Did You Know?

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.

Despite the drawbacks of hospitalization, for many young people it is a repeat experience. A recent meta-analysis involving more than 83,000 young people found that 13.2% were readmitted to a psychiatric hospital after being discharged. BC data show similarly problematic readmission rates, with 553 young people being hospitalized for mental health concerns three or more times in 2019.

Researchers have been able to identify risk factors for being readmitted to hospital including initial hospitalizations being due to suicidal ideation and diagnoses involving psychotic, bipolar, attention-deficit/hyperactivity, autism spectrum, intellectual or eating disorders.

As well, youth with longer hospital stays and youth discharged to residential treatment were more likely to be readmitted than those with shorter stays who were discharged to other settings, such as their homes. Of note, age, gender, race/ethnicity, family psychiatric history, maltreatment history and non-suicidal self-injury were unrelated to readmission risk. Also unrelated to readmission risk were diagnoses of depressive, anxiety, oppositional defiant, conduct and posttraumatic stress disorders.

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

International Overdose Awareness Day is the world’s largest annual campaign to end overdose. Convened each year by the Melbourne-based Penington Institute, the day acknowledges the grief felt by the family and friends of those who have died or been permanently injured by an overdose, raises awareness of overdose and spreads the message that drug overdose is preventable.

This year’s theme, “Together we can,” encourages people to come together on August 31 and support those connected to the tragedy of overdose. Visit the International Overdose Awareness Day website to learn more and access campaign resources.

Overdose deaths and opioid misuse are a critical problem in BC. The BC government declared a public health emergency eight years ago due to the number of toxic drug related overdoses. When it comes to children and youth, knowing how many young people are using opioids is critical to inform prevention efforts. To learn more about opioid use and prevention in children and young people, see Volume 18, No. 2 of the Children’s Mental Health Research Quarterly.

Young people are increasingly connected to technology and are leading the way in digital innovation. That’s why the UN’s theme for International Youth Day this year is “From Clicks to Progress: Youth Digital Pathways for Sustainable Development.”

This theme celebrates young people’s digital contributions while highlighting the challenges youth face, including disparities in access to technologies and digital skills for young women and youth in low-income countries. International Youth Day 2024 advocates for enhancing digital inclusion and recognizing the contributions of young people as digital innovators.

International Youth Day was established by the UN in 2000. It advocates for the meaningful inclusion of youth in all areas of society and is held annually on August 12.

The 50th edition of the Children’s Mental Health Research Quarterly celebrates youth and offers fifty lessons learned to help improve young people’s mental health. To learn more and explore these 50 lessons, see Volume 13, No. 2.

There are many reasons for ensuring that children receive needed mental health care in their communities. The physical environments of hospital emergency rooms, including their busyness and lack of privacy, can be challenging at any time, but even more so when a child is experiencing a mental health problem. When young people are hospitalized, they are also frequently asked to repeat their histories — which often include painful and traumatic experiences — to multiple care providers.

As well, many young people feel labelled and stigmatized after being hospitalized for their mental health needs. Given the discrimination experienced by countless Indigenous individuals in Canadian hospitals, this setting may be particularly difficult for children from these communities. Lastly, at a societal level, hospital care is costly and can consume a disproportionate share of funding for children’s mental health. 

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

From 2009 to 2019, Canadian hospitals saw a 60.6% increase in children’s emergency-room use for mental health concerns and a 59.7% increase in inpatient admissions. These Canadian data also reveal that ER use and hospitalizations have varied considerably based on children’s age, gender and place of residence. Youth aged 15 to 17 have the highest rates of both ER visits and hospitalizations among young people. The lack of community-based mental health resources for teens may be a possible reason for the disproportionate rates. And among these older teens, girls were twice as likely to be hospitalized as boys. As well, children from rural communities accessed ERs at rates that were nearly 50% higher than those from urban centres. Reasons for higher rural ER use may include a lack of mental health specialists and limited service options in these regions, as well as lengthy travel to access community-based services.

