Author Archives: Daphne Gray-Grant

Leaders speak at student research conference

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Charlotte Waddell and Nicole Catherine both gave brief talks May 4, 2021, at the first student-organized research conference for SFU public health and health sciences students.

The aim of the three-day conference was to give students the opportunity to present their own research, and to hear about the research of others in the Faculty of Health Sciences.

Waddell spoke about improving social and emotional wellbeing for all children, and on the public policies needed to reach these goals. And Catherine spoke about her work with the BC Healthy Connections Project and its examination of the Nurse-Family Partnership program.

 

 

Risks of youth self-harm are identifiable

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Self-harm in young people has been correlated with a number of situations or conditions. Being female is a particularly strong correlate. In one systematic review, girls were noted to be 1.7 times more likely than boys to harm themselves. Another survey has found even more pronounced gender differences, with girls harming themselves at triple the rate of boys (24% vs. 8%). Other correlates of youth self-harm include:

  • low socio-economic status,
  • parenting problems,
  • adverse childhood experiences (including child maltreatment),
  • exposure to others harming themselves,
  • concerns about sexual orientation,
  • limited problem-solving skills, and
  • mental health problems (including depression, anxiety and substance misuse).

In particular, researchers have found that being victimized is a particularly strong risk factor for self-harm — including being maltreated by parents, peers or siblings, and being a victim of cyberbullying or a crime. For more information, see Vol. 13, No. 3 of the Children’s Mental Health Research Quarterly.

Effective interventions for preventing and treating childhood mental disorders

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What interventions can best help children facing mental health concerns in BC right now?

That was the topic Christine Schwartz addressed on a March 30, 2021  Zoom presentation to more than 100 senior leaders and clinicians from the BC Ministry of Children and Family Development.

An Adjunct Professor with the Children’s Health Policy Centre and lead writer for the Children’s Mental Health Research Quarterly, Schwartz was also co-author of a paper on these interventions published in October 2020.

As a clinical psychologist, Schwartz told the group that there are numerous effective interventions for both preventing and treating the most common mental disorders experienced in childhood.

“Every child who needs an effective intervention should be able to get one that works,” she told the group. But she added, “there are a lot of children who aren’t being addressed or they’re being given ineffective interventions.”

Starting with the most commonly experienced mental health disorder, anxiety, Schwartz said there is excellent evidence that cognitive behavioural therapy (CBT) is effective at both prevention and treatment. CBT is also effective at both prevention and treatment for depression. And for behaviour disorders — such as conduct disorder or oppositional defiant disorder — parent training programs are effective for both prevention and treatment.

The full presentation can be viewed here.

 

Research Day Addresses Child Wellness and COVID-19

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An inaugural Child Research Day, sponsored by SFU’s Faculty of Health Sciences, Developmental Trajectories Research Challenge Area on March 25, 2021, included presentations by Children’s Health Policy Centre director Charlotte Waddell and BC Healthy Connections Project scientific director Nicole Catherine.

Naomi Dove, Public Health and Preventative Medicine Physician in the Office of the Provincial Health Officer, provided the keynote talk on the topic of COVID-19 and public policy responses affecting children. As part of this, Waddell addressed child mental wellness and the impact of the pandemic.

Waddell said that nearly 800,000 Canadian children were already coping with mental disorders pre-COVID-19 — and this has only worsened during the pandemic. She also noted that some children are likely to be disproportionately affected, including those with neuro-diverse needs, those with pre-existing mental health conditions and those affected by adversities such as limited income and racism.

She also described how COVID-19 may particularly affect Indigenous Peoples, who have always shown great strength and resilience, but who are still coping with harms related to colonialism such as unsafe housing, lack of access to clean water and food insecurity – conditions that put children at increased risk.

Speaking later in the day, Nicole Catherine presented an overview of the BC Healthy Connections Project (BCHCP), describing the active  collaborations between research, policy and practice since the project launched in 2012.

She said that the BCHCP data — collected during research interviews with 1,500 mother-child pairs — represents a large ‘Data Repository’ for future students and mentees to examine healthy child developmental trajectories.

The BCHCP aims to examine the effectiveness of a nurse-home visiting program, Nurse-Family Partnership, in promoting child and maternal health and wellbeing in BC. Prenatal findings have shown reductions in substance use. Findings on child injuries, cognition, language and mental health, and on maternal life-course, will be available in 2021–2022.

For measuring children’s mental health, we need high-quality epidemiological data

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Recommendations for public health surveillance relating to children’s mental health was the topic for Charlotte Waddell, the director of the Children’s Health Policy Centre, in speaking to students at the UBC School of Population and Public Health.

In her one-hour March 24, 2021 presentation, Waddell addressed the huge value of high-quality epidemiological studies, which give the most robust data on how well children are doing. These studies are robust because they tell us about all children, not just those who obtain services, or who sign up for studies.

