Commentary: Can a modernised psychiatric unit space reduce the use of coercive measures in child and adolescent psychiatry? A commentary on Czernine et al. (2024)

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Abstract

The environment influences the way we act, react and adapt to our surroundings whether it is consciously or unconsciously. Though it is widely accepted that multiple interacting systems influence human behaviour and development across the life span, the reality of teasing these factors apart is difficult and challenging. In this brief commentary on Czernine and colleagues' important and timely paper, ‘Can a modernised psychiatric unit space reduce the use of coercive measures in child and adolescent psychiatry?’, I evaluate and build on the evidence presented by making constructive suggestions on ways of improving the status quo healthcare and treatment conditions for children and adolescents today. The underlying assumption is that by furthering this complex yet important area of research in the field of psychiatry and adjacent disciplines, we can improve existing healthcare systems and processes that are aligned with meeting child and adolescent needs.

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The Ecology of Human Development : Experiments by Nature and Design

Urie Bronfenbrenner (1979)

Here is a book that challenges the very basis of the way psychologists have studied child development. According to Urie Bronfenbrenner, one of the world’s foremost developmental psychologists, laboratory studies of the child’s behavior sacrifice too much in order to gain experimental control and analytic rigor. Laboratory observations, he argues, too often lead to “the science of the strange behavior of children in strange situations with strange adults for the briefest possible periods of time.” To understand the way children actually develop, Bronfenbrenner believes that it will be necessary to observe their behavior in natural settings, while they are interacting with familiar adults over prolonged periods of time. This book offers an important blueprint for constructing such a new and ecologically valid psychology of development. The blueprint includes a complete conceptual framework for analysing the layers of the environment that have a formative influence on the child. This framework is applied to a variety of settings in which children commonly develop, ranging from the pediatric ward to daycare, school, and various family configurations. The result is a rich set of hypotheses about the developmental consequences of various types of environments. Where current research bears on these hypotheses, Bronfenbrenner marshals the data to show how an ecological theory can be tested. Where no relevant data exist, he suggests new and interesting ecological experiments that might be undertaken to resolve current unknowns. Bronfenbrenner’s groundbreaking program for reform in developmental psychology is certain to be controversial. His argument flies in the face of standard psychological procedures and challenges psychology to become more relevant to the ways in which children actually develop. It is a challenge psychology can ill-afford to ignore.

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Editorial Perspective: Rapid responses to understand and address children and young people’s mental health in the context of COVID‐19

Cathy Creswell (2022)

Prior to the pandemic, we already had good reason to be concerned about the mental health of children and young people. As an example, the 2017 Mental Health of Children and Young People (MHCYP) survey in England, comprising a large, national probability sample, identified that one in nine children had a probable mental health disorder, with a 49% increase in emotional disorders compared to a previous survey in 2004 (Sadler et al., 2018). The pandemic has clearly brought a broad range of challenges to children and young people. These include the direct viral threat to self, friends, and family (with recent estimates of a 17.5%–20.2% increase in parental bereavement in the United States; Kidman et al, 2021), as well as disruptions to school work, social interactions, family pressures, economic impacts, a lack of opportunity and ongoing uncertainty, and reduced access to mental health and other support from outside the home. So how have these experiences affected the mental health of children and young people?

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Impact of the COVID-19 pandemic on young people from black and mixed ethnic groups’ mental health in West London: a qualitative study

Romane Lenoir, Keri Ka-Yee Wong (2023)

Objectives The COVID-19 pandemic has disproportionately impacted vulnerable groups’ physical and mental health, especially young people and minority ethnic groups, yet little is known about the crux of their experiences and what support they would like. To address this gap, this qualitative study aims to uncover the effect of the COVID-19 outbreak on young people with ethnic minority backgrounds’ mental health, how this changed since the end of lockdown and what support they need to cope with these issues. Design The study utilised semi-structured interviews to conduct a phenomenological analysis. Setting Community centre in West London, England. Participants Ten 15 min in-person semistructured interviews were conducted with young people aged 12–17 years old from black and mixed ethnic groups who regularly attend the community centre. Results Through Interpretative Phenomenological Analysis, results indicated that the participants’ mental health was negatively impacted by the COVID-19 pandemic, with feelings of loneliness being the most common experience. However, positive effects were concurrently observed including improved well-being and better coping strategies post lockdown, which is a testament to the young people’s resilience. That said, it is clear that young people from minority ethnic backgrounds lacked support during the COVID-19 pandemic and would now need psychological, practical and relational assistance to cope with these challenges. Conclusions While future studies would benefit from a larger ethnically diverse sample, this is a start. Study findings have the potential to inform future government policies around mental health support and access for young people from ethnic minority groups, notably prioritising support for grassroots initiatives during times of crisis.

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Keri Ka‐Yee Wong: (View ORCID Profile)

Journal

Title: Child and Adolescent Mental Health

Abbreviated Title: Child Adoles Ment Health

Publisher: Wiley

ISSN (Print): 1475-357X

ISSN (Electronic): 1475-3588

Publication date (Electronic): August 16 2024

Affiliations

[1 ] Department of Psychology and Human Development University College London London UK

[2 ] UCL Centre for Education and Criminal Justice University College London London UK

Article

DOI: 10.1111/camh.12732

SO-VID: 3dc62026-7661-4d58-a572-89086cc6a509

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http://creativecommons.org/licenses/by/4.0/

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Commentary: Can a modernised psychiatric unit space reduce the use of coercive measures in child and adolescent psychiatry? A commentary on Czernine et al. (2024)

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UCL: UN SDG 03 Good Health and Well-Being

Most cited references 11

The Ecology of Human Development : Experiments by Nature and Design

Editorial Perspective: Rapid responses to understand and address children and young people’s mental health in the context of COVID‐19

Impact of the COVID-19 pandemic on young people from black and mixed ethnic groups’ mental health in West London: a qualitative study

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