Interventions for siblings of children and young people with mental health conditions: A systematic review

Background

Childhood mental health conditions typically affect the entire family, including siblings, however there is a lack of research investigating interventions supporting siblings.

Methods

The review was prospectively registered with PROSPERO (CRD42022377163). We conducted systematic searches of 7 databases (Medline, EMBASE, PsycINFO, Child and Developmental and Adolescent Studies, Applied Social Science Index and Abstracts, Education Research Information Centre, and British Eduction Index) for studies evaluating interventions for children and young people (CYP) with siblings presenting with mental health conditions from January 1980 to August 2024. We included interventions for young people aged 4 to 24 years who have a sibling with a mental health condition, with symptoms and impact lasting at least 3 months. Quality of reporting was assessed using the Critical Appraisal Skills Programme qualitative checklist for qualitative and the Effective Public Health Project Practice quality assessment Tool for quantitative studies.

Results

We identified 4 eligible studies; 2 of family-based treatment and the other of drop-in group support from 2469 studies that were screened in total. Quantitative results were rated weak for three out of four studies, while qualitative results were rated moderate for two studies, and high for one study. The two studies of sibling support groups reported high acceptability.

Conclusion

The evidence for the effectiveness of interventions for siblings of CYP with mental health conditions is limited in both size and quality, highlighting a significant gap in research and practice. We cannot draw definitive conclusions from the available evidence, but it suggests support groups have potential to improve sibling outcomes. Additional research is required to determine sibling mental health trajectories and to identify risk and resilience factors possibly influencing poorer mental health outcomes. Clinicians should be mindful of potential effects of mental health conditions on other family members and encourage parents to communicate openly with siblings about family dynamics and the challenges they may face.