Treating Concurrent Childhood Mental Disorders

  •  How can we treat concurrent mental disorders in children? This presentation from September 2023 highlights recent findings on the number of young people who are coping with concurrent mental disorders and the associated burdens they face. It also discusses when young people can be treated for more than one disorder using a single intervention.

Childhood interventions can reduce racism

A systematic review by the Children’s Health Policy Centre found two childhood interventions that appear to reduce racist attitudes. Pro-refugee books, alone and when paired with classification skills training, increase positive attitudes toward refugees. As well, history lessons led to improved attitudes toward Black people and to the increased valuing of racial fairness. Notably, both interventions were relatively brief — only two hours duration. Interventions that had no impact included pro-diversity TV programming, diversity workshops and classification skills training (when delivered alone). No interventions were successful in changing children’s responses to hypothetical scenarios, and no studies assessed actual behaviours. As well, the review found no assessments of interventions that focused on reducing anti-Indigenous racism. This work is greatly needed.

Still, these results offer an important starting point. Given the success of pro-refugee books, parents, teachers, librarians and practitioners may want to invest in antiracism
reading materials with relevance for the current Canadian context. To this end, the Canadian Children’s Book Centre provides a reading list for tackling racism. As well,
the American Academy of Pediatrics  and UNICEF provide helpful antiracism guidelines and resources — suitable for differing development stages from the early years to the
teens. Similarly, the Canadian Paediatric Society offers antiracism resources for child and youth health care providers. Finally, given that teaching history has proven benefits, a recent publication aimed at adults, which could be used with youth, provides helpful information on the history of racism in BC.

For more information, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

 

Teachers play an important role in respecting diversity

Researchers have identified how teacher feedback can affect children’s acceptance of migrant peers. They conducted a study with nearly 1,000 students in Grades 3 to 6 in Germany, Austria and Switzerland. First, students saw photos of children they did not know on a computer screen and were asked to rate how much they would like to sit beside them. The photos included both migrant and non-migrant children. Then students were told that teachers often praised the children on the screen for being attentive or, alternatively, often scolded them for being inattentive. Teacher feedback significantly influenced students’ stated willingness to sit beside migrant children, with positive comments increasing this willingness and negative comments decreasing it. These results suggest that teachers can play an important role in changing children’s attitudes and helping them to appreciate diversity. For more information, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

Mark FASD awareness and suicide prevention in September

Two preventable health concerns are marked by back-to-back special days in September.

Sept. 9 is international Fetal Alcohol Spectrum Disorder (FASD) Awareness Day. In fact, September itself is an Awareness month in Canada for the condition — which is created by prenatal alcohol exposure, affecting brain and body development in utero. FASD is considered the leading cause of preventable developmental disabilities in Canada. While there is no cure, services and supports play an important role in preventing it. Not drinking alcohol, in any amount and at any point during or when planning a pregnancy, is the only way to fully prevent it. For more information, see Vol. 5, No. 2 of the Children’s Mental Health Research Quarterly.

Then, Sept. 10, marks World Suicide Prevention Day. Suicide is the second leading cause of death in Canada, behind only unintentional injuries, for 15- to 19-year-olds, and the third leading cause for 10- to 14-year-olds. Researchers have also documented differing patterns in Canadian youth suicide rates over time, by gender. Between 2000 and 2018, the suicide rate for boys between 10 and 19 years declined slightly. But the comparable suicide rate for girls showed a statistically significant increase of 0.09 deaths per 100,000. Suicide, of course has a devastating impact on families. For more information, see Vol. 16, No. 4 and Vol. 17, No. 1 of the Children’s Mental Health Research Quarterly.

International Overdose Awareness Day is Aug. 31

International Overdose Awareness Day is the world’s largest annual campaign to end overdose, remember without stigma those who have died from overdose, and acknowledge the grief of the family and friends left behind. Campaign resources linked to the day can be picked up here. The theme for 2023, “Recognizing those people who go unseen” is about acknowledging people in our communities who have been affected by overdose but might go unseen in the crisis.

The Children’s Health Policy Centre recognizes that some of the unseen may be young people — whether through their own substance use problems or as a result of a parent’s overdose. To learn more about helping prevent young people from engaging in problematic substance use, see Vol. 13, No. 4 of the Children’s Mental Health Research Quarterly.

International Youth Day is Aug. 12

The word “ageism” tends to be associated with seniors but, in fact, children and youth are also affected by this form of discrimination. A Global Report on Ageism launched by the United Nations in March 2021 highlights that young people continue to report age-related barriers in various spheres of their lives such as employment, political participation, health and justice.

