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Highlights in child mental health research: July 2021

Prepared by AIFS, Australia, July 2021

Related to Aboriginal and Torres Strait Islander social and emotional wellbeing, Adverse Childhood Experiences (ACEs), Anxiety, Child and family, Child development, Child mental health, Depression, Family and social relationships, Homelessness, Mental health care, Mental health services, Pandemic, Parental mental illness, Parenting, Perinatal infant mental health, Money, housing and food insecurity, Responding to traumatic events, Trauma

Resource Summary

The monthly research summary provides a selection of recently released papers, systematic reviews, and meta-analyses related to infant and child mental health.

Each summary includes an introductory overview of the content for the month, followed by a list of selected articles. Each article is accompanied by a brief synopsis which presents the key messages and highlights. Links to abstracts, full-text articles and related resources, where available, are provided.

What’s new this month in child mental health research?

This month’s highlights include:

Participation in sport and mental health indicators in adolescence

The current study assessed the relationship between sport participation and mental health in 3956 children (12-17). Greater participation in team sport predicted fewer symptoms of depression and anxiety, differing according to gender. Findings suggest sport is a relatively affordable and accessible activity that can benefit adolescent mental health.

Risk and resilience factors for youth homelessness

This article presents a systematic review of risk or resilience factors related to homelessness among young people (0-25 years). Risk factors include a history of running away, being in foster care, and being from a single-parent family. Being in a supportive and high-functioning family, higher SES, and educational attainment protect against homelessness. A more comprehensive understanding of protective factors could inform the primary prevention of homelessness.

Mental health in high income countries

This review found that an average of 12.7% of the 61,545 children aged 4-18 years had a mental health diagnosis across 14 population-level studies. The most common mental health diagnoses were: Anxiety, attention-deficit/hyperactivity, oppositional defiant, substance use, conduct and depressive disorders. Only 44% of diagnosed children received any services for these conditions and further services are recommended to support child mental health.

Mental health services for Aboriginal children in Sydney

This study aims to address limited data on the health status of Aboriginal children attending community health services. Drawing on data form 273 Aboriginal children presenting to an Aboriginal Community Paediatric Service in Sydney, it found that the majority presented for mental and behavioural reasons (55.0%). The lack of an Aboriginal workforce was identified as a potential barrier to service uptake and the study emphasised the importance of inter-disciplinary and trauma-informed care.

Coronavirus (COVID-19) and children: Resources, research, and reports

Recently released journal articles on COVID-19 include:

  • Be my safe haven: Parent-child relationships and emotional health during COVID-19

This study examines the association between COVID-19 impact and the mental health of parents and school-aged children. COVID-19 impact had a significant impact on parent’s emotional health and predicted the level of children’s emotional health. This was particularly the case when there was high levels of relationship conflict and low levels of positivity. Families may benefit from supports targeting the parent–child relationship.

  • COVID-19 and children’s education

This study looked at experience of distance learning during COVID-19. The study surveyed 279 students from 20 classes of two secondary schools. Findings include that general enjoyment and joy of learning during the crisis were linked to self-belief and level of self-belief in turn influenced by support from family and school as well as a supportive student–teacher relationship. School authorities and teachers can effectively contribute to students’ experience with consistent informal and learning routines.

Participation in sport and mental health indicators in adolescence

Prospective associations between sport participation and indices of mental health across adolescence

Authors: Graupensperger, S., Sutcliffe, J., Vella, S.A.

Journal: Journal of Youth and Adolescence

Highlights

  • Youth sport offers physical and psycho-social benefits for children’s and adolescents’ mental health.
  • The current study examined longitudinal associations between participation in individual and team sport and mental health indicators (depressive symptoms, anxiety symptoms, emotional symptoms, hyperactivity symptoms, conduct problems, peer problems, and prosocial behaviour) in 3956 adolescents (ages 12-17).

Key Findings          

  • Greater participation in team sport predicted fewer symptoms of depression and anxiety.
  • Team sport involvement predicted fewer emotional symptoms, while more emotional symptoms predicted less team sport involvement.
  • Adolescents with emotional symptoms may be less likely to continue with sport but playing more team sport could potentially reduce their emotional symptoms.
  • The study found differences according to gender. Boys tend to play more team sport and tend to experience fewer symptoms of depression.
  • Girls reported greater psychosocial benefit than boys from participating in team sport than individual sport but tended to participate less.

Implications

  • Sport is relatively cost-effective public platform that can benefit adolescent mental health.
  • Girls’ participation in organised team sport could be further encouraged given the benefits it offers to depressive symptoms and the lower rates of participation.
  • Practitioners can help find pathways to organised sport participation or informal activities that include physical activity and social relationships and friendships and may provide come of the benefits of sports participation.

Read the free full-text article

Risk and resilience factors for youth homelessness

Risk and resilience factors for youth homelessness in western countries: A systematic review

Authors: Grattan, R., Tryon, V. L., Lara, N., Gabrielian, S.E., Melnikow, J., Niendam, T.A.

