Mental Health Status Of Children Research Articles

Long-Term Mental Health Outcomes of Bronchopulmonary Dysplasia in Neonates: An 18-Year National Cohort Study

To evaluate the association between neonatal bronchopulmonary dysplasia and the subsequent development of mental health conditions in children and adolescents. This was a retrospective cohort study, utilizing data from individuals born in South Korea between 2002 and 2005 and followed up until 2021, using the National Health Insurance Database. The cohort included 1,893,314 participants born during that period, with 927 diagnosed with bronchopulmonary dysplasia during the neonatal period (the exposed cohort). They were matched 1:10 with 9,270 unexposed individuals (the unexposed cohort) based on key demographic factors. The median age at the first mental health disorder diagnosis was 9 years (interquartile range, 5-15 years), with 5,698 individuals (55.9%) being male. During an average follow-up of 15.2 years, the incidence rate was 481/10,000 person-years in the exposed and 138/10,000 person-years in the unexposed cohort. By the age of 18 years, the cumulative incidence in the exposed cohort was 54% (95% confidence interval [CI]; 50%-57%), with an adjusted hazard ratio of 3.18 (95% CI; 2.81-3.60) compared with the unexposed cohort, and adjusted hazard ratios for early- and late-onset mental health disorders of 4.48 (95% CI; 3.84-5.22) and 1.89 (95% CI; 1.61-2.22), respectively. Sensitivity analyses confirmed these findings, and a subgroup analysis revealed a higher risk among individuals with bronchopulmonary dysplasia who required prolonged respiratory support or oxygen. Half of children with bronchopulmonary dysplasia in our cohort developed mental health disorders by the age of 18 years, emphasizing the need for interventions and support for such individuals.

Evolution of the Correlation Between Body Mass Index (BMI) and Agility of Primary School Students in North-Eastern Romania

Interacting with children's cognitive processes and mental health status, body mass index (BMI) could be analyzed in relation to motor performance. This study aims to analyse the relationship between BMI and agility of primary school students in the northeast of Romania. Hypothesis testing was done by analyzing data obtained from 3250 pupils (1605 girls and 1645 boys) aged 6 to 11 years old from the North-East of Romania. BMI was calculated based on height and weight, as well as agility through the 505 change of direction speed test. The sample was divided according to gender and age, and the differences and correlations were analysed. We assumed that our sample has a significant correlation of BMI with agility and that its strength increases with age, based on neural maturation. Children's results showed gender- and age-determined differences in anthropometric as well as motor skills. The development of Romanian girls and boys differs punctually at this stage, with the two genders having close BMI values at age 11. The time to complete the 505 test is close at age 6, with boys performing better by age 11. The correlation between BMI and agility has weak strength in the 6-11 years age group of Romanian students. It is significant in girls at 9 (r = 0.20) and 10 years (r = 0.15), and in boys from 7 (r = 0.20) to 10 years (r = 0.22). The data partially confirm our hypothesis, with the correlation existing in the 7-10 years age range, its strength having a fluctuating evolution. At 11 years the link between BMI and agility ceases to exist.

Socio-demographic factors and mental health trajectories in Australian children and primary carers: Implications for policy and intervention using latent class analysis.

Children's mental health status (MHS) is frequently influenced by their primary carers (PCs), underscoring the significance of monitoring disparities longitudinally. This research investigated the association between socio-demographic clusters and mental health trajectories among children and their PCs over time. Data from waves 6-9c2 of the Longitudinal Study of Australian Children (LSAC) were analyzed using Latent Class Analysis (LCA) to identify four socio-demographic classes among children aged 10-11 years at wave 6. Multinomial logistic regression and predictive marginal analysis explored associations between classes and mental health outcomes. PCs in Class 4 (disadvantaged and separated families with indigenous children) exhibited higher odds of borderline and abnormal MHS compared to Class 1 (prosperous and stable working families) across all waves. However, while MHS of PCs' impacted children consistently, the association with socio-demographic classes was significant only in wave 6. Class 4 children had elevated risks of mental illness compared to Class 1, while Class 3, characterized by educated working mothers, had lower risks. Reducing mental health risks entails addressing socio-economic disparities, supporting stable family structures, and offering tailored interventions like counseling and co-parenting support. Longitudinal monitoring and culturally sensitive approaches are crucial for promoting mental well-being across diverse groups.

