British Society for Paediatric and Adolescent Dermatology (BSPAD) assessment and support of mental health in children and young people (CYP) with skin conditions: A multi-disciplinary expert consensus statement and recommendations

Abstract

Background Psychological and mental health difficulties are common in children and young people (CYP) living with skin conditions and can have a profound impact on wellbeing. There is limited guidance on how best to assess and support the mental health of this population who are at risk of poor health outcomes. Objectives The primary objective was to provide consensus-based recommendations on the assessment and monitoring of and support for mental health difficulties in children and young people (CYP) with skin conditions (affecting the skin, hair and nails). The secondary objectives were to address practical clinical implementation questions relating to consensus guidance; and to provide audit and research recommendations. Methods This set of recommendations has been developed with reference to the AGREE II instrument. A systematic review and literature appraisal was carried out. A multidisciplinary consensus group was convened with two virtual panel meetings taking place: an initial meeting to discuss the scope, review the current evidence and identify areas for development; the second to agree content and wording of the recommendations. Recommendations were then circulated to stakeholders, following which amendments were made and agreed by email.

Results The expert panel achieved consensus on eleven recommendations for health workers managing CYP with skin conditions. A new patient completed history taking aid – ‘You and Your Skin’ was developed and is being piloted.

Conclusions The recommendations focus on improved mental health assessments for CYP presenting with a skin condition with clinical guidance and suggested screening measures included. Information is given regarding accessing psychological support for CYP when required and recommendations provided for training in mental health and neurodiversity for staff. Embedding a psychosocial approach within services treating CYP with skin disease should ensure that CYP with psychological needs are able to be identified, listened to, supported and treated. This is likely to improve health outcomes.