Category Archives: News

What public data sources can help us monitor children’s mental health in BC?

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Improving the mental health of children in BC requires monitoring across all age groups — from infancy through late adolescence — to assess public investments aimed at better meeting children’s needs.

How to achieve this goal comprehensively was the subject of a report prepared by the Children’s Health Policy Centre (CHPC) at the request of the Child and Youth Mental Health Policy Branch of the BC Ministry of Children and Family Development. The BC Ministry of Mental Health and Addictions cosponsored the project.

The CHPC conducted an audit of possible data sources with potential application in BC, applying a population health framework to ensure comprehensiveness. The report examined 25 sources, identifying two types that — if used in aggregate —offer potential for ongoing monitoring. They are:

  1. For assessing determinants and status: Canada Census and BC Education data (determinants; covering all ages); Early and Middle Years Development Instruments (status; covering younger and middle school-age children only); and Canadian Community Health, Health Behaviour in School-Age Children and McCreary Adolescent Health Surveys (status; covering adolescents only); and
  2. For assessing interventions and services: MCFD’s Brief Child and Family Phone Interview (BCFPI) combined with BC Medical Services Plan (MSP) diagnoses from fee-for-service practitioners (mental healthcare encounters; covering all ages).

Yet each of these sources has limitations. For example, the BCFPI and MSP only cover those children who access services. And we know from high-quality epidemiological studies that the majority (56%) of children with mental disorders do not receive any services for these conditions.

So it is crucial to use population-based public data sources (such as #1 above) in combination with “clinical” sources (such as #2 above). And most importantly, public data sources should always be normed against epidemiological studies — which give the most accurate depiction of how many children need assistance.

For more information and to review the entire report, see here.

Report suggests interventions for childhood mental disorders

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Mental health, or social and emotional wellbeing, is crucial for all children. But in BC, high-quality epidemiological studies show that nearly 95,000 children aged four to 18 years— or an estimated 12.7% — will experience mental disorders.

All children with mental disorders require effective treatments, and many additional children would benefit from effective prevention programs. To inform policymakers about how to address these needs, the Children’s Health Policy Centre has prepared a research report for the BC Ministry of Children and Family Development.

This report summarizes the best available research evidence on effective interventions for preventing and treating 12 of the most common mental disorders (or groups of disorders) affecting children. These include:

  1. anxiety disorders
  2. attention-deficit/hyperactivity disorder (ADHD)
  3. oppositional defiant disorder
  4. conduct disorders
  5. substance use disorders (SUDs)
  6. depression
  7. autism spectrum disorder
  8. obsessive-compulsive disorder (OCD)
  9. bipolar disorder
  10. eating disorders
  11. posttraumatic stress disorder (PTSD), and
  12. schizophrenia

The report identifies effective prevention interventions for eight of these disorders and effective treatments for all 12.

To view the entire report, please see here.

 

Increased mental health struggles will result from COVID-19

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COVID-19 will have significant mental health consequences for B.C. children and youth, according to a report authored by the Children’s Health Policy Centre and released Nov. 12/20.

The report concludes that the pandemic creates a critical need for government to invest in B.C.’s over-stretched and underfunded child and youth mental health services system.

Sponsored by the BC Office of the Representative for Children and Youth, the report reviews several studies on mental health outcomes for children and youth after earlier pandemics and natural disasters. This research identifies the mental health challenges children and youth can be expected to experience during and after COVID-19, including anxiety, post-traumatic stress, depression and behavioural problems.

The report indicates that because untreated mental health problems can persist, even extending into adulthood if left untreated, supports for children and youth will significantly reduce future costs.

The report also finds that some children and youth may be disproportionately affected, including those with neuro-diverse needs, pre-existing mental health conditions, youth in foster care and those affected by adversities such as socioeconomic disadvantage and racism. It also finds that COVID-19 may particularly affect Indigenous peoples, who disproportionately experience harms related to colonialism such as unsafe housing, lack of access to clean water and extreme food insecurity – conditions that the report recognizes as putting children’s mental health at risk.

“This report underlines the importance of addressing mental health issues in the early stages,” says Representative for Children and Youth Jennifer Charlesworth. “The data indicates that children do well when their communities have more socioeconomic resources… Clearly, community and family health play significant roles in child and youth mental health, and that is what we need to be supporting.”

