Surviving Crying: supporting the mental health and coping of parents with excessively crying infants

We conducted a study, supported by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme, to create the Surviving Crying Materials. The package includes a website, booklet, and Cognitive Behaviour Therapy (CBT)-based sessions by a psychologist. After evaluating it with 52 parents and 50 health visitors, we found a significant reduction in parental depression and an increase in coping, unrelated to changes in infant crying.

Recognizing the challenge of cost-effective CBT delivery by psychologists, a second study, supported by the Burdett Trust for Nursing, showed that health visitors (HVs) could be trained to effectively deliver the CBT element.

Now, in our current study, NIHR HTA is funding a Cluster Randomised Controlled Trial to assess if combining the Surviving Crying package with usual Health Visitor services is more clinically and cost-effective than usual services alone in improving the mental health and coping of parents with excessively crying infants. The trial involves eight NHS Trusts or Local Authorities in England, with data collection starting in September 2022 and concluding in late 2024.

For more details, you can visit the study's page here.

By undertaking this programme of research, we aim to improve patient care and address three key areas of focus for the NHS: perinatal mental health, reducing usage and costs of NHS services, and workforce planning.

The government indicated a commitment to perinatal mental health and enabling faster access to community mental health services.  By training practitioners in the use of CBT based approaches to supporting parents of babies who cry excessively, we can reduce waiting times for support with depression and anxiety.  Further, early intervention could potentially prevent the exacerbation of symptoms reducing negative consequences for parents and their families.

By offering an early focused intervention package designed to fit in with standard Health Visiting ‘universal’, ‘targeted’ and ‘specialised’ care we can support a reduction in use of NHS and Social services by parents anxious about their babies crying.

Our approach of up-skilling Health Visitors and other practitioners in the use of the Surviving Crying package and CBT approaches could potentially reduce referrals to mental health services.

This programme of research is being led by Jayne Brown, Professor of Health Care Professions at Nottingham Trent University alongside:

Ian St James-Roberts Emeritus Professor Institute of Education, University College London; Dieter Wolke Professor of Developmental Psychology & Individual Difference, University of Warwick;

Traolach Brugha Professor of Psychiatry University of Leicester;

Elaine Boyle Professor of Neonatal Medicine University of Leicester;

Stephen Morris RAND Professor of Health Services Research University of Cambridge; Cassandra Brookes Principal Statistician Leicester Clinical Trails Unit;

Andrew Willis. Senior Post Doc Researcher, HRB Clinical Research Facility, School of Public Health, University College Cork;

Cheryll Adams Institute of Health Visiting;

Louise Wolstenholme Research lead Sheffield Children's NHS Foundation Trust

Yvette Walters Senior Trail Manager Leicester Clinical Trails Unit