Neurodevelopmental and Mental Health Conditions in Children With Medical Complexity.

Children with medical complexity (CMC) may be at a high risk of neurodevelopmental and mental health conditions given disease comorbidities and lived experiences. Little is known about the prevalence of these conditions at a population level. In this study, we estimated the prevalence of neurodevelopmental and mental health diagnoses in CMC relative to children without medical complexity and measured associations between these diagnoses in CMC and subsequent health care utilization and in-hospital mortality. We applied the Child and Adolescent Mental Health Disorders Classification System to identify neurodevelopmental and mental health diagnoses using all-payer claims data from three states (2012-2017). Poisson regression was used to compare outcomes in CMC with neurodevelopmental and mental health diagnoses to CMC without these diagnoses, adjusting for sociodemographic and clinical characteristics. Among 85 581 CMC, 39 065 (45.6%) had ≥1 neurodevelopmental diagnoses, and 31 703 (37.0%) had ≥1 mental health diagnoses, reflecting adjusted relative risks of 3.46 (3.42-3.50) for neurodevelopmental diagnoses and 2.22 (2.19-2.24) for mental health diagnoses compared with children without medical complexity. CMC with both neurodevelopmental and mental health diagnoses had 3.00 (95% confidence interval [CI]: 2.98-3.01) times the number of ambulatory visits, 69% more emergency department visits (rate ratio = 1.69, 95% CI: 1.66-1.72), 58% greater risk of hospitalization (rate ratio = 1.58, 95% CI: 1.50-1.67), and 2.32 times (95% CI: 2.28-2.36) the number of hospital days than CMC without these diagnoses. Neurodevelopmental and mental health diagnoses are prevalent among CMC and associated with increased health care utilization across the continuum of care. These findings illustrate the importance of recognizing and treating neurodevelopmental and mental health conditions in this population.

Cross-sectional analysis of the association between household food insecurity and mental health conditions in children aged 5–11 years in Canada

BackgroundChildren living in food insecure households have poorer mental health outcomes compared with their food-secure peers; however, the relationship between the severity of food insecurity and diagnosed mental health conditions...

Comprehensive Virtual Treatment for Severe Anxiety in Youth: A Case Report

Anxiety disorders and obsessive-compulsive disorder (OCD) are among the most common mental health conditions in children and adolescents and are associated with various impairments and long-term consequences. Evidence-based treatments exist but are often lacking in elements needed to effectively treat youth with more severe presentations. This case report illustrates a patient’s treatment course in an innovative program for children, adolescents, and young adults with severe anxiety. The program offers a continuum of outpatient, evidence-based care tailored to the severity of the patient’s condition. The case study focuses on “Jane,” an adolescent female with anxiety as well as obsessive-compulsive spectrum disorders, who had previously received extensive treatment without sustained improvement. Through the program’s three treatment phases, Jane and her parents demonstrated consistent engagement and adherence to treatment. Jane showed significant progress, with rapid reduction in symptoms and functional impairment. This case report underscores key elements of this treatment that address gaps in traditional approaches to care, particularly for patients with severe presentations, including the coordinated, team-based approach; the continuum of evidence-based, phased treatment titrated to need; the utilization of virtual individual, group and parent-focused care and between-session coaching to enhance learning generalization; and the use of measurement-based care. Further research is warranted to evaluate the generalizability and long-term outcomes of this program and its potential to transform the treatment landscape for pediatric anxiety and OCD.

The comparative study of chronically ill and healthy children and adolescents in the light of their general mental health