Families who were in more precarious economic situations before COVID-19 are now facing many added difficulties, according to Charlotte Waddell, director of the Children’s Health Policy Centre and the lead author of the report.

“We found that children who experience socioeconomic inequalities are much more likely to develop emotional and behavioural concerns,” says Waddell. “The pandemic has the potential to amplify inequalities – in turn putting less advantaged children at even greater risk for mental health concerns.”

The full report may be found here.

Report highlights effective interventions for anxiety

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The COVID-19 public health crisis has introduced new and urgent mental health challenges for children across British Columbia.

As a result, the BC Representative for Children and Youth, Jennifer Charlesworth,  asked the Children’s Health Policy Centre (CHPC) to prepare a “Rapid Response” report on effective approaches for reducing childhood anxiety.

Published today, the report identifies two interventions that can be delivered by practitioners virtually and three that can be self-administered by children and families themselves.

“We know it is crucial to address anxiety symptoms and disorders early to ensure they don’t persist into adulthood,” Charlesworth said. “Help cannot wait until the pandemic is over.”

Nearly 45,000 children in B.C. were estimated to have anxiety disorders, before COVID-19, according to Charlotte Waddell, director of the CHPC. “Our new report confirms there are many effective ways for practitioners, caregivers and families to prevent and reduce anxiety during these challenging times,” she said.

Read the entire report here.

Scientific team update on BC Healthy Connections Project now available

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The scientific team guiding the BC Healthy Connections Project has published an update. The project is a randomized controlled trial evaluating the Nurse-Family Partnership program, involving 739 BC-based girls and young women — and their 744 children. The update may be viewed here.

Following last year’s publication of data describing maternal participants and the life conditions they were coping with in early pregnancy, the team is now analyzing initial data on the effectiveness of the nurse-visitation program. A first findings report will soon be released — examining the program’s impact on prenatal substance use. Further findings reports will follow in 2020-2022.

As well, some 27% of project participants identified as Indigenous (including First Nations, Métis or Inuit). The scientific team is collaborating with the First Nations Health Authority to produce publications telling their stories.

The scientific team expects to provide an additional update every quarter until March 2022.

 

Coping with COVID-19

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The Faculty of Health Sciences at Simon Fraser University has created a brief video offering parents advice on how to help children cope with COVID-19.

The video features Charlotte Waddell, director of the Children’s Health Policy Centre, who says that physical distancing doesn’t have to mean loss of connections.

She suggests that parents help children by:

• Getting help themselves when needed to manage stress and to help kids maintain healthy routines
• Encouraging kids to stay connected with friends and family using social networks and the phone
• Remembering how COVID19 affects some children and families more than others
• Thinking of ways to be helping others, which in turn contributes to resilience

“Social connections are crucial for children, as they are for adults,” Waddell says. For more information on specific steps parents and caregivers can take to support kids in the time of COVID-19, go here.

New prevalence study will address children’s mental health needs in BC

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The Children’s Health Policy Centre has taken on a new research project to comprehensively estimate children’s mental health needs in BC and recommend how they can be met. The BC Ministry of Children and Family Development (MCFD) has requested this effort, to inform new services for children’s mental health.

This project will inform needs-based planning by:

• Reviewing the latest epidemiological data on the prevalence of the 10 most common childhood mental disorders
• Summarizing the best evidence on exemplary prevention and treatment interventions for young people
• Examining public datasets that can be used to track children’s mental health outcomes going forward, and
• Synthesizing prevalence, intervention and public data evidence to suggest a comprehensive plan for BC

Led by BC MCFD’s Child and Youth Mental Health Policy Branch, a cross-governmental policy advisory group for the project includes senior representatives from the:
• BC Ministry of Mental Health and Addictions (co-sponsor)
• BC Ministry of Health
• BC Ministry of Education
• First Nations Health Authority, and
• Métis Nation of BC
Other policy collaborators are also being consulted as needed.

The CHPC team is being led by Charlotte Waddell, Christine Schwartz and Nicole Catherine — together with Jen Barican, Donna Yung and Yufei Zheng. Additional scientific collaborators include Kathy Georgiades from McMaster University and Bohdan Nosyk and Emanuel Krebs from Simon Fraser University.

This project is being conducted from 2019 through 2021.

