Highlights in child mental health research: August 2021

Highlights

• Refugees are at increased risk for major depressive disorder and suicidality compared to the general population in the country they have immigrated to regardless of their own country of origin.
• The findings are based on 28 reviewed articles that assessed the relationship between refugee/asylum seeker child and adolescent populations with depression and suicidality.

Key findings

• Child and adolescent refugees have higher rates of depression and suicidality than non-refugees.
• Child and adolescent refugees that arrive in a new country without their family or another person (unaccompanied refugee) have higher rates of depression and suicidality than accompanied refugee children.
• Due to the differences in the assessment tools used, it is hard to work out the relationship between mood disruption, depressive disorder, post-traumatic stress disorder and suicidality.

Implications

• To date, published literature has focused on the increased risk of developing PTSD in this population. Findings from this review highlight the importance of screening for other mental health difficulties alongside PTSD.
• Risk of depression is a consistent pattern in children and adolescents who originated from diverse areas around the globe including North Korea, Southeast Asia, Middle East, East Africa.
• Various factors may influence the type and degree of depression a child or adolescent experiences. This may include the original culture, country of asylum, the time of the study, instruments used to diagnose depression, and the variation in trauma experienced prior to seeking asylum.

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Highlights

• This study provides the first longitudinal examination of changes in childhood mental health during COVID-19 lockdowns in the UK.
• During the UK lockdown, children’s symptoms of depression increased substantially.

Key findings

• Mental health assessments on 168 children (aged 7.6–11.6 years) were taken before and during the UK lockdown (April–June 2020). Assessments included self-reports, caregiver reports, and teacher reports.
• A significant increase in symptoms of depression during the UK lockdown was observed (as measured by the Revised Child Anxiety and Depression Scale short form).
• Changes in anxiety and emotional problems were small and not statistically significant, suggesting that depression may be a particular risk from lockdowns.
• Given the small sample size of this study, validation of the findings with a larger sample would help get the most accurate picture of child mental health.

Implications

• This evidence for the direct impact of lockdown can be combined with larger scale population-level studies that establish which children are most at risk of depression and tracks their future recovery.
• Educators will need additional supports to appropriately identify, respond to and prevent childhood depressive symptoms.
• Families with children experiencing depression will need additional support.
• Future work is needed to test whether children’s mood rebounds when school resumes or if developmental and age-related changes continue to influence rates of depression.

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Highlights

• This study aimed to gather Aboriginal and Torres Strait Islander parent/carer perspectives of health-related quality of life in children (HRQoL) to inform the development of a culturally appropriate tool to measure HRQoL.
• The concepts of HRQoL identified in this study are not included in conventional measurement tools. Consideration should be given to concepts proposed by Australian Aboriginal and Torres Strait Islander populations to adequately capture perceived HRQoL relevant to those populations.
• The findings come from yarning circles and face to face interviews documenting the experiences of parents and carers of Aboriginal and Torres Strait Islander children who had experienced a chronic illness.

Key findings

• Childhood has been targeted as a key area for health interventions and evaluation because many chronic conditions have their origins in childhood.
• Key to supporting HRQoL is children being able to do normal things in life, such as go to school, be active, sleep, eat and be social, being culturally healthy and feeling good mentally and emotionally.
• Cultural health was also raised as an attribute of overall health and wellbeing. A multi-dimensional concept, culture can transcend practice and ceremony and be about identity and your place in the world
• A lack of social support for parents and carers was explained as having both direct and indirect effects on child HRQoL.
• Participants described the importance of being heard; their voice trusted and valued by health practitioners.
• Racism and prejudicial behaviour had negative impacts on HRQoL. Issues raised included health professionals making negative assumptions about children and their families; not believing or trusting parents/carers; and unwelcoming environments where parents/carers felt judged and unable ask questions or engage with health professionals confidently.

Implications

• Perceptions of HRQoL are impacted by socio-cultural status. Practitioners can engage those who speak English as their 2nd, 3rd or 4th language and/or live in rural and remote locations to understand what HRQoL means to them and how best to incorporate it into current service provision.
• The language participants used in describing emotional states, such as feeling good, has important implications for future culturally inclusive tools.
• Parental/carer social support had implications for child HRQoL and a holistic approach to family wellbeing is needed to appropriately address child wellbeing.

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Highlights

• Children have different ideas about wellbeing than adults but these are not well understood.
• This study aimed to explore what constitutes children’s wellbeing through their drawings and discussions. Ninety-one 7- and 8-year-old children participated in the study from two primary schools in areas of relatively high deprivation in eastern England.

Key findings

• Children’s drawings suggested indicators of wellbeing including: the need for safety, happiness and positive relationships.
• The drawings illustrated that children’s perceptions of wellbeing were connected to their favourite spaces for emotional, mental, physical and material wellbeing.
• The theme that received the most attention was nature or outdoor space with more than half of the children who participated in this study (56 out of 91) including a representation of nature or outdoor space within their drawing.
• While the majority of these did not foreground nature, 17 out of 56 children (approximately one in five) focused explicitly on the importance of the environment and nature for their wellbeing.
• Almost half of the children referred to the importance of relatedness and belonging with family, friends and the community, as a crucial aspect of their wellbeing.

Implications

• Connections to nature should be a key priority for future research and practice exploring children’s wellbeing.
• Findings are limited to the perspectives of children from similar geographical locations and should be interpreted in conjunction with other studies in child wellbeing.

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