Identifying core measures to be used in mental health research with care experienced young people: A Delphi study

Background: Care experienced young people, including those who are neurodivergent, experience worse mental health outcomes than their non-care counterparts. Understanding the mental health of this population, including how it changes over time, is critically important to the development of more effective, supportive services. However, one of the challenges to this is the lack of consensus around a set of suitable mental health measures that can be used with care experienced young people, including those who are neurodivergent.
Aim: The primary aim of this study was to develop consensus around a core set of measures that can be used by researchers when investigating the mental health of care experienced young people, including with those who are neurodivergent. Additional research questions included: (1) what are the strengths and limitations of these measures?; (2) what is the value and drawbacks of attempting to develop a set of core measures?; (3) what do young people with care experience think about the measures?
Methods: This study used a mixed methods approach. The primary method was a classical Delphi design where consensus from a panel of experts (n=18) was sought in relation to the recommendation of 7 mental health measures. These measures covered 4 domains: general mental health, quality of life/related quality of life, anxiety and depression, suicide and self-harm. Alongside the Delphi, an advisory group of care experienced young people (n=6) was asked to examine the suitability/ appropriateness of the collection of measures.
Findings - There were a number of strengths and limitations of the measures highlighted by the panel of experts. Given these, only the SDQ and the RCADS-25 were recommended for routine use with care experienced young people. Moreover, the panel recommended the use of the SDQ for care experienced young people who are neurodivergent. In addition, the advisory group suggested that there would need to be significant changes to the wording and content of all measures to improve their suitability. Lastly, a tension exists relating to the utility of recommending a core set and the potential restrictions this may impose.