from control to intervention condition in a randomised order. Eight clusters are randomised to deliver REFOCUS-RETAFORM in year one and eight clusters in year two. Each cluster delivers REFOCUS-RETAFORM to two teams from their organisation (32 teams in total). Participants are a) service users aged 13–65 years attending services implementing REFOCUS-RETAFORM, and b) staff receiving the intervention. The primary outcome is the Questionnaire about the Process of Recovery. Secondary outcomes include perceived stigma and coercion, self-stigma and wellbeing for service users, and recovery-orientation for staff. Data will be collected from 540 service users (180 at baseline, 180 at month 12, 180 at month 24) and 220 staff. We will use multilevel mixed-effects models, adjusting for secular trends and thematic analysis for the qualitative interview data.DiscussionFindings will inform the continued transformation of French specialist mental health services toward a recovery orientation.Trial registrationClinical Trials NCT05824234, registered 21 April 2023.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12888-025-07253-w.

Aims: The present study examines the pattern of electroencephalographic (EEG) abnormalities and their demographic and diagnostic characteristics among children with Neurodevelopmental Disorders (NDDs) referred for EEG at a child mental health facility in Southwestern Nigeria. Study Design: A prospective observational study. Place and Duration of Study: Child and Adolescent Mental Health Service Center, Federal Neuropsychiatric Hospital, Lagos, between July and December 2024. Methodology: We included 167 children (aged 0–18 years) with confirmed NDD diagnoses. EEGs were performed using a 64-channel Nihon Kohden system, following the international 10-20 electrode placement protocol. EEG features were classified, and statistical analyses (Chi-square, logistic regression) were used to explore associations. Results: The mean age was 6.75 ± 4.79 years; 58.7% were male. The most common diagnoses were seizure disorder (30.5%), autism spectrum disorder (15.6%), and global developmental delay (15.6%). Abnormal EEGs were seen in 51.5% of participants, with burst epileptiform activity (18.6%) and primary generalized epilepsy (17.4%) being the most common. Abnormal discharges were frequently localized to frontal and temporal lobes. Age group and diagnosis significantly predicted EEG abnormalities (p<.001). Children aged 6–11 years and those with Global Developmental Delay (GDD) or GDD+seizures were at higher risk. Conclusion: EEG abnormalities are common among clinically indicated NDD cases and may support early detection of cortical dysfunction, especially in children with GDD and seizures.

Adolescent cadres are adolescents who are selected or voluntarily volunteer and are trained to participate in implementing adolescent health services for themselves, their peers, their families and the community. The aim of this research is to determine the role of youth cadres as motivators, facilitators, communicators and promoters in youth posyandu activities. This research method is qualitative with a phenomenological approach. The research sample in this study consisted of 3 youth cadres, 3 teenagers, and 1 youth posyandu supervisor. The sampling technique in this research was nonprobability with a purposive sampling technique. This research was conducted at the Batu Selicin Lubuk Baja youth posyandu, Batam City. Data was collected by in-depth interviews. The results of this research showed that there was no role for teenage cadres as communicators in the activities of the Batu Selicin youth posyandu, Lubuk Baja, Batam City. The conclusion from this research is that teenage cadres have not optimized their role as communicators. This is because youth cadres are not provided with special training and youth cadres are also not given in-depth knowledge. This research can also be a reference for further research regarding the importance of youth cadre training.

IntroductionThe perspectives of stakeholders directly affected by mental health services for autism spectrum disorder (ASD) are essential for the quality of these services. However, it is crucial that these perspectives are informed by the best available evidence and adapted to the local context. This study aims to analyse barriers related to mental health services for children and adolescents with ASD from the perspective of families and caregivers, considering social, racial and gender aspects.MethodsThree steps will be taken: stakeholder engagement through an online meeting to refine the research question and understand the magnitude of the problem; (b) qualitative evidence synthesis using five databases and grey literature to identify studies that have collected and analysed qualitative data on barriers to mental health services for children and adolescents with ASD in Brazil. Only studies conducted in Brazil that consider the perspectives of family members and caregivers will be included. (c) A citizen panel with families of children and adolescents with ASD will be used to discuss and validate the synthesis findings.Ethics and disseminationWe will provide a set of evidence-informed and stakeholder-experienced barriers to mental health services for children with ASD in Brazil. This represents an effort to engage stakeholders in evidence descriptions to inform policy. We plan to disseminate the findings through various means, including peer-reviewed journal publications, presentations at national conferences, invited workshops and webinars, patient associations and academic social media platforms. The project was approved by the Ethics Committee for Research at the University of Sorocaba (approval number 78747224.7.0000.5500).Trial registration numberOpen Science Framework—10.17605/OSF.IO/DVAKG.

Advanced practice in child and adolescent mental health services