Research tracking rates of concurrent mental disorders highlights the strength of Indigenous children

Researchers tracked the rates of concurrent mental disorders for more than 600 Indigenous children to determine if there were changes as they reached adolescence. The children, who were living in one of eight Indigenous communities in Canada or the United States, were assessed when they were ages 10 to 12 years, and then again at ages 12 to 15. At the first time point, 9.2% met criteria for two mental disorders. By the second time point, this percentage had increased to 26.6%. This latter concurrence rate was similar to other populations of children — potentially reflecting the strength of Indigenous children, given that many faced added challenges, including limited service access and economic disadvantage.

For more information, see Vol. 17, No. 3 of the Children’s Mental Health Research Quarterly.

New research shows delivering an early prevention program as intended has greater benefits for child language and mental health

Catherine, N.L.A., Zheng, Y., Xie, H., Boyle, M., Jack, S., MacMillan, H., & Waddell, C. (Forthcoming). Effectiveness of Nurse-Family Partnership on child outcomes by patterns of program intensity: Secondary evidence from a randomized controlled trial (British Columbia Healthy Connections Project). Child Abuse & Neglect.

Research Overview

This forthcoming paper examines how program intensity influenced child outcomes in the Canadian scientific evaluation of the Nurse-Family Partnership (NFP) program. Led by Nicole Catherine, Associate Director of the Children’s Health Policy Centre, the research team found that when NFP was delivered as intended, with sustained intensity — meaning families received the majority of recommended nurse-home visits consistently throughout the program — children experienced greater benefits in language and mental health-problem behaviour by age two years.

Methodology

  • The researchers conducted secondary analysis of data from the British Columbia Healthy Connections Project (BCHCP), a randomized controlled trial evaluation of NFP involving 739 maternal participants and their 737 children in British Columbia.
  • Participants in the BCHCP were enrolled in early pregnancy and randomly assigned, like flipping a coin, to two different groups — NFP versus Comparison (the existing services on offer in BC) — to investigate whether NFP provided greater benefits for mothers and children by age two years.
  • The BCHCP study team collected data at regular intervals across pregnancy and early childhood (2013 to 2019) including on child injuries, language, cognition and problem behaviour (mental health) at age two years.

Key Findings

  • Delivering NFP as intended, with sustained intensity, led to greater benefits regarding maternal-reported child language and mental health-problem behaviour.
  • Importantly, the research team also found benefits using a rigorous measure of child language development (Bayley Scales of Infant Development), where children were observed directly in the home. This method is considered less biased than mothers’ self report of their children’s language development.

Implications

  • Benefits for kids: Sustaining long-term program engagement with young families experiencing disadvantage can make a difference for children. Improvements in language and mental health — as early as age two years — are associated with longer term benefits across childhood and the school years.
  • Longitudinal research: It is important to follow the participating children across adolescence to assess long-term program effects on mental health and academic functioning.
  • Funding priorities: Policymakers should fund evidence-informed prevention programs that commence early in pregnancy at adequate levels of intensity to maximize benefits for children in need and for society as a whole.

 

National Indigenous Peoples Day is celebrated on June 21

Image credit: CIRA

June 21 is National Indigenous Peoples Day — a time to celebrate the strength, innovation, culture and histories of First Nations, Inuit and Métis Peoples.

The day is held on the summer solstice in recognition of the many celebrations and community gatherings traditionally held by Indigenous peoples at this time of year. These gatherings include traditional cultural activities, parades, festivals, dancing, music and food. You can find a list of public gatherings and celebrations in BC at the Indigenous Tourism BC website.

Cultural connections — like those made during these annual summer celebrations — offer important mental health benefits for Indigenous youth. Mental health practitioners can promote well-being by supporting Indigenous young people to connect with their cultures, and policy-makers can also play a role by supporting Indigenous communities to ensure their cultures flourish. For more information, see Vol. 17, No. 2, page 3 (sidebar on enhancing mental health for Arctic Indigenous youth) of the Children’s Mental Health Research Quarterly.

Early Life Adversity and Epigenetic Aging: Findings from a 17-Year Longitudinal Study

Barr, E., Comtois-Cabana, M., Coope, A., Coté, S. M., Kobor, M. S., Konwar, C., Lupien, S., Geoffroy, M.-C., Boivin, M., Provençal, N., Catherine, N. L. A., Dennis, J. K., & Ouellet-Morin, I. (2025). Early-Life Adversity and Epigenetic Aging: Findings from a 17-Year Longitudinal Study. Biomolecules15(6), 887. https://doi.org/10.3390/biom15060887

Continue reading

Nicole Catherine discusses early prevention of intimate partner violence on CBC Radio

Children’s Health Policy Centre Associate Director Nicole Catherine was recently featured on CBC Radio Saskatchewan’s The Morning Edition discussing new research on early prevention of intimate partner violence (IPV).

