Mental health in Mexican children with cleft lip and/or palate aged 8–12 years: A quantitative and exploratory study

Internationally, the mental health of children and adolescents is undoubtedly an important construct of theoretical, clinical, and policy level concern. Worldwide, five mental disorders (depression, alcohol misuse, bipolar affective disorder, schizophrenia, and obsessive-compulsive disorder) represent half of the 10 leading causes of disability and premature death; with mental disorders accounting for 15–30% of disability adjusted life years in the first three decades of life. This provides a solid rational founded in implications for population health as to why reducing and preventing mental health problems in children and adolescents deserves attention. Past research has indicated interventions focussed on building resilience through strengthening protective factors may offer the potential to address mental health problems in children and adolescents, and in particular aid in reducing such problems during times of increased risk or adversity. With childhood and adolescence being critical periods of development, there is a need to reflect on the strengths and limitations of resilience-focussed interventions and anticipated future needs of the world’s youth. This conceptual analysis identifies a number of future research directions that may meaningfully add to the evidence base and improve implementation, evaluation, and impact of resilience-focussed interventions. These largely relate to refining the understanding of how resilience protective factors relate to mental health problems in children and adolescents. Important issues and potential opportunities to improve the related research field include improved reporting of intervention content; improved measurement of resilience protective factors in intervention trials; continued reporting and review of evidence of association between protective factors and mental health outcomes; and incorporation of mediation analysis within intervention trials. There is a need for further intervention studies in this space to be conducted as rigorous trials of resilience-focussed approaches based on such evidence of association, with clearly posited mechanisms of change, and inclusive of analysis of differential intervention effects. The suggested implications for research made in this conceptual analysis will aid in improving the quality of the evidence base relevant to the fostering of resilience and prevention of mental health problems in children and adolescents.

Perspective matters: Differences between child- and caregiver-reports of emotion regulation mediating the relationship between cumulative childhood trauma and mental health problems in foster children

The relationship between parental suicide attempts and offspring suicide risk has been established. However, the impact of parental suicide attempts on mental health problems in offspring as youth remains unexplored. This study examined the prospective association between parental suicide attempts and offspring internalizing, externalizing, and attention/hyperactivity problems in childhood and adolescence. We also examined how offspring mental health problems in childhood mediated the association between parental suicide attempts and offspring mental health problems in adolescence. A subsample of 6,381 (48.4% female) cohort members with complete data on mental health problems in childhood and adolescence was extracted from the Northern Finland Birth Cohort 1986 Study. Offspring mental health problems were assessed via teacher's Rutter B2 scale during the childhood assessment (child's age of 8) and the Youth Self-Report scale (child's age of 15/16). Information about first parental suicide attempts was collected using ICD codes from hospital discharge records. Lifetime parental suicide attempts during the study period (N=95) were associated with offspring internalizing, externalizing, and attention/hyperactivity problems in adolescence. Parental suicide attempts before the childhood assessment (N=55) were associated with offspring behavioral problems in childhood [B (95% CI)=.64 (0.08-1.28)]. In the mediation models, parental suicide attempts before the childhood assessment had a significant indirect effect on offspring externalizing [B (95% CI)=.03 (0.01-0.05)] and attention/hyperactivity problems [B (95% CI)=.02 (0.01-0.04)] in adolescence via offspring behavioral problems in childhood. Our findings highlight the importance of assessing and monitoring mental health problems in offspring whose parents have been hospitalized for attempting suicide. Among children with behavioral problems, clinicians should inquire about parental history of suicide attempts, as children with familial vulnerability to suicide may develop externalizing and attention/hyperactivity problems in adolescence.

Many married Sri Lankan women annually migrate for employment overseas. Despite widely speculated psychological consequences in these children, their mental health status has not been systematically studied using validated instruments. To describe mental health status of children of women overseas workers and compare that with children of locally employed women, and to describe socio-demographic factors and risk factors associated with abnormal mental health in these children. A cross sectional comparative survey was conducted among 253 children (aged 5-10 years) of women migrant workers in the Colombo District and age and sex matched controls from same neighbourhood. Tools used were the validated Sinhala translation of Child Behaviour Check List (CBCL-S) and questionnaires on socio-demographic/risk factors and school functioning. Mean CBCL-S scores and proportion of children with mental health problems were significantly higher in the study group. Not having an elder sibling, father not living with child, mother educated up to grade 5 or less, change of principal carer (PC) twice or more, living with a relative (or not living in own home), child not communicating freely with PC, and not being permitted to engage in recreational activities at school were significantly associated with abnormal mental health of children of migrant women. A high awareness is required among health and social care authorities regarding mental health problems in these children and relevant risk factors in order to take preventive measures.

Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.

The COVID-19 pandemic is an unprecedented public health crisis impacting all age groups and all areas of society, irrespective of the risk of exposure or disease severity. In fact, containment measures put into place, such as social distancing, limiting mobility or closing of schools, carry many risks for health, especially for mental health. It is also said, that the pandemic accentuates existing health risks. Childhood and adolescence is characterized by ongoing physical, social, emotional and academic developments and dependencies, and is therefore considered a population of increased vulnerability. While this age group is not a high risk group for SARS-CoV 2 diseases, they are heavily impacted by the containment measures, which caused a drastic change to their everyday lives with closures of schools and recreational activities, social distancing and stay at home orders. Loss of day structure and contact to friends can be destabilizing. Children and adolescents rely on their parents for stability and security. However, the general and specific fears related to health and economic situation during the pandemic may affect parents' ability to provide this support. First evidence indicates a drastic rise in mental health problems in children and adolescents with potential long-term impact. The workshop addresses mental health in children and adolescents during the pandemic and will provide the opportunity to discuss public health reactions to this mental health crisis. We present four studies with data collected during the lock-down or pandemic, of which two present data on psychological difficulties and associated risk factors, underlining the role of parents in mental health of children and adolescents, while the other two address solutions, namely interventions for improving mental health literacy in adolescents and parental support groups. While the workshop topic relates to COVID-19 pandemic, the lessons-to be learned go beyond the current public health crisis. Key messages Covid-19 containment measures come with serious side-effects for mental health in children in Europe, strongly associated with parental health and economic situation. Public health must address the rise in mental health problems in children during and after the pandemic to ensure a healthy development of this generation.

Mental health problems in childhood and adolescence (e. g., attention deficits, problems in emotional understanding and subclinical levels of anxiety) are reported to develop further in adulthood and/or to increase the risk of developing mental health disorders in adulthood. Although it is important to provide treatment or prevention interventions for children and adolescents in order to reduce the risk of the further development of mental health problems, the pharmacological and behavioral treatments for this age group have limitations (e.g., limited access, unsustainable treatment effects and the lack of engagement in intervention). In order to overcome the limitations of conventional treatments, the use of digital technology, especially video games for this age group, is suggested. In order to be accepted as clinical interventions, objective evidence for the therapeutic effects of digital therapeutic that used video games to treat or prevent targeted mental health problems are required. Thus, this review aims to explore whether game-based digital therapeutics (DTx) for children and adolescents showed therapeutic effects on targeted mental health problems. As game-based DTx are suggested to show sustained therapeutic effects and the transfer of cognitive functions, it also reviews the maintenance of the therapeutic effects of DTx and the extent of the transfer of cognitive functions. Game-based DTx that are developed to treat or prevent mental health problems (e.g., attention deficit, depression) in children and adolescents are found to show therapeutic effects on targeted mental health problems despite the limitations (e.g., small sample size, limited investigation of the sustainability). This review would contribute to the understanding of whether there is objective evidence of the therapeutic effects of digital therapeutics using video games that deliver treatment or prevention interventions for mental health problems in children and adolescents.

The reduction of coercive or inadequate parenting is essential if the mental health status of Australian children and adolescents is to be improved. Of the available approaches that address parenting practices, behavioural family interventions have the strongest empirical support and are effective in reducing parenting practices that contribute to the development of behavioural and emotional problems in children. However, only a small proportion of parents access such interventions. A comprehensive multilevel, evidence-based parenting and family support strategy needs to be implemented on a wide scale to reduce the prevalence of mental health problems in children and youth. The Triple P - Positive Parenting Program is an example of a population-level strategy that can be used to improve the mental health status of children and their parents.

