Development of the children's wellbeing continuum: Fostering conversation in child mental health

Objective: The growing focus on child mental health presents opportunities for prevention and early intervention. A shared, accessible language to describe child mental health that is understood by both parents and professionals across diverse settings is crucial. This study aimed to design and test a novel Children's Wellbeing Continuum tool as a shared communication resource to help adults discuss and reflect on a child's mental health. Methods: A mixed-methods study was conducted with Australian educators, health professionals, and parents/ caregivers. A Delphi consensus study (n = 261) was used to establish consensus on the language for a four-point continuum model. Subsequently, focus groups (n = 69) gathered qualitative feedback on the language, visual elements and utility of the continuum tool across diverse contexts (e.g., schools, primary health care, First Nations Communities). Findings: The terms "good, coping, struggling, overwhelmed" emerged as the preferred terms for the anchor points along the continuum tool. A traffic-light colour system and accompanying emoticons were supported for visual accessibility. Descriptors of functioning/symptoms were deemed too confusing and excluded from the final version. Inductive content analysis revealed that participants valued the continuum as a tool to facilitate discussions about a child's mental health among stakeholders in the 'team' supporting the child. Conclusions: The Children's Wellbeing Continuum, developed through extensive stakeholder consultation, is designed as a universal early intervention and prevention tool to start a conversation and encourage dialogue about a child's mental health. It has the potential to improve early help-seeking, reduce stigma, and strengthen support systems for children.