Children's hospitalisation is difficult for the family and the immediate environment. In these cases, the provision of psychological support is particularly important. Chronically ill children who are regularly hospitalised are in a particularly difficult situation, often feeling vulnerable. Our research aims to explore and analyse in detail the psychological state, attitudes and mental health of chronically ill children and to compare patient groups (children receiving care in pulmonology, gastroenterology, onco-haematology and rehabilitation) to understand the interacting factors, which may be of great importance for quality patient care and for measures to improve patient care in the future. We studied chronically ill children (N = 107) aged 10 to 18 years (M = 14.3; SD = 2.0), cared for by the Department of Paediatric Rehabilitation, Paediatric Psychiatry and Psychosomatics of the University of Debrecen Clinical Centre, the second largest paediatric institution in Hungary. In our survey, sociodemographic questions, the Connor–Davidson Resilience Scale, the Satisfaction With Life Scale, the Cantril Ladder, the Non-Productive Thoughts Questionnaire, the Problematic Internet Use Questionnaire, the Drawing version of Pictorial Representation of Illness Self-Measure (PRISM-D), the Beck Depression Inventory—Shortened Scale, the Illness Intrusiveness Ratings Scale, the Spielberger State-Trait Anxiety Questionnaire—Child Version and the Strength and Difficulty Questionnaire were applied. One-way analysis of variance (ANOVA) was used to examine differences between groups, and Pearson rank correlation analysis was used to measure the relationships between individual variables. The results show significant differences between patient groups in terms of resilience, depression, nonproductive thoughts, problematic internet use, anxiety and coping, but no consistent pattern in the development of scores. In addition, for some psychological correlates, the role of sociodemographic background also showed significant results. The practical utility of our study is that using questionnaire methods to map patient satisfaction, compliance, and patient attitudes will provide regarding the factors that influence the mental health status of children living with chronic illnesses. In the light of this, additional methods and tools can be included to improve the quality of healthcare and to develop a set of procedures that will serve the intended purpose.

Clinical effectiveness of the psychological therapy Mental Health Intervention for Children with Epilepsy in addition to usual care compared with assessment-enhanced usual care alone: a multicentre, randomised controlled clinical trial in the UK

Mental health difficulties are common in children and young people with chronic health conditions, but many of those in need do not access evidence-based psychological treatments. The study aim was to evaluate the clinical effectiveness of integrated mental health treatment for children and young people with epilepsy, a common chronic health condition known to be associated with a particularly high rate of co-occurring mental health difficulties. We conducted a parallel group, multicentre, open-label, randomised controlled trial of participants aged 3-18 years, attending epilepsy clinics across England and Northern Ireland who met diagnostic criteria for a common mental health disorder. Participants were randomised (1:1; using an independent web-based system) to receive the Mental Health Intervention for Children with Epilepsy (MICE) in addition to usual care, or assessment-enhanced usual care alone (control). Children and young people in both groups received a full diagnostic mental health assessment. MICE was a modular psychological intervention designed to treat common mental health conditions in children and young people using evidence-based approaches such as cognitive behaviour therapy and behavioural parenting strategies. Usual care for mental health disorders varied by site but typically included referral to appropriate services. Participants, along with their caregivers, and clinicians were not masked to treatment allocation but statisticians were masked until the point of analysis. The primary outcome, analysed by modified intention-to-treat, was the parent-report Strengths and Difficulties Questionnaire (SDQ) at 6 months post-randomisation. The study is complete and registered with ISRCTN (57823197). 1401 young people were potentially deemed eligible for study inclusion. Following the exclusion of 531 young people, 870 participants were assessed for eligibility and completed the SDQ, and 480 caregivers provided consent for study inclusion between May 20, 2019, and Jan 31, 2022. Between Aug 28, 2019, and Feb 21, 2022, 334 participants (mean ages 10·5 years [SD 3·6] in the MICE group vs 10·3 [4·0] in control group at baseline) were randomly assigned to an intervention using minimisation balanced by age, primary mental health disorder, diagnosis of intellectual disability, and autistic spectrum disorder at baseline. 168 (50%) of the participants were female and 166 (50%) were male. 166 participants were randomly assigned to the MICE group and 168 were randomly assigned to the control group. At 6 months, the mean SDQ difficulties for the 148 participants in the MICE group was 17·6 (SD 6·3) and 19·6 (6·1) for the 148 participants in the control group. The adjusted effect of MICE was -1·7 (95% CI -2·8 to -0·5; p=0·0040; Cohen's d, 0·3). 14 (8%) patients in the MICE group experienced at least one serious adverse event compared with 24 (14%) in the control group. 68% percent of serious adverse events (50 events) were admission due to seizures. MICE was superior to assessment-enhanced usual care in improving symptoms of emotional and behavioural difficulties in young people with epilepsy and common mental health disorders. The trial therefore shows that mental health comorbidities can be effectively and safely treated by a variety of clinicians, utilising an integrated intervention across ages and in the context of intellectual disability and autism. The evidence from this trial suggests that such a model should be fully embedded in epilepsy services and serves as a model for other chronic health conditions in young people. UK National Institute for Health Research Programme Grants for Applied Research programme and Epilepsy Research UK Endeavour Project Grant.

