Child Mental Health Research Articles

Food Consumption and Mental Health in Children and Adolescents: A Systematic Review Protocol

Mental illnesses are prevalent among children and adolescents worldwide and may be associated with food consumption and unhealthy lifestyles. This study aims to evaluate the association between food consumption and mental health in children and adolescents through a systematic review and meta-analysis. The electronic search will include keywords related to childhood, adolescence, mental health issues (e.g., anxiety, stress, depression), and eating behaviors (e.g., eating patterns, ultra-processed foods), verified using MeSH terms. The systematic review will follow the PRISMA 2020 guidelines, employing the PECOS strategy, and will include quantitative observational and mixed-methods studies. A search will be conducted in the following databases: Scopus, CINAHL, SPORTDiscus, LILACS, Web of Science, APA-PhysioNET, PubMed (Medline) and EMBASE. Identifying the association between mental health and food consumption will contribute to the development of preventive and intervention strategies aimed at improving the health and well-being of children and adolescents. The analysis of the data will provide results on how psychological factors are linked to the consumption of various food groups, implying the formulation and updating of public policies. These guidelines can assist managers and researchers in creating effective interventions to promote mental health and healthy eating behaviors, ultimately leading to long-term positive impacts on public health..

Effectiveness of a structured teaching program on knowledge and attitude regarding child mental disorders among primary school teachers at selected schools in Vijayapur, Karnataka

This study aimed to assess the effectiveness of a structured teaching program on the knowledge and attitudes of primary school teachers regarding child mental disorders. Given the projected rise in childhood neuropsychiatric disorders, teachers, who spend significant time with students, are in a pivotal position to identify mental health issues early. A pre-experimental one-group pre-test post-test design was utilized, involving 100 primary school teachers selected through purposive sampling. Data were collected using a self-structured knowledge questionnaire and an attitude scale. Results indicated a significant increase in knowledge (pre-test mean = 8.47, post-test mean = 21.39; t = 36.31, p < 0.001) and attitudes (pre-test mean = 23.60, post-test mean = 33.77; t = 15.51, p < 0.001) post-intervention. Additionally, the study found significant associations between knowledge and specific socio-demographic variables, including prior identification of children with mental disorders. The findings suggest that structured teaching programs can effectively enhance teachers' knowledge and attitudes toward child mental health, underscoring the need for such initiatives in educational settings.

Supporting the Well-Being of Children and Youth With Special Health Care Needs: NASEM Proceedings.

Children and youth with special health care needs (CYSHCN) are living longer than ever. These advances come with a price: Patients, families, communities, and systems must absorb the challenges of chronic caregiving, including protracted stress and poor mental health. In 2023, the National Academies of Science, Engineering, and Medicine convened thought-leaders for conversations about supporting the emotional well-being of CYSHCN and their families. Invited panelists included 2 parents and 3 academic pediatricians. Parents suggested opportunities for clinicians and systems to better support CYSHCN. Clinicians described work focused on:Individual patient- and family-level resilience: Defined as a process of harnessing resources to sustain well-being in the face of stress, resilience is learnable. Programs that teach people to identify and bolster "resilience resources" show promise in improving child and caregiver mental health;Clinician- and practice-level provision of care: Individual-level interventions are only effective if clinicians know when and how to deliver them. Hence, the American Board of Pediatrics created and demonstrated the success of a "roadmap" to support routine screening for and discussion of social and emotional health needs; andSystems-level barriers: Even with patient-level programs and clinician-practice guidance, unmet social and mental health needs persist. Accessing and coordinating services is difficult, may not be covered by insurance, and historically marginalized populations are the least likely to benefit. Together, the panel underscored a critical fact: We cannot optimize child and family well-being without focusing on patients, caregivers, clinicians, and systems.