Supporting kids in the time of COVID-19

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The COVID-19 public health emergency is putting a lot of pressure on parents, caregivers and others who work with children. They must explain challenging concepts to help children manage their fears and keep routines as stable as possible.

To assist with these challenges, we offer the following suggestions:

  • Create situations for children to comfortably ask questions at their own pace. Answer questions honestly using concepts that children can easily understand. For example, explain that the new coronavirus is one of many different types of viruses, like the ones that cause colds. And be ready to repeat your answers as children may re-ask the same questions as a way to gain reassurance.
  • Help children manage their fears by modelling calmness and by providing accurate information. This can include explaining the steps you are taking to keep them healthy and safe. (See sidebar, below.) It may also involve highlighting the many actions that community members are taking to protect everyone. And avoid letting children be exposed to media sources that could unnecessarily increase their anxiety.
  • Maintain children’s regular routines as much as possible. Fun activities, like playing outdoors and bike riding, are still possible even with physical distancing. Similarly, technology can help with other important activities like play dates and connecting with grandparents.
  • Encourage children to think about ways they can help others. This could include, for example, helping neighbours who may need things delivered to their doors, sending positive messages to loved ones who may not be near, or communicating with other children about doing schoolwork together, remotely.

Our sidebar, below, gives helpful resources for parents and families. For children who are experiencing more severe anxiety, the book Helping Your Anxious Child may be particularly useful. (Many local bookstores are offering free shipping for online and phone orders.) The book provides guidance to parents of school-age children on ways to teach cognitive-behavioural strategies to reduce anxiety, including recognizing worries and changing the thinking that encourages them.

Collectively, we have faced serious challenges in the past — including wars, 9/11 and wildfires. We will weather this latest crisis as well, with strong public health leadership and with the support of everyone who cares for and works with children.

Resources for parents and families

New resources to help children — and their parents or caregivers — cope with COVID are being developed rapidly. These include:

Research making a difference for children

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A significant percentage of very young mothers in BC are coping with low income, poor education and mental health challenges. These were the issues highlighted by Katie Hjertaas, Ange Cullen and Charlotte Waddell speaking at SFU Vancouver’s inaugural Lunch ‘n’ Learn event, Feb. 6,  on the topic Improving Children’s Lives Through Research.

This new series of lunch hour sessions showcases how SFU’s Vancouver research is making a positive difference in society.

Hjertaas, Cullen and Waddell came to their understanding of the challenges facing very young mothers in part through working on the BC Healthy Connections Project (BCHCP). This randomized controlled trial aims to assess Nurse-Family Partnership (NFP), an intensive, home-based nursing program for very young mothers and their children. NFP runs throughout pregnancy and the child’s first two years of life.

The talk showed that the 739 girls and young women in the study were coping with daunting challenges when they first enrolled:

  • 83% were living on less than $20,000 per year
  • Half were coping with not having grade 12 or equivalent, and those still in school had their education interrupted by pregnancy
  • Many experienced housing instability
  • 74% were coping with mental or physical health problems that affected their daily activities
  • 56% reported experiencing maltreatment when they were children themselves.

Findings from this study are already informing public health policy locally, nationally and beyond — with more reports to come, particularly on how NFP can benefit children.

 

 

CHPC marks milestone in Nurse-Family Partnership study

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The Children’s Health Policy Centre marked the closure of research interviews for the BC Healthy Connections Project, its randomized controlled trial assessing the Nurse-Family Partnership program, with a celebration on Dec. 10.

The trial, which is sponsored by the BC government, involves 739 young mothers and their 744 children. Nurse-Family Partnership is a landmark public health program that begins even before children are born. It involves intensive home visits by nurses, which continue until children reach their second birthday. Program outcomes will be compared with BC’s existing health and social services to learn how we can better improve children’s mental health and development.

Above, CHPC director Charlotte Waddell is shown with SFU’s Dean of Health Sciences Tania Bubela, cutting a cake. Also attending was the Scientific Director and Co-Principal Investigator for the BC Healthy Connections Project (BCHCP) Nicole Catherine and many members of the BCHCP team from over the past eight years.

Guests of honour included BC’s former Provincial Health Officer, Perry Kendall, the Executive Director of BC’s Public Health Services, Kim Bruce and BC Ministry of Health Nurse-Family Partnership Provincial Coordinator Donna Jepsen.