The effect of the Growing Minds Check-in for parents (GMCI-P) on parents/caregivers seeking help for child mental health

Participants are parents/caregivers (henceforth referred to as ‘parents’) of children aged from birth to 17 years, 6 months of age, who self-refer and would like to check-in on their child’s mental health (MH) or learn more about specific online evidence-based programs that could meet their child’s mental health and wellbeing needs. The GMCI-P will take approximately 15 minutes to complete in one sitting, but if parents need to attend to other matters, they are able to return to the GMCI-P and complete the questions at a later time. Commencement and completion of the GMCI-P is entirely at parent's discretion and is to be completed in a private location of their choosing. The GMCI-P website and tool is hosted by Netfront, who adhere to the NHMRC and University of Sydney privacy and data security recommendations. They also provide the ability to set up a family profile in order to track progress through the GMCI-P, to return to use the tool in the future and see prior recommendations, and provide website analytics. The aim of this research is to evaluate the efficacy, acceptability and cost-effectiveness of the GMCI-P, a new, brief, online self-directed check-in (or screening) and referral tool for parents/caregivers of children aged birth to 18 years. We will conduct an RCT with 500 families. The study will randomise parents to receive the GMCI-P immediately versus a Waitlist control (WLC) group, and the GMCI-P intervention group will be followed at post-intervention, three-month follow-up and six-month follow-up. In addition, the first 50 participants in the intervention group will be assessed at post in an optional qualitative interview. The Waitlist group will receive the GMCI-P after the three-month follow-up and will not be followed up further. The aim of this research is to examine the efficacy and acceptability of the GMCI-P in increasing the likelihood that children at risk of MH problems will be identified and to increase parent help-seeking for child mental health by connecting to evidence-based online programs (via the recommendations provided). We will also investigate further help-seeking behaviour (for those parents currently seeking help for their child’s MH and wellbeing), child MH symptoms, parents’ intentions to seek help or access a program (help-seeking intentions measured at 3mfu), parenting, parent wellbeing, parenting self-efficacy, knowledge about where to access support to strengthen their child’s MH and wellbeing if needed, cost-effectiveness, parents’ satisfaction with help-sought, and the acceptability (as determined by parents’ responses to satisfaction and perceived usefulness questions at post-intervention questionnaire). We will also explore possible iatrogenic effects from the use of the GMCI-P (namely, increases in help-seeking stigma and parental anxiety about child mental health and wellbeing). We will further examine acceptability and possible iatrogenic effects qualitatively, through a post-intervention interview for a sub-sample of the intervention group only. Predictors and moderators to be examined include socio-demographic variables, prior child MH diagnosis, service type, dosage of service and perceived barriers to help-seeking. The GMCI-P contains the five primary components: 1) subjective questions on parents’ perceptions and concerns about their child’s MH and development, and 2) objective questions, including validated measures of child MH for parents (e.g., Pediatric Symptom Checklist) to complete online at their own pace. The GMCI-P questions have been developed based on a review of the current evidence on UMHS, and in collaboration with an expert Advisory Group and the end-users of the system (e.g., parents/caregivers); 3) automatically generated feedback to parents based on their response to questions. Using the validated measures of child MH appropriate to the child’s age, children’s aggregate scores will be categorised into a relative risk profile, with scores below the specified clinical cut off considered “low risk” (i.e., low range) and those scores that fall above the clinical cut off considered “high risk” (i.e., at risk). Parents will be prompted to save their feedback and recommendations as a PDF and share it with to their GP, or if they feel they need more than the online recommendations, directed to the ‘Additional Resources and Help’ page with links to other services, supports and resources; 4) if scores are within the high risk range for any of the objective validated measures or a parent indicates a concern they would like help for on subjective questions, they will receive a matched recommendation to child’s age and identified needs for an online evidence-based program and information source. If scores are within the low-risk range for any objective validated measure, they will receive universal recommendations for programs/information that can help increase general parent knowledge and skills. All recommendations will include descriptions of the program or resource that identify the focus, the evidence supporting it, the cost (if applicable), and the length. Those parents who identify multiple concerns may receive multiple recommendations; and 5) post-intervention questions which ask parents evaluate acceptability of the intervention. All parents will also be reminded that the GMCI-P is not designed to provide a comprehensive assessment or diagnosis of child mental health and well-being, and therefore may not identify the issues that would be identified by a full clinical assessment conducted by a health practitioner, and those seeking a mental health diagnosis should speak to their GP about referral pathways. Parents will be guided to save their feedback and recommendations as a PDF and share it with/talk to their GP or other health professional if desired. An example of matched recommendations made for a child with high anxiety symptoms include an overview of 1) what they selected they wanted help with (e.g. anxiety symptoms), 2) the range their scores fell within on our objective measures (i,e,, age dependent version of the pediatric symptom checklist). In this example, we would provide information about the following online programs: 1) Cool Kids Online, 2) Brave Program, 3) Fearless Triple P, 4) Parent Works, and provide links to relevant sections of the Raising Children's Network.