Counseling Strategies for the Traumatic Psychological Problems of Divorced Children

With the increasing number of divorced families in our country in recent years, the mental health problems of children from divorced families have received more and more attention. The divorce of parents makes it impossible for children to grow up healthily in a sound family environment, and their body and mind are very vulnerable to influence. In order to improve the mental health status of children from single-parent families, it is not only necessary for both parents to make efforts but also for schools and society to make efforts. Therefore, this paper mainly analyzes the status quo of children's mental health in divorced families and gives corresponding suggestions for improvement.

Parental evaluations of neighbourhood green and play spaces and children's mental health

AbstractGeographical analyses of mental health problems have been undertaken since at least the 1930s, with such work preoccupied primarily with ecological correlations between the prevalence of mental illness and small‐area variations in socioeconomic status. More recently, parks and other green spaces have emerged as place characteristics of interest for their possible public health significance, as they relate to both physical and mental health, including the psychosocial well‐being of children. In this paper, I consider the relationships between parent‐reported adequacy of neighbourhood play and green spaces and children's psychosocial well‐being, as measured by parental assessments of their children's mental health, as well as scores on the Strengths and Difficulties Questionnaire, a psychometric instrument that is demonstrably effective in the identification of behavioural problems in children and adolescents. The findings reported here are consistent with the notion that access to natural spaces and opportunities to play are associated with a reduced risk for mental health problems. Specifically, risk reduction is suggested for overall behavioural functioning, as well as specific behavioural difficulties related to problems in peer relationships, hyperactivity, and emotional problems, as well as parent‐assessed child mental health status.

Maternal mental health disorders and offspring asthma and allergic diseases: The role of child mental health.

Maternal psychological stress during pregnancy and postnatally has been shown to be associated with offspring atopic diseases (asthma, atopic dermatitis and allergic rhinitis). The aim of this study was to assess whether this association may be attributable to the child's own mental health disorders. The study population included 15,092 twin children born 2002-2010 in Sweden. Questionnaire data at age 9 years was linked to national patient- and prescription registers. Maternal mental health during pregnancy and 3 years postnatally were identified from diagnosis and medication data (depression, anxiety and stress disorders). Atopic diseases in children were identified from questionnaires, diagnosis and medication data. Child mental health status (depression and anxiety) was identified from questionnaires. Three-way decomposition methods tested for mediation or interaction by child mental health disorders. Maternal mental health disorders were associated with most child atopic diseases including asthma aRR1.36 (95% CI 1.12, 1.60), and child mental health disorders, aRR1.73 (95% CI 1.56, 1.92). Children with mental health disorders were comorbid for atopic diseases with only asthma reaching statistical significance, aRR1.29 (95% CI 1.14, 1.47). Three-way decomposition found that mediation or interaction by child mental health disorders did not account for the mother mental health and child atopy associations except in parent-report asthma, where child mental health disorders mediated 13.4% (95% CI 2.1, 24.7) of the effect, but not for objectively defined (diagnosis and medication) asthma. The associations between maternal mental health and child asthma and allergic diseases do not appear to be attributable to child mental health disorders.

The influence of birth order on anxiety disorders in emerging adulthood: A longitudinal study.

Introduction: The current longitudinal scholarly research analyses the impact of birth order on children's psychological and mental health status.
 Objective: The birth order indicates the paramount effect on an individual's psychological, physiological and behavioural transformation.
 Methodology: This research study enrolled 150 individuals aged 18 to 25 years to assess their anxiety status in association with birth order. The study applied a mixed-method approach involving structured questionnaires, semi-structured interviews and focal group discussions.
 Results: The statistical analysis yields that birth order is statistically inversely related to the level of anxiety, having weak statistical evidence of significance. It predicts that the latterly born (younger) children experience fewer episodes and severity of anxiety as compared to the elder ones.
 Conclusion: Family support is a critical factor in buffering anxiety among children. The study suggests the parental consideration of birth order to provide a balance of attention and care to overcome the psychological adverse outcomes among children. Further scholarly attention is required to study the association among these dynamics with multiple approaches for further analysis of associated aspects.

Research Review: Grandparental care and child mental health - a systematic review and meta-analysis.

