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The paper aims to explore the anxiety of university students. The authors note that the rhetoric of the snowflake is frequently invoked in lay discourse to characterise a generation of young people as overly sensitive. This misleading conceptualisation is potentially stigmatising.

Interviews were conducted with tweleve young women (18–25 years) about anxiety during their transition through university and into adulthood.

The authors identified three themes: (1) students in a modern world, (2) gendered demands and (3) anxiety of adulting. Analysis demonstrated numerous, transecting and discourse-informed anxieties about modern life.

University professionals may benefit from understanding the gendered dimensions of anxiety associated with transitions to adulthood, including the increased pressures to succeed and achieve.

The arguably pejorative label of “snowflake” could negatively impact the social progress made in recognising the importance of taking care of mental health and help-seeking. This is especially concerning for females, as they have higher prevalence of anxiety conditions than males.

This paper contributes to a dialogue about the psychoanalytic concept of free association and its application in the context of qualitative research interviewing. In doing so, it also adds to wider discussion regarding the relationship between clinical psychoanalysis, psychoanalytic psychotherapy and qualitative research.

Critical consideration of different perspectives on the application of free association in the qualitative research interview, extending earlier work addressing this issue. Differences and similarities in the way the concept of free association is articulated are examined regarding its framing in psychoanalysis and psychoanalytically oriented psychotherapy.

Whether researchers see themselves as borrowing, applying or drawing inspiration from free association, there is scope for muddling distinct ways of viewing it as it is conceived in psychoanalysis.

Considerations are outlined for researchers interested in psychoanalytically informed methods to be mindful of.

This study aims to establish the perspectives of community providers on challenges and enablers in developing child mental health capacity in disadvantaged communities in South Africa.

The authors involved 29 community providers operating in a large urban-deprived area in the Gauteng Province, east of Johannesburg. Community providers had educational, social and health care backgrounds. Their perspectives were captured through three focus groups, two participatory workshops and reflective diaries. Data were integrated and subjected to inductive thematic analysis.

Three interlinked themes were identified. Community mobilization was viewed as pre-requisite through mental health awareness and strategies to engage children, youth and parents. Service provision should take into consideration contextual factors, predominantly inequalities, lack of basic needs and gender-based issues (domestic violence, teenage pregnancy and single motherhood). Participants referred to severe mental health needs, and related to physical health conditions, disabilities and impairments, rather than to common mental health problems or wellbeing. They proposed that capacity building should tap into existing resources and integrate with support systems through collaborative working.

Child mental health policy and service design in Majority World Countries (MWCs), should involve all informal and structural support systems and stakeholders. Contextual factors require consideration, especially in disadvantaged communities and low-resource settings, and should be addressed through joined up working.

Children’s mental health needs are largely unmet in MWC-disadvantaged communities. These findings capture the experiences and perspectives of various community providers on how to enhance mental health provision by mobilizing communities and resources.

The purpose of this paper is to report findings from a service evaluation of a training initiative in participatory practice with children and young people (CYP) for early help (EH) professionals. The training was based on the Lundy model of child participation.

A questionnaire-based survey was undertaken of staff completing the training. Within the sample of professionals surveyed, various work contexts were represented.

Reported benefits arising from the training included increased understanding of the utility of the tenets of the Lundy model, as well as changes in practice with CYP. Barriers and issues encountered in seeking to work in a participatory way were identified in relation to time for relationship-building, resources and interprofessional and interagency working.

The evaluation findings provide insight into ways training in participatory practice with CYP is experienced by EH professionals. The role of networks of practitioner champions in influencing participatory practice is also addressed, as well as the interface between participatory and relationship-based practice.

The purpose of this paper is to develop a child psychosocial framework among stakeholders in areas of disadvantage in three low- and middle-income countries (LMIC), i.e. Kenya, Turkey and Brazil, and to capture their proposed recommendations through action plans according to this framework.

Workshops were facilitated with a total of 54 participants from different disciplines. The framework addressed safety and child-centredness, quality of care, resilience-building in schools and communities, enhancing competencies within existing roles, counselling and psychological interventions, and access to mental health services. Stakeholders’ perspectives were captured through a participatory action procedure.

The emerging 33 categories across the framework dimensions and the three sites led to four overarching and inter-linked themes. These related to community awareness; empowerment and “mobilization” of children, young people and families; inter-agency policy and practice; and capacity-building on skills acquisition at different levels.

The next stage in this service research should be full implementation and evaluation in different LMIC contexts.

It is feasible to implement such a child psychosocial framework in contexts of conflict and disadvantage, and in the absence of specialist mental health services. Active stakeholder engagement and co-production should be central to the next phase of service transformation in LMIC.

This study captured the views and experiences of stakeholders in LMIC areas of disadvantage, and demonstrated their readiness to establish interdisciplinary networks and re-focus existing services.

The purpose of this paper is to report findings from a service evaluation undertaken within a single specialist child and adolescent mental health service (CAMHS) team. The team works closely with local authority children’s services to serve specific populations recognised as experiencing higher levels of mental health need, including children living in alternative care and with adoptive families. The evaluation sought to better understand the experience of this provision during the COVID-19 pandemic and concomitant increase in remote and digitally mediated care delivery.