Journal: Psychiatric Services

Highlights

  • This article presents a systematic review of 16 published research articles reporting risk and resilience factors related to homelessness among young people (ages 0-25) in Western countries.
  • Homelessness impacts social, emotional, and physical development and can result in poorer physical and mental health outcomes.
  • Factors affecting risk of homelessness among youths differ from those for adults.

Key findings

  • The risk factors that led to the largest odds of homelessness included a history of running away, being in foster care, and being from a single-parent family.
  • Additional factors include family conflict, mental health, behavioural difficulties, substance use, a history of trauma, school or academic issues, housing instability as a child and a history of homelessness.
  • Less is known about the protective factors, but evidence suggests supportive and high-functioning family, higher SES, and educational attainment are protective.
  • Family connection was important across all populations studied.
  • Limitations of the study include that research on specific populations (e.g., foster care, youth accessing homelessness services and LGBTIQ+ populations) was limited, affecting the ability to determine whether risk factors differ across population groups.

Implications

  • An understanding of risk and resilience factors can help inform the development of future interventions, with the aim of reducing youth homelessness.
  • Supporting families to stay connected and supportive in times of difficulty may help protect against youth homelessness.
  • Training medical, substance use, and metal health providers to identify homelessness risk factors and intervene early may help prevent homelessness.
  • A more comprehensive understanding of protective factors would facilitate development of a primary prevention strategy.

Read the abstract

Mental health in high-income countries

Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking

Author: Barican, J. L., Yung, D., Schwartz, C., Zheng, Y., Georgiades, K., Waddell, C.

Journal: Evidence-based mental health

Highlights

  • The paper draws on population-level studies that report on mental health diagnosis prevalence in children aged 18 years or younger from 1990-2021 in high income countries (all data were collected pre-COVID-19).
  • Systematic review and meta-analytic methods were chosen to condense a large body of research evidence to inform policy.

Key findings

  • Across 14 studies, an average of 12.7% of the 61,545 children aged 4-18 years had a mental health diagnosis.
  • Findings suggested that the most common mental health diagnoses were: Anxiety (5.2%), attention-deficit/hyperactivity (3.7%), oppositional defiant (3.3%), substance use (2.3%), conduct (1.3%) and depressive (1.3%) disorders.
  • Among children with mental disorders, only 44.2% received any services for these conditions.

Implications

  • While the study did not provide a direct comparison with low-, middle- and high-income countries, high-income countries need to address a service shortfall with 1 in 8 children having a mental health diagnosis and most not receiving treatment.
  • A better understanding of barriers to service access is needed.
  • Establishing tiers of service to match the type and intensity of need can help extend the reach of practitioners while also reaching more children.
  • Plans to prevent avoidable adversities such as socioeconomic and educational disparities could help prevent the number of children at risk of ill mental health.
  • Tracking child outcomes in the general population and for those in clinical care, will help evaluate the impact of policy efforts and shape future mental health care for children.

Read the free full-text article

Mental health services for Aboriginal children in Sydney

Health status and health service use of urban Aboriginal children attending an Aboriginal community child health service in Sydney

Author: Harding, G., Nan Hu, N., Larter, A. M., Stephensen, J., Callaghan, L., Zwi, K., Lingam, R and Woolfenden, S.

Journal: Journal of Paediatrics and Child Health

Highlights

  • Aboriginal children and youth 10–24 years old make up 5% (n = 200 512) of the total child health population in urban areas of NSW. There is limited data on the health status of Aboriginal children attending community-based child health services.
  • The objective of this study was to describe the health status and service use of children and young people presenting to an Aboriginal Community Paediatric Service in Sydney, Australia.
  • The study is based on a total of 273 Aboriginal children and young people who had 609 visits to the service.

Key findings

  • Perinatal and social factors play a role in child mental health and wellbeing. Poor housing, low income, experiences of domestic violence and neglect are associated with a range of physical and mental health problems throughout childhood and beyond.
  • The most common diagnostic condition for an appointment was mental and behavioural reasons (55%). The most frequent specific diagnosis for all age groups was speech and language delay (23%), attention-deficit hyperactivity disorder (13%) and school difficulty (12%).
  • Contrary to previous studies, there was no statistically significant difference in the complexity or occasions of service use between children in out-of-home care and those not in care. However, this may be due to the small sample size.
  • The study uncovered pathways to help seeking. A third of children were identified by presenting as a casual ‘drop in appointment’ and most had a general practitioner that they had received immunisation with.

Implications

  • Greater links with general practitioners could help provide an opportunity for effective care coordination for prevention and early intervention initiatives.
  • Given the number of casual “drop ins” it is important to reduce barriers to care by allowing “soft entries” into care including on the spot appointments.
  • The lack of an Aboriginal workforce within mental health services was identified as a barrier to service provision that needs to be addressed to support the mental health of young Aboriginal people.
  • Inter-disciplinary care is required to appropriately address the diversity in mental health and physical health and social and economic needs.
  • The study authors recommend an approach that is trauma-informed and culturally competent, developed in partnership with Aboriginal communities.

Read the free full-text article

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