Highlights in child mental health research: February 2021

Highlights

• This study investigated the characteristics of children presenting to a metropolitan paediatric hospital (i.e. The Prince Charles Hospital, Brisbane) emergency department (ED) over a 5-year period from 2013 to 2018. Key indicators of care for these children were also explored.
• During the 5-year period over 1,000 children presented to the emergency department for a review of their mental health, with selected data analysed by researchers.
• Key study findings included:
  • Mental health presentations almost doubled across the 5-year period, however as a proportion of overall ED presentations, no significant increase was found (this is in contrast to past Australian studies).
  • Most children (95%) who presented to the ED for mental health reasons were aged between 12 and 16 years old.
  • The most common presenting complaint was suicidal ideation, which made up around 72% of mental health presentations.
  • Around 77% of children who presented for a review of their mental health already had a confirmed history of prior mental health difficulties.
  • Compared to children who presented with other emergency presentations, children presenting due to mental health were more likely to experience delays in accessing appropriate care.

• The researchers highlight the need for additional research to assess the standard of care that Australian children receive when presenting to paediatric ED’s, particularly given these children continue to experience delays in receiving appropriate care compared to children presenting with non-mental health emergencies. This will be important for optimising the mental health care of children in acute hospital settings.

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Highlights

• This review paper will provide practitioners and service providers with a helpful summary of the current state of evidence on anxiety disorders in children and adolescents.
• The article provides updates on anxiety disorders in relation to:
  • emergence and course (e.g. the median age of onset of anxiety disorders is 6 years of age, which makes them amongst the first mental health disorders to emerge).
  • prevalence rates.
  • types of anxiety disorders (e.g. generalised anxiety disorder, separation anxiety disorder, specific phobia).
  • risk factors (e.g. disruptions in early attachment; showing behavioural inhibition, which is the tendency to withdraw and feel overwhelmed when confronted with unfamiliar experiences or people).
  • neurobiology (i.e. changes in brain structure or function).
  • treatment (e.g. psychotherapies, such as cognitive behavioural therapy; various medications).
  • factors that predict and influence recovery.

• Importantly, the researchers highlight that anxiety disorders have been found to be ‘consistently responsive to treatment’ (p. 1). However, they emphasise that further research is still needed to determine which children will benefit the most from what treatment(s) and to identify predictors at the patient-level that will help determine the most optimal treatment pathway for a child.

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Highlights

• This study explored the prevalence of sleep problems and the potential determinants of sleep health in Indigenous Australian children.
• Sleep is essential for children’s health and wellbeing. Poor sleep has been shown to affect Indigenous Australian children’s emotional regulation, behaviour and academic performance.
• Data from 13 studies, including over 4,600 children aged 0-17 years old, were analysed.
• Studies were mostly community-based using parental or self-report measures. Two studies were conducted in a sleep laboratory.
• Three categories of poor sleep are reported in the studies:
  1. Insomnia symptoms such as short sleep duration, difficulty getting to sleep or staying asleep.
  2. Sleep-related breathing disorders such as snoring or obstructive sleep apnoea.
  3. Sleep pattern or timing issues such as irregular sleep patterns.

Key study findings included:

• A high proportion of Indigenous Australian children experience sleep problems including:
  • Insomnia symptoms (15-34.7%).
  • Daytime sleepiness (20%).
  • Short sleep (10.9%).
  • Late sleeping (50%).
  • Snoring (14.2%) in community-based studies.
  • Obstructive sleep apnoea (51%) in clinical studies.
• Indigenous Australian children are significantly more likely than their non-indigenous counterparts to experience short sleep duration and a high portion experience sleep-related breathing disorders.
• Racial discrimination was associated with children aged 5-10 years old having difficulty getting to sleep and staying asleep.
• Poor sleep health adds risk to the physical and mental wellbeing of Indigenous Australian children.
• These findings will be of interest to researchers and policy makers working with Indigenous Australian communities to promote sleep health and reduce health and wellbeing inequalities. The study highlights the need for culturally safe and responsive sleep support at a systems-level and for work with Indigenous people to be collaborative.

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Highlights

• This review explores the role and impact of social networks for vulnerable children and young people, particularly how they impact children’s physical, mental and social health wellbeing.
• Social networks have been established as important to the mental health and wellbeing of vulnerable adult populations, however this has not been systematically explored in children and young people.
• A child’s social network refers to their personal community (e.g. the people with whom they have active and significant ties to in their everyday life).
• The review analysed data from 49 studies, mostly from the USA. Within these studies, 32 vulnerable child groups with a mean age below 18 years old were investigated.
• Key findings included:
  • Vulnerable children and young people have limited social networks, although this did not apply to minority children (in this review, minority children were mostly African American).
  • Access to social networks is a protective factor against negative outcomes.
  • Social networks are associated with a range of positive outcomes, including mental health, risky behaviour and academic outcomes.
  • Social ties, mostly with immediate family, provide children with access to personal resources.
  • Alternative social ties can compensate for a child’s lack of connection with their family
• The review found no evidence of trends specifically relating to children’s gender or age. It also found no evidence to demonstrate effectiveness of interventions aimed at increasing social networks.
• This review may be of interest to professionals working with vulnerable groups of children. Supporting children to develop their social networks, particularly if they are not well connected with their family, may increase their wellbeing and resilience. Further research into effective interventions that increase social networks are needed.

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