During the eight-minute segment, Catherine explained how a study led by the Children’s Health Policy Centre revealed promising signs that a nurse-home visiting program could help prevent IPV exposure for young first-time mothers and their children.

The study, published in January in BMJ Open, offers compelling evidence that policymakers across Canada should invest in research-backed approaches to early IPV prevention.

“Investing in prevention programs that commence as early in life as possible, especially for families experiencing disadvantage, that also have rigorous research evidence of effectiveness — that’s going to have the most benefits for children and mothers and society,” Catherine told host Adam Hunter.

The full interview is available on CBC Listen.

June 10 marks Action Anxiety Day across Canada

Each June, Action Anxiety Day educates Canadians about anxiety, raises awareness and reduces stigma around anxiety disorders. It offers parents and educators an opportunity to empower children and youth with coping strategies and knowledge.

Anxiety Canada established Action Anxiety Day in 2021. Though Anxiety Canada closed their doors on April 30, 2025, the event lives on in schools and communities. Resources and educator toolkits will remain available on the Anxiety Canada website until March 2026.

A systematic review from the Children’s Health Policy Centre found that anxiety disorders are the most commonly experienced child and youth mental health concern. At any given time, approximately 5.2% of four-to-18-year-olds will meet criteria for an anxiety disorder. But evidence-based interventions such as cognitive-behavioural therapy (CBT) can help.

To learn more about preventing and treating anxiety in children and youth, see Vol. 19, No. 1 and Vol. 19, No. 2 of the Children’s Mental Health Research Quarterly.

June is Pride Month around the world

Celebrated in Canada and around the world each June, Pride Month brings LGBTQ+ communities and allies together to celebrate the achievements and resilience of LGBTQ+ people, advocate for equal rights and gather in support and solidarity.

Pride commemorates the Stonewall Uprising of 1969, which marked a turning point in the fight for LGBTQ+ rights. Since then, Pride has become a global movement, with celebrations taking place worldwide throughout the summer.

Pride Month also offers an opportunity to address the mental health impact of anti-LGBTQ+ discrimination, particularly on young people. LGBTQ+ youth often deal with serious social inequities and, as a result, experience an unequal burden of mental health concerns. Trans and non-binary youth in particular often face significant challenges compared to their cisgender peers, including peer victimization and harassment.

Much can be done to support LGBTQ+ youth. Adults can make a difference by educating themselves about LGBTQ+ issues, modeling acceptance, creating environments free from harassment and supporting transgender youth in taking steps to express their identity. To learn more, see Volume 11, No. 2 of the Children’s Mental Health Research Quarterly.

Why policymakers should invest in early prevention to reduce intimate partner violence exposure for mothers and children

An early prevention program shows promise for preventing exposure to intimate partner violence (IPV) for mothers and children, according to a recent article by the team from the Children’s Health Policy Centre.

Published in The Conversation, the article is based on new research examining the benefits of Nurse-Family Partnership (NFP), a nurse home-visiting program for expectant mothers and their children.

“These findings come at a crucial time,” the article said. “IPV is occurring at epidemic proportions. Yet, supports for children and mothers remain inadequate and early childhood prevention investments remain sparse.”

To understand the impact of NFP on intimate partner violence exposure, a team of researchers led by Nicole Catherine, Associate Director of the Children’s Health Policy Centre, examined data from the BC Healthy Connections Project, the Canadian randomized controlled trial of NFP. The program involved the provision of frequent support visits from public health nurses to expectant mothers and their children throughout pregnancy and early childhood.

Upon entering the study in early pregnancy, more than one-third (38 per cent) of the participating mothers-to-be reported IPV exposure within the past year. “By the end of the trial, when children were age two years, significantly fewer NFP mothers reported IPV exposure (since last interview) and psychological distress (in the previous month),” the article said.

These findings, while exploratory, offer compelling evidence that policymakers should invest in research-backed approaches to early IPV prevention.

According to a 2014 study cited in the article, the economic burden of childhood IPV exposure totaled over $7 billion in a 10-year period — roughly $9 billion in 2024 dollars.

“These costs could have been averted by early childhood prevention programming,” the article said. “Yet in 2024, only 6.1 per cent of Canada’s health spending was allotted to public health, including prevention.”

