A new study on the Covid-19 pandemic by SFU Assistant Professor and CHPC team member Kim Thomson, has just been published in Plos One.

The study found that parents with children at home reported nearly double pre-pandemic population estimates of moderate to severe psychological distress.

Psychological distress was more frequently reported among parents with pre-existing mental health conditions, disabilities and financial stressors. As well, parents with greater psychological distress reported an increase in negative interactions with their children as a result of the pandemic, and perceived higher anxiety in their children.

“These results highlight that meaningful responses to promote mental health among parents and families must address social and structural inequalities,” the report concluded.

In the same timeframe, Thomson was also co-author of another paper on the Covid-19 pandemic, this one published in the Journal of Adolescence. It profiled the social connectedness among early adolescents in Grade 7 before the pandemic was declared (Winter 2020) and in Grade 8 during the second wave of the pandemic (Winter 2021).

The paper concluded that connectedness with peers and adults in Grade 7 was significantly related to higher levels of mental wellbeing in Grade 8 even during the Covid-19 pandemic, highlighting the protective role of social connection.

Charlotte Waddell, Centre Director, joined BC Ministry of Health lead partners for the Sept. 26 Annual Education Meeting held online for approximately 10 public health nurses with BC’s Interior Health Authority.

The focus was Nurse-Family Partnership (NFP) and a review of the main findings from the 10-year randomized controlled trial that the Centre has led. This trial has evaluated NFP in Canada for the first time. Nicole Catherine and Harriet MacMillan are co-leads with Waddell.

The study has shown that NFP reduces prenatal substance exposure and improves child language and mental health by age two years. All three outcomes are crucial for early healthy development.

Waddell also spoke about the high number of Indigenous participants and about ongoing work with Indigenous collaborators to tell the stories of these participants. As well, she noted long-term follow-up plans: “In the US and England, NFP led to enduring benefits in middle school and beyond, so we are also committed to learning how well NFP works to help children longer-term in BC.”

Charlotte Waddell, Centre Director, gave a Sept. 14 talk with the Doctors of BC, Community of Practice on Child and Youth Mental Health. The talk was titled, “Children’s mental health: Research for informing practice and policy.”

Waddell covered crucial messages including the high prevalence of childhood mental disorders and the severe service shortages — with fewer than half of children with these disorders getting any kind of help.

For this talk, which took place in Vancouver with an audience of approximately 100 family physicians, child and youth psychiatrists and policymakers, among others, she urged strong advocacy — to not only address the service gaps, but also ensure that BC invests in effective prevention programs to reduce needs in the population. Waddell noted: “Your advocacy can and will be very powerful in making a difference for children.”

A passion for child and youth mental health has brought Kimberly Thomson to Simon Fraser University and the Children’s Health Policy Centre.

Recently named an Assistant Professor in the Faculty of Health Sciences, Thomson started her academic career by earning an undergrad degree in psychology from Queens University. Thinking initially what she’d become a counsellor, she did her Master’s degree in educational and counselling psychology at the University of BC.

“But I ended up pivoting away from a purely clinical perspective when I started working with a team looking at children’s health from a population level,” Thomson recalls. She then joined the Human Early Learning Partnership (HELP)  team at UBC, becoming a research coordinator supporting the pilot of a population-based survey of child wellbeing.

Shortly after that, she began her PhD in population and public health. Her dissertation focused on finding early indicators of children’s social and emotional development at the time they entered school. Her objective? To see how these indicators related to the children’s future mental health and well-being, using both public health administrative data and also children’s self-reports.

“One of the main takeaways was that more than 40% of children entering the school system were showing up with relative social-emotional vulnerabilities,” she said, citing higher than average scores for issues such as anxiety or hyperactivity.

Following graduation, Thomson did a post-doc in Melbourne, Australia, where she worked at Deakin University with a group studying the social factors and conditions that predict child and youth mental health. There, she was helping to investigate one of the earliest origins of childhood mental health challenges – among the parent’s generation. “We suspect there are multiple pathways between generations,” she says. “It can be genetic, but it can also be psychological and social.”