Understanding Mental Health Impact of COVID-19 on Puerto Rican Youth: Influence of Parental Stress

The COVID-19 pandemic disrupted all areas of society. The socioemotional effects of isolation, financial instability, and educational and employment uncertainty are anticipated to have a ripple effect on the mental health of parents and children, which has not yet been studied in the Puerto Rican context. To examine the impact of COVID-19 on Puerto Rican families, we used a cross-sectional, correlational research design that studied the following: (a) Adverse experiences (AE) related to the COVID-19 pandemic reported by parents; (b) Parental stress; (c) Parental psychopathology: (d) The mental health of their children. We hypothesized that AEs have direct and indirect effects on child mental health, which are mediated by parental mental health and stress. One hundred and thirty-five parents with children aged 4 to 18 years completed an anonymous online survey from March to May 2022. Results show that COVID-19 AEs have significant direct and indirect effects on child mental health, which are mediated by parental stress and parental psychopathology. We observed medium-to-large effect sizes in the associations between child mental health and COVID-19 AEs, which are mediated by parental stress and psychopathology. Children’s mental health symptoms worsen as parental stress and parental psychopathology increase in the context of COVID-19 AEs.

Giving children a voice: Concept development and foundation of the first Children's council “mental health” in Germany

AbstractBackgroundAs summarized by the Lancet Psychiatry Commission on youth mental health (McGorry et al., 2024), the statistics on mental disorders in children are alarming and highlight the need to expand and optimize research on childhood mental health. Although patient and public involvement (PPI) of those affected has the potential to boost both the acceptance and outcomes of research studies, the active involvement of young children, that is, primary school children, in mental health research has been neglected.MethodsBased on the results of our systematic literature analysis of PPI of children in mental health research, the concept development of the Children's Council ‘Mental Health’ was administered in cooperation with several stakeholders and focus groups (practitioners and researchers in the field of clinical psychology and psychotherapy across the lifespan, representatives from three self‐help organizations for mental disorders, children's focus group). The concept was further optimized in collaboration with the German Children's Fund (Deutsches Kinderhilfswerk e. V.).ResultsThe Children's Council was successfully founded with five children aged between 6 and 9 years. Participation is positively received, and each meeting is evaluated using visual measurements. The results from the meetings are presented and discussed. They serve as basis for concrete recommendations for involving young children in mental health research.ConclusionsTo the best of our knowledge, this is the first structured approach involving young children in mental health research studies. The main goal of our study is the direct and immediate empowerment of children, in this case primary school children at the age of 6–12 years. This is associated with a child‐friendly exchange on topics related to mental health, as well as the enhancement of the education process on mental disorders and prevention.

Effects of the COVID-19 Pandemic on Early Childhood Development and Mental Health: A Systematic Review and Meta-Analysis of Comparative Studies

From 2020 to 2023, the coronavirus-19 (COVID-19) pandemic exposed children to a variety of adverse childhood events, including parental loss, abuse, and disruption in services, and it exacerbated societal inequities. Studies evaluating the mental health of older children and adolescents reported increases in depression and anxiety symptoms, but no reviews have addressed the effects of the pandemic on preschool children. This systematic review and meta-analysis is the first to explore these effects. The goal was to analyze and synthesize longitudinal cohort studies to determine impact of the COVID-19 pandemic on the development and mental health of young children. Searches of multiple databases were performed for studies published between 2018 and 2023 with pre- and post-pandemic evaluations of the mental health or development of preschool children (aged 0–6 years) using objective measures and according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Cohen’s d effect sizes were calculated for each study that utilized the Strengths and Difficulties Questionnaire (SDQ), Ages and Stages Questionnaire (ASQ), or the Child Behavior Checklist (CBCL). Random-effects mixed models combined the estimates of effect sizes to calculate the overall mean effect size. The meta-analyses included 22,348 children from 16 countries. The analyses showed small increases in emotional symptoms and conduct problems, as well as increases in emotional reactivity, anxiety/depression, withdrawal symptoms, attention problems, and aggressive behaviors. A decrease in fine motor and personal–social skills was noted. Studies not included in these meta-analyses also showed negative effects on language and executive function. This systematic review characterizes the detrimental effects of the COVID-19 pandemic on the mental health and development of preschool children across the world. Our results suggest the vulnerability of early childhood to pandemic-related disruptions, although the heterogeneity in study design and child characteristics may limit some of these conclusions.

'I'm sick of being the problem': Autistic mothers' experiences of interacting with schools for their autistic children.