Analysis of the accounts of 38 parents, carers and professionals involved with the team gathered via telephone interviews and email and postal questionnaires.

Similar views were expressed from participants involved with the team before and following the onset of the pandemic. Overall, satisfaction was high; however, changes in care appeared more challenging for those already involved with the team before the pandemic. Differences in experience between groups were also evident. Whereas foster carers’ accounts were generally appreciative of the involvement of clinicians, particularly regarding clinician–patient relationships, amongst adoptive parents and members of children’s birth families there were more mixed and negative impressions.

Locally based service evaluations can help inform care pathway planning in specialist CAMHS provision as part of wider quality improvement initiatives. This is especially relevant considering the repercussions of the COVID-19 pandemic and as the longer-term acceptability of remote working practices is appraised.

This paper aims to examine the role of bullying victimization in predicting psychopathology, encompassing post-traumatic stress disorder (PTSD), risk of developing prodromal psychosis and emotional and behavioural problems, among in-school Nigerian adolescents.

A total of 351 junior secondary students (n = 173 males, 178 females; age range: 9–17 years) were recruited from five randomly selected public secondary schools in Nigeria. Students completed a variety of self-report measures, including a socio-demographic questionnaire, the prodromal questionnaire – brief version, the strengths and difficulties questionnaire (SDQ) and the multidimensional peer victimization scale. They were also interviewed using the PTSD module of the Mini International Neuropsychiatric Interview-Kid Version.

Although bullying victimization was not found to predict the presence of PTSD, it predicted the risk of developing prodromal psychosis. All SDQ subscales also held significant positive associations with bullying victimization. This indicates that higher levels of victimization are associated with increased behavioural and emotional difficulties among adolescents.

The study findings add support to whole system approaches involving relevant stakeholders in health, education, social and criminal justice sectors via protective policies to address the problems of bullying in schools.

The study contributes to evidence demonstrating a need for improved understanding regarding the role of exposure to bullying victimization in predicting various forms of psychopathology. Furthermore, there is specifically a need for research with this focus in developing countries in sub-Saharan Africa and the Nigerian education system.

This paper aims to report a non-randomized control study undertaken to investigate prevalence and correlates of conduct disorder among male secondary education students in South-West Nigeria and to assess the impact of a problem-solving skills and attributional retraining (PSSAR) intervention with this population.

In total, 787 male students from two schools were screened for conduct disorder. All participants who met criteria for the disorder were allocated to either treatment (n = 55) or control (n = 47) groups. Outcome measures comprised the strengths and difficulties questionnaire (SDQ; teacher and student versions) and the teacher rating of students’ aggressive behaviors.

Of the sample, 13% were found to present with difficulties that met criteria for conduct disorder. The presence of these difficulties correlated with several demographic variables, including parental conflict and alcohol use. A statistically significant reduction in mean scores was observed for the treatment group in the student rating of the SDQ emotional subscale and total difficulties scores. Teacher ratings were less consistent in that conduct problems, prosocial behavior and total difficulties increased following the intervention, whereas peer problems and aggressive behavior were reported by teachers to reduce. No statistically significant change was found in the outcome measures for the control group.

In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed.

In resource-constrained settings, school-based interventions are an important means through which treatment gaps in child and adolescent mental health can be addressed. This study’s findings offer some preliminary support for the PSSAR intervention for conduct disorder in this context and indicate areas for further research.

Children in majority world countries (MWC) have high rates of unmet mental health needs, with limited access to specialist resources. Integration of child mental health in existing psychosocial care can improve provision. Through a Train-the-Trainer (ToT) cascade approach, this study aimed to provide a framework for such integration in resource-constrained communities in Karachi, Pakistan and to establish hindering and enabling factors.

Eight practitioners attended a child mental health ToT program, including training on a five-domain service transformation framework. Trainers co-designed and implemented interventions that integrated child mental health knowledge and skills on each domain. These were attended by 136 end-users (youth, parents, teachers, managers), of whom a sub-sample of 47 stakeholders, as well as the trainers, attended focus groups on their experiences. Data were analysed through a thematic codebook.

Established themes reflected common ingredients across all domains/interventions that were deemed important for child mental health care integration. These included child-centric approaches, positive parenting, community mobilization and systemic changes.

Integrated child mental health care informed by the Train-of-Trainer approach can be a useful model for resource-constrained MWC contexts. Integrated interventions should be co-produced with communities.

Specialist CAMHS provide skilled assessment and interventions for children, young people and their families who have mental health disorders. The training needs of the staff who work in specialist CAMHS are not always clear or prioritised, due to the complexities and differing contexts in which specialist CAMHS are provided. The aim of this paper was to establish stakeholders' experiences of service complexities and challenges that affect training within specialist CAMHS. The project employed interviews to gain wide‐ranging consultation with key stakeholder groups. The sample consisted of 45 participants recruited from policy departments, professional bodies, higher education providers, commissioners, service managers, and practitioners. The participants identified a number of themes that limit training, and put forward solutions on how these could be facilitated in the future. Emerging themes related to leadership and the role of service managers, strategic management of training, commissioning, levels of staff training, resources, impact of training on service users, and availability of training programmes. The findings emphasise the need for the strategic workforce planning of training to meet service delivery goals. Policy, commissioning, workforce training strategies, service needs, and delivery of training should be integrated and closely linked.