What policymakers may do in the absence of such data, Waddell said, is rely on administrative data, such as records of physician visits. “The problem,” Waddell said, “is that most children with mental health problems don’t get any services at all so their needs are essentially unknown.” As well, families with greater economic means, may end up seeing private practitioners such as psychologists, but those data are not captured either.

The workshop suggested approaches for identifying and using high-quality epidemiological data to measure children’s mental health, worked through some case studies and included a lively question and answer session.

National mental health week starts May 3

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May 3 marks the beginning of the 70th Annual Canadian Mental Health week and May 7 is National Child & Youth Mental Health day. The Children’s Health Policy Centre celebrates these important events and reminds all readers that research should be used to assist parents.  Behaviour problems, for example, account for as many as half of all referrals to children’s mental health services. So practitioners need effective approaches for addressing these problems. Parenting programs, such as Incredible Years, have strong evidence of success and should be readily available to families in need. For more information, see Vol. 10, No. 1 of the Children’s Mental Health Research Quarterly.

Child health conference tackles topic of COVID-19

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In a one-hour Zoom presentation for the McMaster University Child Health Conference on March 13, Christine Schwartz addressed the topic of COVID-19 and children’s mental health.

An Adjunct Professor with the Children’s Health Policy Centre and lead writer for the Children’s Mental Health Research Quarterly, Schwartz has a clinical psychology practice with children and youth and is co-author of a recent paper on COVID and children’s mental health.

Speaking to the group at McMaster, she advised that there are going to be a significantly greater number of children who will need mental health services following the pandemic, particularly with respect to anxiety.

“Children who experience socioeconomic inequalities are much more likely to develop emotional and behavioural concerns,” she noted, adding that data are already starting to show that needs are increasing.

In addition to her presentation, Schwartz also moderated a lively question and answer session.

The annual research symposium was founded in 2016 by a group of Bachelor of Health Sciences students at McMaster specializing in child health.

Senior Health Authority officials contributed to successful completion of study

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The name of the committee was a mouthful: The Regional Evaluation Advisory Committee. It’s abbreviated as REAC (and pronounced: ree-ack).

But its work was essential to the successful completion of a recent scientific evaluation of the Nurse-Family Partnership program (NFP) through the British Columbia Healthy Connections Project.

NFP is a program developed nearly 40 years ago in the US, but never before scientifically evaluated in Canada. The program helps girls and young women and their children who are facing disadvantages such as low income — aiming to reduce child maltreatment while also improving child mental health and development. The program starts early — in pregnancy, before children are even born — and involves intensive home visits by public health nurses, continuing until children reach their second birthday.

REAC was the group of roughly 18 high-level public health managers — from the Fraser, Interior, Island and Vancouver Coastal Health Authorities — helping launch and implement the project in a “real-world” effectiveness trial. Other members included representatives from the BC Ministries of Health and Children and Family Development and the Children’s Health Policy Centre.

“We met every two weeks for many years,” recalls Dr. Nicole Catherine, the scientific director for the study. “It was a fantastic group of dedicated people helping trouble-shoot and overcome all the various project challenges we faced.”

The first challenge, back in 2012, was developing participant eligibility criteria for the study of NFP – criteria that were appropriate and efficient for nurses to use in screening potential participants over the phone. Criteria included, for example, young age or first-time pregnancy.

But challenges emerged early in the study when the Health Authorities had a hard time reaching and referring participants to the study. “When it launched we had slow recruitment as the prenatal referral systems were new,” Catherine says. “REAC worked to develop active recruitment strategies to reach those who could benefit from the NFP. The nurses would visit physician offices and schools. We fondly called it ‘pounding the pavement’.”

When research data collection wrapped up in 2019, REAC had achieved its goal and the group disbanded. Prenatal findings showing that NFP has positive effects on reducing substance use are already published. Additional main outcome results showing how NFP works in BC are expected in 2021/2022. Meanwhile, senior health authority officials are continuing to be involved in the study via the project’s Provincial Advisory Committee.

Self-harm in youth is more common than some may think

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Self-harm affects a surprising number of young people. According to studies in representative samples, 11 to 28% of adolescents have reported harming themselves. As well, two BC studies provide information about local rates. A survey of nearly 40,000 youth from 58 school districts in this province have found that 17% reported engaging in self-harm in the past year. Similarly, a population-based survey of nearly 600 Victoria youth found that 17% reported harming themselves. For more information, see Vol. 13, No. 3 of the Children’s Mental Health Research Quarterly

Foster healthy body images

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Eating disorders can be prevented. In particular, young people can learn how to combat messages promoting thin ideals, improve their body image and stop unhealthy weight control practices such as dieting. These approaches in turn can reduce eating disorder symptoms. For more information, see Vol. 9, No. 2 of the Children’s Mental Health Research Quarterly