The number of children residing in grandfamilies is growing worldwide, leading to more research attention on grandparental care over the past decades. Grandparental care can influence child well-being in various forms and the effects vary across contexts. In this systematic review and meta-analysis, we synthesize the evidence on the relation between grandparental care and children's mental health status. We identified 5,745 records from seven databases, among which 38 articles were included for review. Random effects meta-analyses were used to synthesize evidence from eligible studies. We also examined the variability across study and participant characteristics, including study design, recruitment method, child age, child gender, study region, family type, comparison group, and outcome rater. The meta-analysis consisted of 344,860 children from the included studies, whose average age was 10.29, and of which 51.39% were female. Compared with their counterparts, children being cared for by their grandparents had worse mental health status, including more internalizing problems (d = -0.20, 95% CI [-0.31, -0.09], p = .001), externalizing problems (d = -0.11, 95% CI [-0.21, -0.01], p = .03), overall mental problems (d = -0.37, 95% CI [-0.70, -0.04], p = .03), and poorer socioemotional well-being (d = -0.26, 95% CI [-0.49, -0.03], p = .03). The effects varied by study design and child gender. The findings highlight that grandparental care is negatively associated with child mental health outcomes with trivial-to-small effect sizes. More supportive programs and interventions should be delivered to grandfamilies, especially in disadvantaged communities.

Mental Healthcare in Pediatrics During the COVID-19 Pandemic: A Call for International Public Health Action.

Public health measures associated with coronavirus disease 2019 (COVID-19), such as lockdowns and quarantine of suspected cases, can negatively affect children's mental health status. Although the current crisis provides personal growth and family cohesion opportunities, pitfalls appear to outweigh the benefits. The magnitude and quality of its impact on children depend on several factors, including anxiety, lack of social contact, and a reduced opportunity for stress regulation, along with an increased risk for parental mental health issues, child maltreatment, and domestic violence. Children with special needs and social disadvantages like trauma experiences, disabilities, pre-existing mental illness, e.g., autism spectrum disorders and hyperactivity, and low socioeconomic status, may be at higher risk in this context. Here, the potentials social support can provide for pediatrics, both healthy children and children with special needs, are reviewed after an overview of quarantine's adverse effects on this special population during a pandemic. The most common psychological issues associated with the COVID-19 pandemic are sleep disorders, mood swings, depression, anxiety, decreased attention, stress, irritability, anger, and fear. Moreover, the impact of COVID-19 on children's physical health includes weight gain, reduced physical activity, immune dysregulation, and cardiometabolic disorders. All support systems, involving parents, teachers/school counselors, pediatricians, mental healthcare workers, and Health and Art (HEART) groups, need to enter the scene and make their share of children's mental health care.

The Application of Participatory Art Education Curriculum Design Focused on the Psychological Well-being of Left-behind Children in Rural Revitalization

The future of rural areas hinges not only on the future of its people but particularly on the future of its children. Art must be integrated with education, delving into the realms of childrens psychology, rural culture, and social ecology. Furthermore, culture can reciprocally influence the economy, with the enhancement of spiritual culture having a positive impact on rural economic revitalization. This paper thus focuses on how to address the issue of adverse mental health conditions in children, improve their life skills, and enhance economic conditions in rural areas through participatory art education activities and design. By researching contemporary psychological issues among rural children, it grasps the fundamental problems and expounds on the concept of participatory art education in the context of rural revitalization. Scientific data analysis of various indicator systems is conducted using the Analytic Hierarchy Process (AHP), with Yantianzi Village in Hong Kong as an example. This paper creatively proposes an integrated system of participatory design and art education curriculum, encompassing culture, psychology, skills, and personality development. The aim is to use art education as a means to positively influence the rural economic improvement process, while also providing social value to the development of children and the overall cultural and economic thought of rural areas. This research contributes to the enhancement, refinement, and innovation of existing rural art education teaching systems.

‘The current mental health status of children and young people with JIA, and their wider family’: a charity partner collaboration survey