Effective primary prevention programs could not only save taxpayers billions of dollars — these programs are desperately needed to ensure children and mothers do not experience avoidable harms from IPV exposure.

Read the full article.

How common are co-occurring mental health conditions?

Children who experience one mental health condition often face more than one — what is commonly referred to as having concurrent or co-occurring conditions. But just how common is this experience? A systematic review that combined data from 14 population-based surveys found that for children who met criteria for one mental disorder, 26.5% met criteria for two or more. Researchers have found even higher concurrent rates for children receiving mental health treatment services and for those in foster care.

Research on which disorders are more likely to co-occur is crucial for informing both prevention and treatment efforts. And the co-occurrence of substance use and other mental disorders has been particularly well studied. A systematic review of 21 population-based surveys compared young people with any substance use, including those whose use reached the level of a disorder, to individuals without any substance use. When young people had any substance use or a substance use disorder, their odds of having other disorders significantly increased. This included nearly eight times greater odds of also experiencing conduct, oppositional defiant or attention-deficit/hyperactivity disorders, slightly more than four times greater odds of co-occurring depressive disorders, and approximately two times greater odds of co-occurring anxiety disorders.

Data are more limited on the co-occurrence of disorders that do not involve substance use. A population-based survey of Puerto Rican children nevertheless provides insights on the overlap of conduct/oppositional defiant disorders, attention-deficit/hyperactivity disorder (ADHD), anxiety disorders and depression. Researchers found high levels of co-occurrence across all four conditions. But levels were particularly high for children whose primary diagnosis was conduct/oppositional defiant disorder — with anxiety disorders co-occurring for 55.3%, ADHD for 35.7%, and depression for 17.6%.

For more information, see Vol. 17, No. 3 of the Children’s Mental Health Research Quarterly.

Multiple childhood mental disorders can be prevented

A recent systematic review by the Children’s Health Policy Centre found that transdiagnostic interventions that addressed common risk factors underlying multiple disorders prevented or reduced symptoms of multiple childhood mental disorders. These results suggest six implications for practice and policy:

  • Consider effective transdiagnostic prevention programs for better efficiency. Because multiple symptoms can be prevented using one intervention, greater efficiencies are possible. Efficiencies are also enhanced when programs address particularly common problems such as anxiety, depression, behaviour and substance use concerns. Such efficiencies, in turn, can help mitigate Canada’s limited public prevention investments.
  • Build on the power of parents. Three of the four programs in the systematic review that produced beneficial outcomes for children included parents (or other caregivers). Consequently, including caregivers may be particularly helpful for prevention efforts.
  • Deliver interventions according to need. To optimally support all children, a public mental health strategy should be employed. Such a strategy typically includes promoting healthy development for all children, preventing disorders for those at risk, providing treatment to those with disorders and monitoring outcomes. This approach aligns with efforts to reduce inequities by supporting all children, with an intensity tailored to levels of need.
  • Offer programs that build on solid underlying approaches. Two of programs in the systematic review — Strengthening Families and Strong African American Families–Teen — used parenting training, which is backed by many studies showing reduced child behaviour and substance use problems. Similarly, the Super Skills for Life and EMOTION programs used cognitive-behavioural therapy techniques, which are supported by many studies showing reduced child anxiety and depressive symptoms. But there is only one high-quality randomized control trial evaluating each of these four programs for preventing symptoms of concurrent disorders. So replication evaluations are warranted. As well, adaptations may be needed for the Canadian context, including ensuring that content is culturally safe and relevant.
  • Consider transdiagnostic interventions with children of varying ages. The four successful interventions in the systematic review were delivered to children spanning ages six to 16. This shows it is possible to use these efficient interventions with children at various of developmental stages.
  • Know that effective program delivery can occur in a variety of settings. The four successful programs were delivered to children, and to parents as well in some cases, in community settings including schools. This demonstrates that these programs can be offered in venues that are convenient and accessible for children and families.

Children with one mental health problem often have more than one — resulting in added challenges for them and for their families, and for society when avoidable problems impede young people from flourishing. This systematic review indicates that transdiagnostic prevention programs can effectively and efficiently address multiple mental health needs, including symptoms associated with some of the most common childhood conditions. These programs should therefore be expanded so that more children can be helped. Expansion of transdiagnostic prevention programs may have the added benefit of reducing “downstream” treatment costs.

For more information, see Vol. 17, No. 2 of the Children’s Mental Health Research Quarterly.