International Youth Day, on Aug. 12, is intended to celebrate the power of partnerships across generations. A video message from the UN’s Secretary General can be viewed here.

Preventing Concurrent Disorders

  • How can we prevent concurrent mental disorders in children? This presentation from June 2023 identifies the risk factors that make young people more likely to face concurrent mental disorders, and how effective interventions can reduce these risks.

The need to fight racism begins in childhood

Researchers have long studied the origins of racial identities and prejudicial attitudes — starting in childhood. Early studies showed that children typically began to identify as belonging to a specific “race” around age three or four years. Studies have also found that white children begin to show a pro-white bias, including a preference for playing with white peers, when they are as young as three to five years. These findings suggest that antiracism efforts should begin early. For more information, see Vol. 15, No. 3  of the Children’s Mental Health Research Quarterly.

Effectiveness of nurse-home visiting in improving child and maternal outcomes prenatally to age two years: A randomised controlled trial

Catherine, N.L.A., MacMillan, H., Cullen, A., Zheng, Y., Xie, H., Boyle, M., Sheehan, D., Lever, R., Jack, S. M., Gonzalez, A., Gafni, A., Tonmyr, L., Barr, R., Marcellus, L., Varcoe, C., & Waddell, C. (2023). Effectiveness of nurse-home visiting in improving child and maternal outcomes prenatally to age two years: A randomised controlled trial (British Columbia Healthy Connections Project). Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.13846 Continue reading

Nurse Family Partnership improves child language and mental health, study shows

Findings from the Children’s Health Policy Centre’s scientific evaluation of the program Nurse-Family Partnership have shown that it improved maternal-reported child language and mental health (problem behaviour) at age two years.

Known as the BC Healthy Connections Project, or BCHCP, the study published its findings today in a paper in the Journal of Child Psychology and Psychiatry.

“We are thrilled to have these significant positive findings,” said Nicole Catherine, co-principal investigator for the BCHCP randomized-controlled trial. “We have shown that intervening very early in a child’s life —during pregnancy—can have enduring benefits.”

Co-principal investigator Charlotte Waddell added that the study represents millions of dollars and thousands of hours of work by hundreds of people over 13 years. “Our findings show the power of policy-practice-research collaboration in the service of common goals,” she said. “It’s the ideal way to address tough questions of public health importance.” The Children’s Health Policy Centre (CHPC) at Simon Fraser University led the trial, in collaboration with McMaster University and other organizations.

The study, which started in 2013, enrolled 739 pregnant girls and young women and their 737 children across the four participating regional Health Authorities (Fraser, Interior, Island and Vancouver Coastal Health. Northern Health was involved in an NFP nursing pilot and process evaluation).

Some 200 Indigenous (including First Nations, Métis or Inuit) girls and young women, or 27%,  generously agreed to participate in this long-term trial. Some 237 BCHCP children, or 32%, had an Indigenous mother or father.

The study was funded by the BC Ministry of Health, with support from the BC Ministries of Children and Family Development and Mental Health and Addictions. Participating regional health authorities funded direct nursing costs. The Mowafaghian and Stern Foundations provided addition generous supports.

Nurse-Family Partnership aims to improve the lives of children born to young, first-time mothers. Developed nearly 45 years ago by researcher David Olds and colleagues in the United States, the program starts early — in pregnancy, before children are even born. It involves intensive home visits by public health nurses continuing until children reach their second birthday. The program focuses on those who are coping with socioeconomic inequities.

Public health nurses provide the home visits — up to 64 in total over two-and-a-half years. Nurses delivering the program received extensive education. As well, they received resources to use in the visits, and ongoing supervision and support. “We acknowledge the participating young moms and children who shared their experiences via data collected during 4,000 research interviews,” co-principal investigator Catherine said. “They told us that they wanted to help make a difference for other young families like them.”

An earlier finding, published in the Canadian Medical Association Journal Open, had shown that NFP led to reduced prenatal cannabis use, and in smokers led to modest reductions in cigarette use. Further results will be published in the next year, for example, on NFP’s impact on reducing intimate-partner violence.

“All the findings show that longer term follow-up of our NFP cohort of children is warranted given that further benefits may emerge across childhood and adolescence,” Catherine said adding that the team is identifying new funding to follow the children over 10 years and beyond. “This kind of long-term follow-up is the best way to show the return on public investment in early childhood programs designed to prevent problems from occurring in the first place.”

Full text of the JCPP paper is available here.