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

December 10, 2020

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

November 23, 2020

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

November 12, 2020

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.

Study shows drop in cannabis and cigarette use during pregnancy for young, first-time mothers

October 27, 2020

Findings from a scientific study by Simon Fraser University give encouraging clues on how to reduce cannabis and cigarette use during pregnancy for young, first-time mothers -to-be.

The BC Healthy Connections Project, which is being led by SFU’s Children’s Health Policy Centre, in collaboration with researchers at McMaster University, is a randomized controlled trial examining an intensive nurse-home visiting program, called Nurse-Family Partnership (NFP). Findings suggest that NFP may help in reducing some types of prenatal substance use in girls and young women experiencing socioeconomic disadvantage.

Findings were recently published in a peer-reviewed academic journal, Canadian Medical Association Journal Open. The paper may be seen here.

Prenatal exposure to alcohol, cigarettes/nicotine, cannabis, and street drugs all place children at risk for poor health outcomes including being born too early, having a low birth weight, and having later learning and behaviour problems.

Girls and young women who received NFP (compared with regular prenatal services) showed a statistically-significant drop in prenatal cannabis use. As well, those who were smokers and received NFP showed a statistically significant drop in daily number of cigarettes smoked — which is important, given that even low-level cigarette smoking is harmful to a fetus.

Prevention is by far the best approach to such issues, according to Children’s Health Policy Centre director Charlotte Waddell. “These findings are good news in that they show we can prevent or reduce substance use during pregnancy,” she says. Study scientific director Nicole Catherine agrees. “It’s exciting to see these positive results during pregnancy, which is a crucial window for promoting children’s health and wellbeing.” 

NFP is a prevention program involving public health nursing home visits starting early in pregnancy and continuing until children reach age two years. It aims to improve child and maternal wellbeing, focusing on young, first-time parents facing socioeconomic disadvantage. While NFP trials in the United States have shown many short- and long-term benefits for both children and mothers—including the program more than paying for itself—NFP has never before been tested in Canada.

For this study, the team is following 739 mothers and 737 children across BC. The BC Ministry of Health is sponsoring the trial, with support from the BC Ministries of Children and Family Development and Mental Health and Addictions—in collaboration with Fraser, Interior, Island and Vancouver Coastal Health Authorities.