BC data tell a similar story. Here, children’s hospitalizations for mental disorders increased by 68.8% between 2009 and 2019. Notably, these substantial increases occurred despite there being more effective ways to support children. Overall, these data suggest that hospitals are becoming a de facto safety net for the many young people who experience “fragmented care and significant gaps in mental health service systems.”

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

To ensure social and emotional well-being for all children, an important step involves adopting a population mental health strategy. Such a strategy has four crucial pillars. First, policy-makers can address social determinants of mental health — for example, by implementing programs that reduce the number of children living with socio-economic disadvantage. Second, programs can be implemented to prevent disorders before they develop. Third, for those with mental disorders, timely and effective treatments can enable children to recover and resume their progress on positive developmental trajectories. The fourth pillar involves monitoring the success of these efforts and then making any needed adjustments to better address determinants, prevent disorders and provide treatments.

For more information, see Vol. 16, No. 3 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 with mental disorders. Specifically, the review stresses the need to use a four-pronged population health strategy, including:

1. Addressing social determinants of health, such as socio-economic disparities, and reducing avoidable childhood adversities that contribute to the development of mental health problems
2. Providing effective prevention programs for children who can benefit to reduce the burdens and reduce the number of young people needing treatment
3. Providing effective and timely treatments for all children with mental disorders
4. Monitoring population needs and outcomes over time to evaluate and improve public policy efforts

The first two prongs of this strategy involve “upstream” issues early in children’s lives, before mental disorders develop. In the longer term, society may recoup these investments, for example, through reductions in the use of health, education, social and justice services when more children and families are thriving. And, mounting research evidence supports effective prevention programs, many of which can be implemented by children’s mental health and school practitioners.

The third prong addresses treatment. This requires reaching children early in the course of their disorder(s) with proven and timely interventions that are of adequate duration and intensity. However, the data suggest that many countries, even those that are high income, are far from this goal. But Australia stands as an example of a high-income country that could double the proportion of young people accessing services for mental disorders over a period of approximately 15 years. This was achieved through increasing funding for mental health services overall, as well as changing how funding was used. For example, Australia increased spending for community mental health care services and decreased spending for psychiatric hospitals.

The final prong of this strategy involves measuring collective progress towards improving children’s mental health, through monitoring outcomes and adjusting course over time.

For more information, see Vol. 16, No. 2 of the Children’s Mental Health Research Quarterly.

National Indigenous Peoples Day is a time to recognize and celebrate the history, heritage, resilience and diversity of First Nations, Inuit and Métis across Canada. The day was established in 1996 following concerted advocacy efforts and calls for the creation of such a day by the National Indian Brotherhood (now called the Assembly of First Nations), the Sacred Assembly and the Royal Commission on Aboriginal Peoples. The date was chosen because many Indigenous groups have long celebrated their culture and heritage on or around June 21 due to the significance of the summer solstice.

National Indigenous Peoples Day offers an opportunity to not only celebrate Indigenous Peoples, but also to reflect on how our programs and institutions can better serve Indigenous youth and families. To learn more about the impact of racism on children, see Vol. 15, No. 3 of the Children’s Mental Health Research Quarterly.

Action Anxiety Day educates Canadians about anxiety, reduces stigma and builds awareness of resources and raise funds for programs addressing anxiety. Held annually on June 10, the day was founded by Anxiety Canada, a Vancouver-based organization whose mission is to reduce the barrier of anxiety and its related disorders so people can live the lives they want.

Action Anxiety Day’s organizers encourage participants to use the hashtag #ACTonAnxiety to share stories and promote the event. ACT stands for the following:

• Awareness: Raise awareness of anxiety and trusted, evidence-based resources.
• Colours: Wear blue and orange on June 10 to show support.
• Talking: Tell your anxiety stories and encourage others to share.

Anxiety Canada also offers several resources for promoting the day, including a social media guide and a toolkit for educators.

To learn more about preventing and treating anxiety in children and youth, see Vol. 10, No. 2 and Vol. 10, No. 3 of the Children’s Mental Health Research Quarterly.