Established by the United Nations in 1954, World Children’s Day, Nov 20, promotes and celebrates children’s rights.

Each year, UNICEF, the United Nations Children’s Fund, helps organize kids’ takeovers in which children “take over” high-visibility roles in politics, sports and media. This allows kids to raise their voices on issues that matter to them, including climate change, mental health and education.

World Children’s Day also shines a light on international agreements made to protect the rights of children, including the Declaration of the Rights of the Child and the Convention on the Rights of the Child — adopted on Nov. 20 in 1959 and 1989, respectively. The day calls on world leaders to honour and uphold the rights enshrined in those agreements.

Access to high-quality health care — including mental health care — is one of those rights. But many children in Canada do not have easy access to effective programs for preventing mental disorders. Effective treatments that involve self-delivery may be one way to improve capacity. To learn more, see Vol. 14, No. 2 of the Children’s Mental Health Research Quarterly.

A significant number of young Canadians struggle with thoughts of suicide. Data from the National Longitudinal Survey of Children and Youth revealed that 13% of 14- and 15-year-olds reported having seriously considered attempting suicide in the past year. Similar findings emerged from the most recent BC Adolescent Health Survey which found 17% of respondents reported seriously considering killing themselves in the past year.

Identifying and responding to youth who have thoughts of suicide is critical since about one-third will make a suicide attempt within a year. Services immediately available to children and youth in BC who are struggling with thoughts of suicide include the following:

• YouthInBC.com provides assistance from a crisis responder 24 hours a day by phone (1-800-784-2433 or 604-872-3311 for youth in Greater Vancouver) and online chatting from noon to 1 a.m. through their website: youthinbc.com.

• Kids Help Phone provides support from a professional counsellor 24 hours a day by phone (1-800-668-6868) or from a crisis responder by text (686868) or via Facebook Messenger through their website: kidshelpphone.ca. Young people can be connected with First Nations, Inuit or Métis crisis responders.

• Youth Space provides support from trained volunteers from 6 p.m. to midnight by chat through their website (youthspace.ca) or by text (778-783-0177).

For more information, see Vol. 16, No. 4 of the Children’s Mental Health Research Quarterly.

The National Longitudinal Survey of Children and Youth provides important information on suicide attempts among Canadian youth. After tracking a representative sample of young people for more than a decade, researchers found most young people (96.0%) had never attempted suicide. But among the 4.0% who did make an attempt, researchers found clear patterns. For half of these young people, attempts occurred only during adolescence, while for the other half, they continued into adulthood. Where attempts were limited to the teen years, risk peaked at ages 14 to 15 and then declined. In contrast, where attempts continued into adulthood, risk increased steadily throughout adolescence.

BC data on youth suicide attempts also exist. Among the 38,000 students in Grades 7 to 12 participating in the McCreary Centre Society’s most recent BC Adolescent Health Survey, 5% acknowledged attempting suicide in the past year  — a figure in keeping with the Canadian data noted above. Overall, suicide attempts warrant serious attention because they are an important risk factor for subsequent attempts, including fatal ones.

For more information, see Vol. 16, No. 4 of the Children’s Mental Health Research Quarterly.

Suicide affects far too many young Canadians and their families. In fact, suicide is the second leading cause of death in this country, behind only unintentional injuries, for 15- to 19-year-olds, and the third leading cause for 10- to 14-year-olds. To help meet the goal of reducing youth suicide, the World Health Organization (WHO) has been a leader in collecting vital information. A recent meta-analysis of WHO data compared suicide rates for 10- to 19-year-olds across 35 countries, including Canada. From 2010 to 2018, the suicide rate for Canadian youth was 5.01 per 100,000 — putting Canada above the average global rate of 3.77 per 100,000. Still, WHO data revealed declining Canadian youth suicide rates in recent years, with the comparable figure for 2000 to 2011 being 5.36 per 100,000.

Suicides by Canadian youth differ based on age, gender and the interaction of the two. Regarding age, suicides are more frequent for 15- to 19-year-olds. Regarding gender, and as typical of other countries, boys account for the most suicides among older teens, at 70%. But among those between 10 and 14 years, girls account for 59% of suicides — making Canada the only country among the 35 included in the meta-analysis of WHO data with higher suicide rates for girls than for boys in this younger age group.

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. The comparable suicide rate for girls showed a statistically significant increase of 0.09 deaths per 100,000.

For more information, see Vol. 16, No. 4 of the Children’s Mental Health Research Quarterly.

ADHD Awareness Month is part of a global effort to share information to help people with ADHD thrive. Attention Deficit/Hyperactivity Disorder (ADHD) affects children and adults all around the world, and this month offers an opportunity to fight misconceptions about ADHD and highlight helpful strategies for managing it. The ADHD Awareness Month Coalition provides numerous online resources, including expert Q & As, videos and podcasts, personal stories, and daily tips for life with ADHD.

ADHD is the second most common mental health disorder in children, exceeded only by anxiety. Positive and engaged caregiving can help children develop the self-regulation skills they need, and there is evidence that interventions such as child Cognitive Behavioural Therapy (CBT), behavioural therapy and neurofeedback can also be effective in helping children with ADHD. To learn more, see Vol. 10, No. 4 and Vol. 11, No. 1 of the Children’s Mental Health Research Quarterly.

On October 10 — World Mental Health Day — mental health organizations and advocates will come together to speak out for better mental health supports in the workplace as part of this year’s theme, “Mental Health at Work.” More than 60% of the global population is employed, making workplace metal health a vital issue for governments, employers and employees to address. Ensuring caregivers and parents have adequate mental health support in the workplace is critical, as the mental health of caregivers significantly impacts that of children and youth. Conversely, childhood mental disorders can also have considerable consequences for families, including parents having to miss work to address their child’s mental health needs. To learn more about the high burden associated with childhood mental disorders, see Vol. 16, No. 2 of the Children’s Mental Health Research Quarterly.

