Service shortages have created a crisis

There is a crisis in children’s mental health due to service shortages.

That was the key message of an April 4/23 talk by Children’s Health Policy Centre director Charlotte Waddell to roughly 200 public health leaders and practitioners from across BC.

Hosted by BC Centre for Disease Control Foundation for Public Health, the talk was the keynote event opening a two-day conference on strengthening mental health for children and youth — or the “Best Brains Exchange.”

“Public health can help greatly to improve children’s mental health by advocating for comprehensive population health approaches,” Waddell told the group. “You can also ensure that effective prevention and treatment interventions are made available to all children in need, and insist on good public data to track our progress.”

The talk was 20 minutes, followed by 40 minutes of conversation.

Extraordinary children’s mental health needs arise from COVID-19

Many more children have needed treatment for mental health conditions — particularly anxiety and depression — during the pandemic, compared to before. This is according to a report authored by the Children’s Health Policy Centre and released April 27/23.

Concerningly, this situation arises against a backdrop of stark pre-existing service shortfalls. Recent international estimates have suggested that only 44.2% of children with mental disorders were receiving any services for these concerns before COVID-19.

The report concludes that BC should make additional investments in children’s mental health, to offset future health care and related social costs and to better meet children’s needs.

Funded by the BC Representative for Children and Youth, the report begins by identifying eight studies in high-income jurisdictions. Seven of eight studies found that children’s mental health suffered during the pandemic. And across three of them, these increases in clinically-important problems were substantial — ranging from 48.1% to 94.2%.

Children’s mental health symptoms also changed during the pandemic, albeit with different patterns for different conditions. Multiple studies found that anxiety and depressive symptoms increased. In contrast, behaviour problems improved according to one study but were unchanged according to another. Substance-related outcomes varied as well, with nicotine and cannabis use and alcohol intoxication showing significant declines in some studies but no change in others.

Beyond increased mental health concerns, some children experienced additional challenges during the pandemic. Those from families facing socio-economic disadvantage tended to have poorer mental health outcomes. As well, children had more mental health difficulties when they knew someone who had experienced COVID-19 and when they had fewer supports and less consistent daily routines. 

The report concludes: “Collectively, our current and future well-being depends on recognizing and addressing children’s rights to social and emotional well-being.”

The full report may be found here.

When children have diverse needs…

Children with autism and other neurodevelopmental conditions are far more likely to have additional mental disorders, according to a report authored by the Children’s Health Policy Centre and released April 5/23.

The report concludes that effective treatments for all these disorders already exist and should be made readily available to all children who need them.

Sponsored by the BC Office of the Representative for Children and Youth, the report begins by identifying the prevalence of common mental disorders for children with autism spectrum disorder (ASD), fetal alcohol spectrum disorder (FASD) and intellectual disabilities.

Available data show that the five most common childhood mental disorders overall — anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant and conduct disorders, and depression — are much more prevalent for children with neurodevelopmental conditions.

For example, estimated prevalence for any anxiety disorder was nearly eight times higher for children with ASD. Estimated prevalence for ADHD was more than 14 times higher for children with FASD, and estimated prevalence of oppositional defiant and conduct disorders was nearly four times higher for children with intellectual disabilities.

The report then goes on to identify effective treatments for at least one mental health concern for all three neurodevelopmental conditions. Specifically, cognitive-behavioural therapy leads to clinically meaningful reductions in anxiety disorder diagnoses and symptoms for children with ASD — across multiple studies. As well, parent training successfully reduces behaviour challenges for children with FASD and intellectual disabilities. And emerging evidence shows that social skills training helps children with FASD.

The report concludes: “Services also need to be offered in ways that celebrate children’s strengths and recognize their preferences, thereby meeting society’s collective responsibility to ensure that all children can flourish and meet their potential.”

The report may be found here.

Grant awarded for strengths-based Indigenous research

Nicole Catherine has been awarded a Mowafaghian Child Health Faculty Award, Faculty of Health Sciences, SFU for 2023, her second such award in two years.

Holding the Canada Research Chair in Child Health Equity and Policy, Tier 2 and associate director of the Children’s Health Policy Centre, Catherine is a passionate advocate for Indigenous-led initiatives that promote child wellbeing.

The new award, which will be used to financially support the work of an Indigenous graduate student in collaboration with a project Indigenous Advisory Board, “will provide British Columbia’s Indigenous communities with access to timely and relevant research evidence to guide Indigenous child health policy,” Catherine says.

The project’s aim is to collaborate with BC Indigenous communities to generate new knowledge on the strengths and resilience of the 200 Indigenous mothers and 237 Indigenous children who participated in the BC Healthy Connections project (2011–2022), for which Catherine was co-leader.

“The girls and young women demonstrated remarkable strength and resilience in seeking prenatal services in early pregnancy,” Catherine says. The families participated in six research interviews starting in pregnancy through until children were age two years.

Catherine says, “These data belong to BC First Nations. We have an ethical responsibility to ensure that each families’ story, told through their research data, is shared in a respectful and empowering way.”

BC gov’t standing committee welcomes message about children’s mental health

Senior members of the Children’s Health Policy Centre (CHPC) team addressed the BC provincial government Select Standing Committee on Children and Youth on Dec. 5/22. This talk was given in collaboration with Jennifer Charlesworth, the BC Representative for Children and Youth.

The topic? How to reduce the number of children needing to come into government care while improving mental health outcomes for those who do.

Christine Schwartz, Simon Fraser University Adjunct Professor, and Charlotte Waddell, CHPC director, were the spokespeople. They shared key findings, including that parents who are at-risk for maltreating their children can be kept out of the government care system with effective interventions, such as the Nurse-Family Partnership program.

