Preventing and Treating Childhood Mental Disorders: Effective Interventions

November 18, 2020

Schwartz, C., Yung, D., Barican, J., & Waddell, C. (2020). Preventing and Treating Childhood Mental Disorders: Effective Interventions. Vancouver, BC: Children’s Health Policy Centre, Simon Fraser University.


Executive Summary

Mental health, or social and emotional wellbeing, is a crucial resource for all children — enabling them to flourish, meet their potential and be resilient in the face of adversity. Yet based on high-quality epidemiological studies, an estimated 12.7% of children — or nearly 95,000 children aged four to 18 years in British Columbia — will experience mental disorders causing significant symptoms and impairment at any given time. All children with mental disorders require effective treatments, and many additional children would benefit from effective prevention programs.

To inform policymaking to address these needs, 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 aged 18 years or younger. These disorders include: 1) anxiety disorders;
2) attention-deficit/hyperactivity disorder (ADHD); 3) oppositional defiant and 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.

Our systematic review identified 113 randomized controlled trials (RCTs) and six systematic reviews that met inclusion criteria. Intervention effectiveness was defined as two or more RCT evaluations showing statistically-significant reductions in disorder diagnoses and/or symptoms for children. Applying these criteria, we identified effective prevention interventions for eight of the most common childhood mental disorders and effective treatments for all 12. However, estimates from high-quality epidemiological studies indicate that an estimated 55.8% of children with mental disorders — or nearly 53,000 children in BC — do not receive services for these disorders in a typical year. These estimates suggest stark service shortfalls, even apart from the question of effective services.

To address these high levels of need, a first step is adopting a comprehensive population health strategy for children’s mental health. Such a strategy includes:

  1. Addressing social determinants and reducing avoidable childhood adversities that contribute to the development of mental health problems
  2. Providing effective prevention programs, such as those reported here, for children at risk
  3. Providing effective treatments, such as those reported here, for all children with disorders, and
  4. Monitoring needs and outcomes over time to evaluate and improve intervention efforts.

Vigorous central leadership is also required to ensure that such a plan is sustained over time, accompanied by adequate and dedicated children’s mental health budgets, and coordinated across all relevant sectors within government. BC’s children will benefit, as will everyone, if children’s mental health is made a high public policy priority — and if children’s mental health needs are better met.

See full report here.