Holding pieces of the same puzzle: using an understanding of the prevalence and impact of adverse childhood experiences (ACEs) to target mental health resources

Introduction: Adverse childhood experiences (ACEs) are known to be associated with poor mental health outcomes. This thesis seeks to understand the extent to which different ACEs can be measured using routinely-collected data, and what early interventions might be indicated to support the mental health of young people who experience them. Methods: The thesis comprises a rapid literature review and survey of experts to understand mental health risk factors, measurement of ACEs in a databank of routinely-collected linked data from young people, and an umbrella review of prevention and early intervention strategies to support young people’s mental health following exposure to ACEs. Results: In brief, the three studies demonstrate that: 1) experts believe ACEs are important risk factors for predicting mental health problems earlier in young people; 2) some, though not all types of ACEs can to a variable extent be measured in routinely-collected linked health and social care data, yet this is currently a time-intensive and costly process, with various limitations including the crucial fact that it clearly misses many cases of ACEs; and 3) there is evidence supporting that early interventions are effective for mitigating poor mental health outcomes following exposure to certain ACEs. Conclusions: Measurement of ACEs using routine data sources is a potential mechanism by which young people could be identified and offered earlier interventions for those who need them. There remains a long way to go before this could be a routine practice and, at present, measurement of ACEs would need to be heavily supplemented by other approaches to ensure measurement gaps are addressed. However, ACE-informed decision-making and resource allocation could be a valuable approach to explore in order to proactively support the mental health of young people, shifting the dial away from late treatment and towards timely and proportionate prevention and support.

Name dc:type.qualificationname

Doctor of Philosophy (PhD)

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

University of Cambridge

Year dc:date.issued

2024

Author dc:creator

• Parkin, Katherine

Advisors dc:contributor.advisor

• Brayne, Carol
• Moore, Anna

• adverse childhood experiences (ACEs)
• children and young people
• data linkage
• early identification
• early intervention
• mental health
• routinely-collected data

Licence

• https://apollo8-f-pro.lib.cam.ac.uk/bitstreams/834edeb6-e360-4cd3-b8bf-0b25268e4025/download
• https://creativecommons.org/licenses/by/4.0/

Author Identifier

0000-0001-7338-5667

OAI identifier oai:identifier

oai:www.repository.cam.ac.uk:1810/386070