Practice challenges at the intersection of child protection and mental health

This paper examines the complexity of collaboration between child protection and mental health services, where a parent has a mental illness and there are protection concerns for children. The paper reports on data from focused in‐depth interviews with 36 child protection workers, adult mental health workers and child and youth mental health workers. Data were analysed thematically, using NVivo to facilitate data management and analysis. Two dimensions were identified. The first, the process of collaboration, relates to four factors that assisted the collaborative process: communication, knowledge, role clarity and resources. The second dimension considers the challenges presented to collaborative work when a parent has a mental illness and a child is in need of protection, and identifies issues that are inherent in cases of this kind. Two types of challenge were identified. The first related to characteristics of mental illness, and included the episodic and/or unpredictable nature of mental illness, incorporating information from psychiatric and parenting capacity assessments, and the provision of ongoing support. The second type of challenge concerned the tension between the conflicting needs of parents and their children, and how this was viewed from both the adult mental health and the child protection perspective. Implications for policy and practice are identified in relation to the need for service models that provide ongoing, flexible support that can be intensified or held back as needed.     

An introduction to methodological challenges in the evaluation of eHealth research: Perspectives from the Health e-Technologies Initiative

In February 2002 the Health e-Technologies Initiative (HETI), a program office of the Robert Wood Johnson Foundation^®, was created to advance discovery of scientific knowledge regarding the effectiveness of interactive eHealth applications. This article is the introduction to a series of seven articles written by grantees of HETI which address challenges, lessons learned, and proposed solutions as researchers implement eHealth projects. From this body of work it is clear that the overall process of conducting evaluation research in eHealth requires careful and detailed planning, recognition of the heightened sensitivity of IRBs, and institutions around the electronic collection and communication of personal health information, and a combination of tenacity and creativity to address the inevitable thorny methodological challenges to eHealth research. Use of established guidelines to help standardize the evaluation process, where feasible, is recommended.