Service shortages have created a crisis

May 16, 2023

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.

Extraordinary children’s mental health needs arise from COVID-19

April 27, 2023

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.

When children have diverse needs…

April 5, 2023

Children with autism and other neurodevelopmental conditions are far more likely to have additional mental disorders, according to a report authored by the Children’s Health Policy Centre and released April 5/23.

The report concludes that effective treatments for all these disorders already exist and should be made readily available to all children who need them.

Sponsored by the BC Office of the Representative for Children and Youth, the report begins by identifying the prevalence of common mental disorders for children with autism spectrum disorder (ASD), fetal alcohol spectrum disorder (FASD) and intellectual disabilities.

Available data show that the five most common childhood mental disorders overall — anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant and conduct disorders, and depression — are much more prevalent for children with neurodevelopmental conditions.

For example, estimated prevalence for any anxiety disorder was nearly eight times higher for children with ASD. Estimated prevalence for ADHD was more than 14 times higher for children with FASD, and estimated prevalence of oppositional defiant and conduct disorders was nearly four times higher for children with intellectual disabilities.

The report then goes on to identify effective treatments for at least one mental health concern for all three neurodevelopmental conditions. Specifically, cognitive-behavioural therapy leads to clinically meaningful reductions in anxiety disorder diagnoses and symptoms for children with ASD — across multiple studies. As well, parent training successfully reduces behaviour challenges for children with FASD and intellectual disabilities. And emerging evidence shows that social skills training helps children with FASD.

The report concludes: “Services also need to be offered in ways that celebrate children’s strengths and recognize their preferences, thereby meeting society’s collective responsibility to ensure that all children can flourish and meet their potential.”

The report may be found here.

Grant awarded for strengths-based Indigenous research

February 14, 2023

Nicole Catherine has been awarded a Mowafaghian Child Health Faculty Award, Faculty of Health Sciences, SFU for 2023, her second such award in two years.

Holding the Canada Research Chair in Child Health Equity and Policy, Tier 2 and associate director of the Children’s Health Policy Centre, Catherine is a passionate advocate for Indigenous-led initiatives that promote child wellbeing.

The new award, which will be used to financially support the work of an Indigenous graduate student in collaboration with a project Indigenous Advisory Board, “will provide British Columbia’s Indigenous communities with access to timely and relevant research evidence to guide Indigenous child health policy,” Catherine says.

The project’s aim is to collaborate with BC Indigenous communities to generate new knowledge on the strengths and resilience of the 200 Indigenous mothers and 237 Indigenous children who participated in the BC Healthy Connections project (2011–2022), for which Catherine was co-leader.

“The girls and young women demonstrated remarkable strength and resilience in seeking prenatal services in early pregnancy,” Catherine says. The families participated in six research interviews starting in pregnancy through until children were age two years.

Catherine says, “These data belong to BC First Nations. We have an ethical responsibility to ensure that each families’ story, told through their research data, is shared in a respectful and empowering way.”