The need for mental health care among children and adolescents in Iran, as in other low and middle income countries (LAMIC) remains mostly unmet. In this paper, we sought to provide an overview of the extent of unmet need and mental health services in Iran. We also aimed to propose approaches to address this gap. We reviewed the published epidemiologic studies of child and adolescent mental and behavioral health problems in Iran. We also examined the current status of child mental health services and the gaps between current needs and available services based on published literature that included papers published in scientific journals, as well as governmental and other administrative reports. The contextual issues relevant to child mental health care were also explored, as well as the possibilities to introduce new or scale up promising services. Child and adolescent mental and behavioral health problems are highly prevalent in Iran. Different studies have estimated that 16.7% to 36.4% of children and adolescents suffer from one or more mental health problems. However, there is a serious scarcity of resources to meet this need. Available services are delivered by independent public organizations (e.g., Ministry of Health, Welfare Organization, and Ministry of Education) or private sector with inefficient communication and collaboration among them and no mandatory national mental health policy. Available specialized child and adolescent services are mostly confined to small inpatient units and university outpatient facilities in larger cities, and there is a scarce evidence for the effectiveness of the available services. Expansion of primary care's role in timely detection and management of child and adolescent mental health problems, implementation of task-shifting and -sharing initiatives, as well as improved collaboration among responsible governmental and non-governmental sectors are some of the most promising future venues to improve mental health care for the Iranian youth.

Systematic Review of Universal Resilience-Focused Interventions Targeting Child and Adolescent Mental Health in the School Setting

OBJECTIVE: To estimate the prevalence of mental health problems in children and adolescents, with or without considering global impairment, within a low-income urban community; to estimate the public service delivery capacity in terms of mental healthcare; and to determine the relationship between delivery capacity and treatment demand. METHOD: Cross-sectional study. Probabilistic sample of clusters including all eligible households (low-income community - Embu, Southeastern Brazil). Participants: 479 children and adolescents (aged 6-17 years; attrition rate: 18.8%). Measurement: 1) Clinical mental health problems in children and adolescents using the Child Behavior Checklist and/or Youth Self-Report total problem scales; 2) Global impairment: positive score in the Brief Impairment Scale (total score > 15.5); 3) Care service capacity: total number of cases annually seen by psychologists/psychiatrists in the health, education, juvenile justice, and child welfare sectors. RESULTS: Prevalence of mental health problems in children and adolescents: 24.6% (20.7-28.5) without considering global impairment; 7.3% (5.0-9.6) with global impairment (cases in need of treatment). Current annual service capacity can only provide care for 14.0% of impaired cases; approximately seven years would be necessary for all to be treated. CONCLUSIONS: Mental health problems in children and adolescents are frequent in the studied community, and the current structure of the community's public service system is not prepared to treat impaired cases in an adequate timeframe.

Mental health literacy for supporting children: the need for a new field of research and intervention.

The relative burden of mental health problems in children is increasing worldwide. Family meals have attracted attention as an effective modifiable factor for preventing children’s mental health problems. We examined the relationship between family meals and mental health problems in Japanese elementary schoolchildren. A cross-sectional, self-administered questionnaire survey was conducted with guardians of children aged 7 to 12 years in Gifu Prefecture, Japan. Frequency of family meals and with whom the child eats breakfast, lunch, and dinner were assessed separately for weekdays and weekends/holidays. Mental health was assessed using the Japanese version of the parent-reported Strengths and Difficulties Questionnaire. Multivariate adjusted odds ratios (ORs) for borderline/abnormal mental health status were calculated using logistic regression analysis. Of the 678 children, 24.9% had borderline/abnormal mental health status. Children eating breakfast with their family less than once a week (adjusted OR, 4.79; 95% confidence interval (CI), 1.51–15.25) and those eating weekend breakfast alone (adjusted OR, 3.61; 95% CI, 1.42–9.23) had a higher prevalence of borderline/abnormal mental health status compared to those eating breakfast seven times a week and weekend breakfast with their family, respectively. These results suggest that family meals, especially breakfast, might be positively associated with better mental health in children.

Editorial: taking our time – a long‐term perspective on child and adolescent mental health provides invaluable insights for scientists, clinicians and policy makers