Development of methods for WHO quality standards for child and youth mental health services to improve quality of care and patient safety in the WHO European region.

Background: Child and youth mental health care is of varying quality across the WHO European Region, with many settings being low-resourced. To improve and standardize quality of care, WHO Regional Office for Europe is developing quality standards for child and youth mental health services. This research aims to develop evidence informed methods to develop these quality standards. Methods: Desk reviews of grey literature aimed to understand what approaches have been used or recommended to develop quality standards for child and youth mental health/health for use across a range of different countries, and consultation was sought from an expert steering group. A thematic approach was used to synthesize relevant themes. The methods were developed based on the results of these steps. Results: Desk reviews identified variation in approaches used and recommended to develop quality standards, with limited available guidance applicable across different resource settings. Nine key themes from stakeholder consultations were highlighted. Based on these results, a seven-step methodology was created to develop the quality standards for child and youth mental health which prioritizes using an evidence-based approach and inputs from a wide range of stakeholders. Discussion: The methods taken to develop quality standards need to be rigorous to ensure that standards accurately define high-quality care for a service. There is a need to develop a unified approach to developing quality standards. It is hoped that this paper will provide inspiration for others developing quality standards for child and youth mental health services and spark research in this area.