Good relationships between families and schools make a difference to children's learning - and the same goes for autistic children. But parents of autistic children often find it very stressful interacting with teachers and school staff. In this study, we focused on autistic parents of autistic children. We wanted to know about their experiences of interacting with schools and the impact these had on them and their children. We spoke to 31 autistic mothers of autistic children about their experiences. They told us that they felt they were constantly fighting with schools to get the support needed for their autistic children and compared it to like being in a 'war zone'. They were 'sick of being [viewed as] the problem' and felt that their views and autistic expertise were not taken seriously by teachers and schools. This was damaging to their autistic children's mental health as well as their own. Autistic mothers did share some positive experiences too. They spoke about the value of mutual respect and its impact on successful school partnerships. Autistic mothers also spoke about standing up for themselves and their children and how this advocacy and self-advocacy helped them to build better relationships with schools. This research showed how difficult it can be for autistic families to interact with teachers and schools and the impact this can have on the whole family. It also showed us that strong, trusting relationships between school and families are possible - when autistic parents feel safe, and when their knowledge and lived experience are taken seriously by educators.

Getting up for brain health: Association of sedentary behavior breaks with cognition and mental health in children

Children spend most of their waking hours sedentary and reducing this behavior has been challenging. Interrupting prolonged episodes of sedentary behavior with active breaks can provide mental and cognitive health benefits. Considering the multifactorial nature of these health aspects, this study aimed to verify the role of body mass index (BMI), cardiorespiratory fitness (CRF), and moderate to vigorous physical activity (MVPA) in the relationship between the break in sedentary time with cognitive and mental health in children. This is a cross-sectional study with 129 children (62 boys), aged between 6 and 11 years (mean 8.73 ± 1.53) from a public school in southern Brazil. For the assessment of fluid intelligence, psychologists applied Raven’s Colored Progressive Matrices test. Mental health was measured using the Strengths and Difficulties Questionnaire. Sedentary breaks were measured using accelerometers, and CRF was determined using the 6-min walk test. Generalized linear regression analyses were used to verify associations of sedentary breaks with fluid intelligence and mental health, according to children’s BMI, CRF, and MVPA. All models were adjusted for sex, age, somatic maturation, and total time of accelerometer use. Our results indicated that sedentary breaks were associated with fluid intelligence in overweight/obese (β = 0.108; p = 0.021) and physically inactive children (β = 0.083; p = 0.010). Regarding mental health, no association was identified with sedentary breaks. In conclusion, sedentary breaks should be encouraged for the benefits of fluid intelligence, especially in children who do not meet physical activity recommendations and are overweight.

Mapping Psychosocial Challenges, Mental Health Difficulties, and MHPSS Services for Unaccompanied Asylum-Seeking Children in Greece: Insights from Service Providers

Background/Objectives: Evidence-based information is crucial for policymakers and providers of mental health and psychosocial services (MHPSS) for unaccompanied asylum-seeking children (UASC). However, there is a scarcity of national-level studies investigating the MHPSS needs of UASC and how these are addressed in Greece. The research objectives of this study were to explore: (a) the psychosocial and mental health needs of UASC living in Greek long-term accommodation facilities as perceived by MHPSS providers, and (b) the range of services across the country, highlighting gaps and best practices in service delivery. Method: An exploratory, predominantly quantitative design was adopted to map UASC’s psychosocial difficulties, mental health problems, and MHPSS delivery. Purposive sampling was implemented, with 16 of 17 NGOs operating long-term accommodation facilities for UASC and 16 child and adolescent mental health services (CAMHS) participating. The sample included 79 participants (34 facility coordinators, 28 field psychologists, and 16 CAMHS directors). A 5-W mapping tool (Who, Where, What, When, and Which) was used for data collection, through an online survey. Data analysis involved quantitative and qualitative methods (content analysis). Results: Of 798 minors, almost 59% showed signs of behavioral or emotional disturbance, with over half referred for psychiatric assessment and 27.7% needing inpatient care. Aggression, disruptive behaviors, self-harm, and suicidal ideation were the most challenging issues. CAMHS directors reported a high rate of crisis-driven responses, with 42.1% of UASC needing emergency psychiatric evaluation. Psychosocial support was hindered by communication difficulties, lack of a shared care philosophy, understaffing, job insecurity, and limited resources. Conclusions: Our findings highlight the mental health needs of UASC, and the challenges faced by facility coordinators, psychologists, and community mental health specialists. Future research should focus on the institutional and organizational factors influencing service delivery to improve support for UASC.