But, caught in the crosshairs of the Covid pandemic, Thomson returned to Canada earlier than expected, in 2020. She transferred back to HELP and began looking at mental health outcomes among subgroups that might have experienced inequities, including children who came to Canada as immigrants or refugees. She also studied the impacts of the pandemic on child and youth mental health, including working with the Canadian Mental Health Association, the BC Ministry of Education and the BC Teachers’ Federation.

Most recently, she worked at the BC Centre for Disease Control as an evaluation specialist with the population and public health team. “This was a great opportunity to apply my skills in evaluating programs and initiatives that are trying to address underlying social factors — such as food insecurity — that influence population health,” she said.

But when an opportunity arose with the Children’s Health Policy Centre, Thomson leapt at the chance. “I’ve always been interested in the intersection between research and policy and practice,” she says. “What drew me to the CHPC was the alignment of our goals. I’m especially interested in opportunities to intervene earlier when interventions are more likely to be effective.”

Right now, she’s developing her research and teaching portfolios and making plans for grant applications. She’s also going to be joining Charlotte Waddell and Nicole Catherine on SFU’s developmental trajectories research challenge team, for the Faculty of Health Sciences.

“I think we share the same goals,” she says. “Our focus is on improving well-being for all children and doing it through policy.”

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.

Canada needs to substantially increase public investments in effective interventions to improve the mental health of children.

That was one of the key messages from a June 19/23 talk by Christine Schwartz, psychologist, SFU adjunct professor and Children’s Health Policy Centre scientific writer.

She was speaking to policy-makers, practitioners and researchers at a talk sponsored by the Children’s Healthcare Canada network.

The 30-minute Zoom presentation, followed by a Q&A session, was part of the SPARK program, designed to showcase knowledge, evidence and expertise to spark conversations, ideas and action.

“Effective collaborations between researchers and policy-makers can play a tremendous role in advancing the wellbeing of children,” Schwartz told the group. Audience members were especially interested in learning how CHPC team members have been able to conduct research that is both academically rigorous and responsive to the needs of policy-makers.

Go here to see a recording of the presentation.

Children’s Health Policy Centre Associate Director Nicole Catherine has just been named an affiliate faulty member of The Human Early Learning Partnership (HELP) at the University of British Columbia.

Catherine also holds the Canada Research Chair Tier 2 in Child Health Equity and Policy and is an assistant professor in the Faculty of Health Sciences at Simon Fraser University.

“I am thrilled to join HELP as an affiliate faculty member,” she said in the announcement of the honour. 

In an April 27 talk to faculty, staff and trainees at HELP, Catherine said that early prevention of childhood adversities through research-policy-practitioner collaborations is one of her major motivators.

As the former scientific director of a public health randomized controlled trial known as the BC Healthy Connections Project, she told the group: “Our plans to examine the longer-term effectiveness and cost-effectiveness of an early intervention, across adolescence, will directly inform policymakers, those who need to act to help children flourish.”

Audience members said the retention protocol — developed prior to data collection — impressed them because it ensured sustained engagement with 739 unserved families across 2.5 years. Catherine said: “Families that are unfairly labelled difficult to reach, and therefore underserved by health care, still need to be reached.”

Catherine is now leading new work exploring how to adapt enhanced maternal-child health programs, such as Nurse-Family Partnership, for Indigenous children and mothers in BC.

A Canadian South Asian lifestyle magazine based in Vancouver, DARPAN, recently interviewed Children’s Health Policy Centre director Charlotte Waddell.

The feature, called the Darpan 10, is directed at community and thought leaders, addressing them with 10 questions relating to their role. Here, for example, is one of the questions:

“As part of your education and work that you have done with children, can you share some insights that would help better the public education system as a whole?”

Waddell’s answer:

“A huge lesson for me, in thinking of the research and the young people I have cared for as a child and youth psychiatrist, is to address social disparities in our society. Again, I am considering adversities such as socioeconomic disadvantage, colonialism, and racism. These problems do not cause all childhood mental disorders. But they affect kids unequally.

“So some kids have to carry higher burdens than others, through no fault of their own. In turn, the stresses associated with kids having to take these extra burdens can translate into higher rates of certain mental disorders over time. So it would help to address these disparities, treat all kids well, and ensure adequate prevention and treatment services for mental health difficulties. In turn, it will help the public education system if more kids are flourishing.”

The entire interview can be seen here.

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.

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.