The National Day for Truth and Reconciliation, held annually on Sept. 30, offers an opportunity to reflect on the harms done to Indigenous peoples by Canada’s colonial and residential school systems. From 1867 through 1996, there were 140 federally run residential schools in operation in Canada. The day honours the Survivors of those schools and the children who never returned home.

The National Day for Truth and Reconciliation coincides with Orange Shirt Day, a grassroots initiative that commemorates the residential school experience and promotes the idea “Every Child Matters.” By wearing an orange shirt on Sept. 30, participants can help promote awareness of the individual, family and community intergenerational impacts of residential schools and make a statement in support of reconciliation.

Orange Shirt Day and the Day for Truth and Reconciliation offer a chance to open a dialogue on anti-racism. As a determinant of health, racism has a profound impact on child well-being. To learn more about the impacts of racism on young people, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

The International Day of Non-Violence occurs a few days later, on October 2. The day commemorates the birth of Mahatma Gandhi, leader of the Indian independence movement. Gandhi used non-violent activism to help end British colonialism in India. Established by the UN in 2007, the goal of the day is to spread the message of non-violence. According to the UN, it reaffirms the desire “to secure a culture of peace, tolerance, understanding and non-violence.”

Violence in the home, including physical punishment, can be a disruptive force in the lives of children and youth. While physical punishment used to be commonplace, fewer and fewer parents are using this form of discipline. To learn more about the trend towards a violence-free childhood, see Vol 9, No. 1 of the Children’s Mental Health Research Quarterly.

Findings from a recent systematic review by the Children’s Health Policy Centre offer hope for children at risk of being hospitalized.  These findings suggest four implications for practice and policy:

• Reduce mental health hospitalizations safely by supporting children in community. An evaluation of a program known as Home Treatment provides evidence that it is possible to shorten inpatient stays when adequate outpatient supports are provided. Young people with these extra supports had stays that were 21 days shorter compared with regular services without any difference in overall functioning eight months later.

• Recognize that extra supports after hospital discharge can have wide-ranging benefits. A study of a program known as Supported Discharge Service demonstrates it’s possible to reduce the number of children frequently engaging in self-harm, while increasing their engagement in school and other productive activities. These findings suggest that supporting children after hospitalization can yield multiple gains across multiple domains.

• Build on the research evidence to better serve children in rural and remote communities. Supported Discharge Service was delivered in two regions, one of which was rural, showing that it is feasible to provide intensive mental health services even in more remote communities. Using technology to deliver interventions virtually may be another way to reach more children in rural and remote communities. Such delivery is increasingly common since the COVID-19 pandemic began, according to a recent US study of mental health care delivery, which found a twelvefold increase in psychologists’ use of telecommunications such as video calls.

• Support children post-hospitalization knowing that doing so will pay off. The Home Treatment and Supported Discharge Service studies both provide evidence of cost-effectiveness. These findings suggest that any costs associated with providing added supports post-hospitalization are likely outweighed by the benefits. For example, even though the costs of Supported Discharge Service were not significantly lower than regular services, the intervention was still cost-effective when considering the benefits it produced, including reducing self-harm and increasing engagement in productive activities.

The CHPC review suggests that after a mental health hospitalization, young people can be supported to return home more quickly and remain there, with less need for rehospitalization. This review also found that intensive community-based services are cost-effective, enabling children and youth to flourish without the impediment of prolonged or repeated hospitalizations. When these interventions are coupled with adequate investments in programs that address social determinants of mental health as well as effective prevention and treatment programs, fewer children will likely need hospital care for mental health issues.

For more information, see Vol. 16, No. 3 of the Children’s Mental Health Research Quarterly.

Health care practitioners in BC are working to improve the hospital experiences of Indigenous children and their families. Their efforts include hiring staff to help Indigenous individuals receive high-quality, culturally safe health care. Although there is variation across health authorities, such positions can include Aboriginal Patient Liaisons, Aboriginal Patient Navigators, Indigenous Patient Navigators and Indigenous Liaison Nurses. These workers provide a range of services that can include ensuring that planning takes patients’ needs into account; facilitating communication and cultural understanding between patients and providers; assisting with language translation; and making referrals to appropriate community resources.

For more information, see Vol. 16, No. 3 of the Children’s Mental Health Research Quarterly.

Sept. 9 and 10 are important days for raising awareness of two preventable health concerns.

Sept. 9 marks international Fetal Alcohol Spectrum Disorder (FASD) Awareness Day. Founded by three parent advocates in 1999, the day takes place on the ninth day of the ninth month to highlight the importance of avoiding alcohol for the full nine months of pregnancy. It was established to bring attention to FASD and to highlight the impact of prenatal exposure to alcohol on fetal development. FASD Awareness Day also advocates for better diagnosis and support for individuals living with FASD. To learn more about the prevention of FASD, see Vol. 5, No. 2 of the Children’s Mental Health Research Quarterly.

The following day, Sept. 10, is World Suicide Prevention Day. Suicide is a major global health problem leading to more than 700,000 deaths each year. World Suicide Prevention Day aims to spread the message that suicide is preventable. It also raises awareness, works to reduce stigma and emphasizes the need to prioritize mental health and suicide prevention in government policymaking. This year introduces a new triennial theme, Changing the Narrative on Suicide, which advocates for a societal shift from a culture of stigma and silence to one of support and understanding. To learn more about suicide prevention for young people, see Vol. 16, No. 4 and Vol. 17, No. 1 of the Children’s Mental Health Research Quarterly.