Staff Experiences of Working with Children and Adolescents Engaging in Behaviours That Challenge in Mental Health and Paediatric Inpatient Environments: A Qualitative Exploratory Study across Four European Countries

ABSTRACT There has been a recent global increase in the number of young people experiencing mental health challenges in both child and adolescent mental health settings and acute paediatric settings. In many of these settings, restrictive practices are used to manage behaviours that challenge, such as aggression and violence. However, little is known about staff’s experiences with responding to behaviours that challenge in these settings. A qualitative descriptive design was adopted, with participants engaging in 1:1 interviews or focus groups in Ireland, Finland, Germany, and Bulgaria. Data were analysed using reflexive thematic analysis. Four themes were identified: (1) the importance of establishing a safe, therapeutic environment, (2) identified antecedents to behaviours that challenge, (3) how staff respond to behaviours that challenge, and (4) the needs of staff when maintaining a safe, therapeutic environment. Consideration needs to be given to the environments where young people are cared for, with an emphasis placed on safe, comfortable, therapeutic spaces to reduce behaviours that challenge. Staff should be better trained in trauma-informed practice, and both staff and service users should be provided with opportunities to de-brief following episodes of restrictive practices, with a focus on enhancing and maintaining therapeutic relationships.

The Relationship between the Mental Health of Refugee Parents and Their Children: An Investigation of Australian Longitudinal Data.

We investigated the relationship between parent and child mental health, including parents' general psychological distress, among refugees resettled in Australia. We utilised longitudinal data from a sample (N = 602 children and 377 parents) of recently settled refugees from the Building a New Life in Australia Survey). Parent psychological distress and post-traumatic stress symptoms (PTSS) were measured by the Kessler 6 and PTSD-8, respectively. Harsh and Warm parenting behaviours were also measured to explore the mechanisms underlying the parent-child mental health relationship. Child mental health was measured using the SDQ. Using path analysis, we found that increases in parent psychological distress directly contribute to harsher parenting practices, which in turn increase child mental health difficulties as reported by parents. Parent psychological distress at Waves 1 and 3 also directly impacted child emotional and conduct difficulties, whilst parent PTSS was indirectly associated with all measured child mental health problems. While both parent PTSS and psychological distress indirectly impacted child mental health, only psychological distress directly impacted on any area of child mental health difficulty and overall explained more variance in the final model. Our findings highlight that non-trauma specific symptoms warrant attention in refugee parents' and children's mental health. Clinicians should assess for general psychological symptoms in addition to trauma-specific symptoms, and we recommend that parental mental health is assessed and treated simultaneously when working with refugee children. Moreover, to reduce the impact of other stressors in refugees' lives, community sector organisations should be resourced adequately to support refugee families in settlement.

Association between Demographic Profile with Behavioral and Emotional Problems in Children Affected by Flash Floods and Landslides in Nagari Tanjung Sani, Tanjung Raya District, Agam Regency

The disaster that occurred in July 2023 in Nagari Tanjung Sani, Tanjung Raya District, Agam Regency caused significant damage and potential short and long-term psychological impacts for children, who are vulnerable to trauma. This study aims to determine the association between demographic profile with behavioral and emotional problems in children affected by flash floods and landslides in Nagari Tanjung Sani. The study used a cross sectional design with a total sampling method from children after flash floods and landslides in nagari tanjung sani, totaling 58 children. Tracked mental emotional disorders in children and adolescents aged 4-18 years using the Strength and Difficulties Questionnaire. Respondents participated are consisted of 30 females (52%) and 28 boys (48%), with most of the respondent was 39 childrens being school-aged (<11 years old). Strengths and Difficulties Questionnaire (SDQ) results showed 2 (3%) respondents experienced issues in the emotional component with majority respondent showed normal levels in the mental difficulties component. There was no association between demographic profile of the children with the SDQ strength and difficulties scores. This study highlights the importance of early detection and intervention to support children's mental health after disasters. More attention is needed from medical personnel and the community to address mental-emotional problems arising from disaster trauma, to prevent long-term impacts on the social and academic development of these children. Keywords: Strengths and Difficulties Questionnaire, Demographic Profile, Disaster, Emotional problem.

Corrigendum: School children's mental health during the COVID-19 pandemic

Corrigendum: School children's mental health during the COVID-19 pandemic

A descriptive analysis of Aboriginal adolescents admitted to a regional inpatient mental health unit: Was culture considered?

