Child Promotion/Preventions (ChiPP) for mental health outcomes – From policy to actions and their effects

Research Problem and specific questions: Mental illness contributes to over one-fifth of the total disease burden in high-income countries, with mental illness that onset in childhood to have longer duration and poorer clinical and functional outcomes. Health promotion/prevention in Sweden is guided by the national public health policy with its eight target areas.

The aim of the research programme is to develop a research line that takes a comprehensive approach on promotion/prevention for child mental health (0-18-years) by addressing policy, actions, and their effects on local level.

In particular, four research questions divided into five work packages (WP) will be addressed.Data and methods: WP 1 address the role of societal investments for child mental health on local level where aggregated public health expenditures on county and municipality level are related to aggregated child mental health outcomes.

National administrative register data for 2 12 457 children will also be used to examine if societal investments contribute to decreased mental health inequality and if the impact of income inequality is reduced by societal investments.

WP 2 address how steering documents on local level target child mental health and inequality where steering documents from 20 counties and 290 municipalities are analyzed and whether their steering documents change after the implementation of the first structured long-term national policy on mental health and suicide.

In addition to analyses of documents, qualitative interviews will be conducted with municipality representatives.

WP 3 address the extent and quality of current child mental health promotion/initiatives in six municipalities with different population size, income level, and urban-rural density.

Further, a child mental health index will be developed, tested, and associated with aggregated data on child mental health.

WP 4 and 5 addresses which children that participates in promotion/preventive initiatives on local level and their collective effect on child mental health and inequality.

Surveys will be distributed to 10,000 randomly selected caregivers of children (0-12-years) and 10,000 adolescents (15-18-years).

Frequency and duration of different initiatives will be asked for as self-reported symptoms on mental health.Relevance and utilization: Child mental health problems increase in Sweden and while most promotion/prevention work is conducted on local level, their quality and effect are unknown.

By addressing policy, actions and their effects on local level, the programme will remedy this knowledge gap.Plan for programme realization: Data will be obtained from open-source databases (aggregated data), from administrative registers, qualitative from interviews, and self-reported from surveys.

Costs consist of salary costs for participating researchers, assistant and doctoral students, costs for data collection, and travel costs to municipalities and to international conferences.