“BC policymakers need to be acknowledged for the substantial investments they’ve already made in keeping children with their parents by offering the Nurse-Family Partnership,” said Schwartz. “The program has proven success in supporting children and families.”

Schwartz also spoke about the mental health burdens experienced by children in care. She noted, “As a practicing psychologist, I’ve seen the connection between the trauma children in government care have experienced and the mental health burdens they still carry.”

Still, CHPC team stressed how children who end up in care can have their health needs met with well-proven prevention and treatment interventions such as cognitive-behavioural therapy for anxiety, depression and posttraumatic stress disorder.

CHPC team member named co-investigator on digital child mental health initiative

Associate Director of the Children’s Health Policy Centre, Nicole Catherine — who has recently been named Canada Research Chair Tier 2 in Child Health Equity and Policy — is a co-investigator for a new mental health initiative know as DIVERT.

The Digital, Inclusive, Virtual, and Equitable Research Training is a transdisciplinary mental health online training platform dedicated to improving child mental health research and practice in Canada. DIVERT aims to improve inclusion and increase accessibility for underserved children and families.

The national team is funded primarily by a multi-million-dollar investment from the Canadian Institutes of Health Research and enabled by a multi-million-dollar investment in digital infrastructure and expertise from IBM Canada.

DIVERT aims to harness the knowledge of a diverse range of educators so they can all learn together through online connections, national mentorship groups based on lived experiences, research collaborations (with children, families, industries, Non-Governmental Organizations and health care organizations), annual in-person meetings, and the future evolution of a certificate program. Anyone can join DIVERT Mental Health. Doctoral students, post-doctoral trainees and early career researchers conducting research on digital child mental health are encouraged to apply.

Building on her research expertise, Catherine will be mentoring three trainees and providing lectures on child health equity and policy and on efforts to better support underserved children and families.

Child heath policy researcher earns major award

Nicole Catherine has been officially been named Canada Research Chair (CRC) Tier 2 in Child Health Equity and Policy. And, with this announcement, she has also become the new Associate Director of the Children’s Health Policy Centre.

The announcement of her CRC appointment, which was made yesterday in Ottawa, is highly significant and a tremendous honour. The CRC program provides universities with the opportunity to recruit world-class scholars who are emerging global leaders in their field.

Catherine joined the CHPC team in 2012 when she was named Scientific Director, and later Co-Principal Investigator, for the BC Healthy Connections Project. She became the Mowafaghian University Research Associate in 2013 and was appointed Assistant Professor in the Faculty of Health Sciences at SFU in 2022.

Catherine’s research to date has focused on three areas:

  • Ensuring better inclusion of children who are experiencing disadvantage — in both research and policy-making
  • Promoting health and wellbeing in early childhood through public health programming
  • Informing the development and evaluation of interventions that address avoidable early childhood adversities and health inequities.

“I continue to be inspired by the children and young mothers who generously contribute to this research,” Catherine said in reflecting on her award.

CHPC director Charlotte Waddell, had an enthusiastic response to the announcement. “I find Nicole’s commitment to scholarship and to children to be exemplary,” she said. “And she could not be a more creative and supportive person to work with. We are thrilled with this news.”

A story on Catherine can also be found on the website of SFU’s Faculty of Heath Sciences.

High school students learn about the importance of mental health

The Children’s Health Policy Centre provided a keynote talk at a recent workshop for high school students.  The talk took place Oct. 19, 2022, on the invitation of BC Children’s Hospital and the UBC Mini Medical School.

Some 450 students from 27 school districts and 117 high schools across BC attended. Roughly 100 attended in person while the rest participated virtually or on-demand.

In the workshop, CHPC director Charlotte Waddell described the critical importance of children’s mental health. She also outlineded how common mental disorders are, how they affect young people, and what causes these disorders. She then described effective prevention and treatment programs to help young people.

A lively question and answer period followed the presentation and some students reached out later, by email, with even more questions.

More mental health support needed, even in wealthy countries

Children’s Health Policy Centre Senior Research Manager Jen Barican is the lead author in a study recently published in the journal Evidence-Based Mental Health.

The study is titled, “Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking.

Barican and her colleagues considered close to two decades of research from 11 countries covering more than 60,000 children aged four to 18. They discovered that roughly one in eight children from high-income countries, including Canada, has a mental health disorder at any given time.

An interview about the study with co-author Charlotte Waddell, director of the Children’s Health Policy Centre, can be found on the SFU website.



New study to investigate impact of COVID-19 on children in Canada

The Children’s Health Policy Centre is part of a national team investigating how COVID-19 public health measures — such as school closures, distancing and masking — have affected children’s day-to-day lives, it was announced Oct. 6/22.

Charlotte Waddell, Centre director, and Nicole Catherine, Centre faculty member, are part of the team. “This is the first study to look at a large, representative sample of children both before and during the pandemic,” Waddell said. “So, we will able to really see how all kids were doing,” she added.

Kathy Georgiades from the Offord Centre for Child Studies at McMaster University is leading the research which is funded by the Canadian Institutes of Health Research, to a sum of $3.1 million.

The team is partnering with Statistics Canada, the Public Health Agency of Canada, and Children’s Healthcare Canada to collect data on children’s physical, emotional, and social well-being, as well as their COVID-19 vaccination status. This study will provide the most robust evidence to date to inform new strategies to support children affected by the mental and physical health challenges stemming from the pandemic.

Close to 27,000 children between the ages of five and 21 will participate in the national study, which gets underway in January and wraps up in June 2023. Statistics Canada previously evaluated this same group, then aged one to 17 years, for the 2019 Canadian Health Survey on Children and Youth.

The results collected in 2019 give the research team solid pre-pandemic baseline data, which will allow them to assess the effects of the pandemic on the group’s well-being. Look to this website for ongoing updates as the study proceeds.