To describe the characteristics of Aboriginal adolescents admitted to a Child and Adolescent Mental Health (CAMH) inpatient unit and assess if cultural identity was acknowledged, and what proportion received cultural support. A retrospective chart review of adolescents who identified as Aboriginal and were admitted to a regional CAMH Unit over 10years. Medical records were reviewed for demographics, diagnosis, details of admission, acknowledgement of Aboriginal identity, cultural information and cultural support provided. A total of 172 patients who identified as Aboriginal were admitted during this period, comprising a total of 266 admissions. Most frequent admission reason was suicidal ideation or self-harm (66%), then psychosis (14%) and 49% were admitted involuntarily. Most frequent discharge diagnosis was a stress-related disorder (23%) followed by post-traumatic stress disorder (18%). A referral for Aboriginal clinician cultural support was made for 30%. Thirty patients (23%) had any detail regarding cultural identity documented. Amongst young Aboriginal people admitted to a psychiatric inpatient unit, the minority had cultural identity acknowledged or were provided cultural support. There is a need for increased access to Aboriginal Mental Health Clinicians and improved training for the broader workforce in the provision of culturally considered care.

Investigating Associations Between Climate Change Anxiety and Children's Mental Health in Pakistan: Impacts and Priority Actions.

Climate anxiety has a negative impact on the mental health and psychological wellbeing of the vulnerable population. The goal is to assess many factors that affect mental health and psychological wellbeing, as well as how climate change affects mental health in Pakistan's vulnerable population. This study provides evidence-based insights on the long- and medium-term impacts of extreme weather events on mental health. To obtain information on these variables, this research uses a quantitative approach and a cross-sectional survey design with a multivariate regression model for empirical tests on a sample of parents and children with an impact on mental health from climate change anxiety. Results indicate that individuals experience shock and climate change anxiety, and their effects on mental health and psychological wellbeing. Climate change can have detrimental effects on children's mental health. (1) disaster risk health (2) children's stress index (3) public health concerns, (4) climate change anxiety, (5) generalized anxiety disorder, and (6) major depression disorder, as reported by the children with mental health outcomes. The findings of this study show that climate change has a stressful effect on mental health. The paper concludes with a discussion on strategies to address the anticipated mental health issues among children due to climate change.

The cost of poverty for child development: The adverse impact on maltreatment, education and mental health outcomes cannot be ignored.

This commentary explores the 'cost of poverty' for child development, with particular reference to the current UK context. Specifically, it comments on the adverse impacts of poverty on child mental health, education, and maltreatment.

Examining the mental health trajectories of children and adolescents: a cross-cohort analysis.

Epidemiological samples provide opportunity to understand the development of mental health trajectories to better understand whether such epidemiological data can help to plan and modify service delivery for youth mental health. Variation between countries is not well understood and thus applying evidence from other countries to national strategies limits support service policy and planning. We therefore examine developmental patterns of youth mental health across different countries using the Growing Up in Ireland (GUI) Cohorts, with comparison to existing UK longitudinal cohort data (Millennium Cohort Study, MCS; Growing up in Scotland, GUS). Youth mental health problems within each cohort across development (5-17/18 years) were assessed using parent reported Strengths and Difficulties Questionnaire (SDQ) scores. Using latent growth curve analyses, we examined trajectories of emotional, conduct, and hyperactivity problems for boys and girls, separately for each cohort. Across cohorts, we observed similar developmental patterns for emotional, conduct, and hyperactivity problems. However, the GUI emotional problems in Ireland emerged earlier than in the UK. By adolescence, GUI emotional scores were similar to the UK, suggesting that the differences in emotional problems between the ROI and UK had narrowed by adolescence. Covariates also had different associations with youth mental health trajectories across cohorts. Utilizing multiple nationally representative cohort longitudinal datasets can help inform clinically meaningful conclusions and potential recommendations on population level multi-tiered service needs and development in the area of child and adolescent mental health support and future provision.

Mental Health Monitoring for Young People Through Mood Apps: Protocol for a Scoping Review and Systematic Search in App Stores.

