Updates

Funding for childhood mental health in BC should increase three-fold to reach all children with mental disorders. That was one of the key messages from child psychiatrist and CHPC director Charlotte Waddell, in speaking at B4Stage4 event in Victoria, November 29.

Sponsored by the Canadian Mental Health Association, B4Stage4 is a campaign highlighting the difference between cancer and mental health care in Canada. “We don’t wait until stage 4 to intervene for cancer, so why do we wait to treat mental illness and addiction,” the website reads.

In her plenary talk, Waddell delineated the numbers for BC:

• Some 84,000 children ages four to 17 — or nearly 13% of children — are estimated to have mental disorders at any given time

• But only 30 % receive the specialized treatment they need

•This means that some 70% — about 58,000 — are not being treated

Waddell emphasized that it is unthinkable that we would ask 70% of BC children with cancer to go without treatment. So we can no longer allow this to continue for children with mental health problems.

Waddell also pointed out that five of the most common mental-health conditions in children and adolescents — anxiety disorders, attention-deficit/hyperactivity disorder, substance misuse, conduct disorder and depression — are also preventable. More information about Waddell’s talk is available in an article in the Times-Colonist.

In marking the May 15 United Nations International Day of Families, the Simon Fraser University website presented a profile of the Children’s Health Policy Centre and its director, Charlotte Waddell.
The story began…
The theme for this year’s International Day of Families on May 15th is “Families, healthy lives and sustainable future,” with a special emphasis on the most vulnerable members of society: children.
At SFU’s Children’s Health Policy Centre, every day is devoted to enhancing children’s social and emotional wellbeing. Its work is guided by the central question, “What are the most effective ways to ensure that every child can flourish and participate?” 
Dr. Charlotte Waddell, the Centre’s director, believes passionately that society should invest in providing all children with the best possible start in life. Mental health problems are like the tip of an iceberg…. (see more)

“For the One and the Many,” is the title of talk given by Children’s Health Policy director, Charlotte Waddell.

Delivered in March 2016 to practitioners at BC Children’s Hospital and in April 2016 to managers at the BC Ministry for Children and Family Development, the talk focuses on the mental health challenges facing many young people in British Columbia today.

In addition to examining the prevalence of various disorders — ranging from anxiety to substance misuse to autism — the talk also tracks health spending in Canada, showing how children’s mental health programs are languishing, even as overall health spending rises. As well, the talk explores effective prevention programs and new alternatives for children such as the Nurse-Family Partnership program.

A complete slide show for the talk may be viewed here.

Nurse-Family Partnership (NFP) — a program aimed at improving the health and development of disadvantaged children — has shown an impressive record in the US for more than 30 years.

In long-term studies in Elmira, New York, Memphis, Tennessee and Denver, Colorado, it improved parenting, improved children’s behaviour and learning, and helped mothers achieve economic self-sufficiency, among other benefits.

Now NFP is being tested in other countries and the results are starting to appear. Results in BC — where NFP is being tested for the first time in Canada — won’t be available for several years. But meanwhile, researchers in the Netherlands have also had positive findings.

As reported in three peer-reviewed journal articles in Midwifery and PLOS ONE, the program has been shown to reduce prenatal smoking, increase breastfeeding, and improve child and family safety.

As the Dutch authors observed: “The results of this randomized controlled trial…corroborate the positive effects of this type of intervention that have been shown in NFP trials conducted in the US.”

In England, on the other hand, NFP has not shown the same impact.  In fact, the Lancet has just published an article outlining limited benefits for children and families who received Family-Nurse Partnership (the UK-adapted version of NFP) compared with existing services.  There, researchers studied prenatal nicotine use, subsequent pregnancies at 24 months postpartum, infant birth weight and child emergency room encounters for all causes. The Lancet has also included a commentary on the English findings by David Olds, NFP’s founder.

Charlotte Waddell, who is the co-principal investigator for BC’s NFP evaluation, says, “Every country is different.  For example, public health spending and other kinds of social supports vary a lot, which can influence how effective a new intervention may appear to be.”

“But this is exactly why we’re conducting a trial in BC — to learn how well NFP works in BC and Canada,” Waddell says.

As to whether the effort and expense of this kind of evaluation is worth it, Waddell has no doubts. “Our aim is to improve the lives of children in BC.  This trial is the best way to find out if NFP should be an important part of this.”

To read the three articles on the Dutch trial results please see the following:
Science Direct
Plos One: 2015
Plos One: 2013

To read the article on the English trial results please see the Lancet.

To read David Olds’ commentary on the English trial results please see his article in the Lancet.

The English Family-Nurse Partnership Unit has also posted a response on their website.