The researchers have used mobile phones to assist in monitoring, analyzing, and managing moods to acquire insight into mood patterns. There is a lack of evidence in their use as clinical tools and interventions, which necessitates a comprehensive review and quality assessment to understand barriers and facilitators for app implementation as an impactful clinical intervention. This review aims to (1) provide an overview of the recent evidence on mobile mood-monitoring apps that are intended for facilitating self-management and support of mental health in children, adolescents, and young people; and (2) investigate the quality of publicly available apps. The study will first involve a scoping review of the literature on mood-monitoring apps for children, adolescents, and young people followed by an evaluation of features of the apps available in the marketplace. The scoping review will follow the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines and search 6 databases- Embase, CINAHL, PubMed, ACM Digital Library, Scopus, and Springer LNCS-for relevant studies and reviews published in the last 3 years. The author will then screen the references, extract data from the included studies, and analyze them to synthesize the evidence on mood apps. Next, the Apple App Store and Google Play Store will be searched for mood apps. A total of 2 independent reviewers will screen the apps based on eligibility criteria, and disagreements will be resolved through consensus. The features of the selected apps will then be evaluated using the Mobile Health Index and Navigation framework, and descriptive analysis will be used to synthesize the findings. Literature search and screening began soon after submission of the protocol and is expected to be completed by September 2024. The app evaluation will be completed by October 2024. Combined, the scoping literature review and app evaluation will provide an in-depth overview of the most recent scientific evidence related to mood apps and the quality of apps actually available for use. PRR1-10.2196/56400.

Study on the correlation between abdominal infection and psychological stress in children based on nucleic acid detection

BACKGROUND Diagnosing and treating abdominal infection in children remains a challenge. Nucleic acid detection, as a rapid and accurate diagnosis tool, has great significance in this field. AIM To investigate the diagnosis and treatment of abdominal infection by nucleic acid detection and its possible correlation with psychological stress in children. METHODS A total of 50 pediatric patients diagnosed with abdominal infections between September 2020 and July 2021 were included in this study. Intra-abdominal pus samples were collected for pathogen culture, drug susceptibility testing, and broad-spectrum bacterial nucleic acid testing. Psychological stress, anxiety, depression, and coping styles were assessed using the coping with a disease (CODI) scale. RESULTS Based on susceptibility testing, a regimen of cefazoxime, piperacillin/tazobactam, and metronidazole or ornidazole achieved 100% effectiveness in treating appendicitis. Psychological assessments revealed a positive correlation between pressure level and both anxiety (r = 0.324, P = 0.001) and depressive disorders (r = 0.325, P < 0.001). Acceptance and distancing as coping strategies were negatively correlated with anxiety and depression, while negative emotional responses were strongly associated with increased anxiety (r = 0.574, P < 0.001) and depression (r = 0.511, P = 0.001). Coping strategies such as illusion and escape showed no significant correlation with emotional outcomes. CONCLUSION Nucleic acid testing helps in the diagnosis of abdominal infections in children, and also focuses on children's mental health.

Clinician attitudes towards adoption of evidence-based practice: a nationwide multiprofessional cross-sectional study of child and adolescent mental health services in Sweden.

Implementation of evidence-based practice (EBP) in child and adolescent mental health services (CAMHS) is a priority to improve service delivery and outcomes. Clinicians' EBP attitudes are likely to play a crucial role in implementation but are poorly understood. This study aimed to assess variation in EBP attitudes in a large national sample of CAMHS clinicians in Sweden, and to compare these findings to findings from the United States of America (USA). CAMHS clinicians (n = 799; 60% response rate) completed the Evidence-Based Practice Attitude Scale (EBPAS) and items from the Organizational Readiness for Change Scale (ORC) ahead of an EBP for depression implementation effort across Sweden. EBPAS scores were compared with the USA study. Predictors of global and specific attitudes (gender, age, working years, education, profession, perceived benefit of diagnosis and organizational readiness and type of service) were examined using simple and multiple linear regressions. Clinicians had positive attitudes towards EBP on the four-dimensional subscales of the EBPAS, somewhat more so than their American counterparts. Clinician and organizational characteristics were related to at least one attitudinal dimension in both models, with perceived utility of diagnosis being the strongest and most consistent predictor across dimensions and models. Results from this large-scale national study underscore the need to consider cultural, contextual, and individual variations in attitudes towards EBP when planning implementation efforts. Such efforts may need to be tailored to the working contexts, needs, and values of CAMHS clinicians, particularly their views on the utility of diagnosis.