BackgroundThis paper presents insight into the scale of mental health concerns for families who have a child or young person with a diagnosis of Juvenile Idiopathic Arthritis (JIA) living in any of the four nations of the United Kingdom (UK). The study’s objective is to share the current experiences of those that responded to a charity survey and consider future work to improve mental health support.MethodsThis work was initiated and led by five UK charity partner organisations working with families affected by JIA. Parents/carers of a child or young person with JIA, and young people with JIA, submitted self-completion online questionnaires. The questionnaire asked 19 core questions, with a focus on the mental health impact of having and living with a JIA diagnosis. Questionnaires were delivered via charity partner UK-wide mailing lists and social media.ResultsQuestionnaire were completed by 291 participants over a 3-week period in February 2022. The majority of respondents were parents (229, 79%), 103 children had been diagnosed for over six years (35%), and 131 (45%) received shared care between paediatric rheumatology centres. In total, 168 (59%) children and young people with JIA had received, were currently receiving or were waiting for mental health support. Parents reported that their child’s diagnosis impacted their own mental health (218, 82%). Children and young people reported never being offered mental health support during appointments for JIA (157, 54%), and 71 (50%) of these had never received support.ConclusionChildren and young people with JIA have significant mental health sequelae from their diagnosis. Our findings found that nearly 60% of our respondents have had or are requiring mental health support, with significant numbers of parents/carers reporting difficulties in accessing care for their child’s mental health or their own mental health, due to their child’s diagnosis. This unique collaborative charity-led study, illustrates the importance of timely and accessible mental health support. Further work is needed to understand why best practice guidance for mental health support is not being met consistently and to identify how to embed it into standard rheumatology care.

Association of Food Insecurity Status with Resolution of Mental Health Conditions in Children and Adolescents.

Adverse consequences related to unresolved mental health issues underscore the importance of identifying factors that impede resolution of mental health conditions. Although studies have identified food insecurity as a risk factor for the diagnosis of mental health conditions, its impact on unresolved mental health issues is not understood. The objective of this study is to investigate the association of food insecurity status with resolution of depression, anxiety, and behavioral/conduct problems in children and adolescents. Using National Survey of Children's Health 2016 to 2019, logistic regression analyses examined the relationship of food insecurity status with the diagnosis and resolution of depression, anxiety, and behavioral/conduct problems in children (aged 5-11 years) and adolescents (aged 12-17 years). Mild, moderate, and severe food insecurity were significantly associated with higher odds of being diagnosed with depression, anxiety, and behavioral/conduct problems. Severe food insecurity was significantly associated with higher odds of unresolved behavioral/conduct problems in children (adjusted odds ratio [aOR], 10.09; 95% confidence interval [CI], 2.99-34.04), after adjustment for demographic covariates. In adolescents, severe food insecurity was significantly related to greater odds of unresolved depression (aOR, 6.64; 95% CI, 2.13-20.70), anxiety (aOR, 3.27; 95% CI, 1.31-8.14), and behavioral/conduct problems (aOR, 5.57; 95% CI, 2.09-14.85). These associations of severe food insecurity with unresolved mental health conditions were significant even after adjustment for the receipt of mental health care. Mild and moderate food insecurity were not significantly associated with unresolved mental health conditions. The findings suggest that severe food insecurity is associated with increased odds of unresolved mental health conditions in children and adolescents. This study highlights the importance of tailoring interventions to provide appropriate mental health services for children and adolescents from severely food insecure households.

Assessment and treatment of mental health conditions in children and adolescents: A systematic scoping review of how virtual reality environments have been used.

There is growing interest in the use of virtual reality environments (VREs) in psychological treatment and assessment. Most research has focused on the application of VREs in adult psychological disorders with fewer studies focusing on its applicability with children and adolescents. A systematic scoping review was undertaken of research assessing how VREs have been used in the treatment and assessment of childhood mental health disorders to provide an overview of the current state of the literature and identify future research directions. Systematic searches of online databases were conducted in PsycInfo, PubMed, Embase, Scopus, and Web of Science. Eleven studies met eligibility criteria and were included in this review, with the majority focusing on VRE interventions for anxiety-related disorders. There is also emerging support for VRE deep breathing training for anxiety, VRE assisted treatment of internet gaming disorder and anorexia nervosa, and VRE assessment of body image evaluation in anorexia nervosa. Most studies were pilot and feasibility studies with only three randomised-controlled trials (RCT). The current literature shows some promise for the use of VRE assessments and interventions of childhood mental health problems, particularly for anxiety-related disorders such as social anxiety and specific phobias. However, high-quality RCTs are now needed to establish effectiveness of VREs in this population, and how it compares to existing evidence-based approaches, given its promise to improve both engagement and outcomes.

Child Mental Health Status in Flint, Michigan: A Worsening Health Inequity, 2018-2022.

Objectives. To determine the burden of mental health disorders among children enrolled in Michigan's Flint Registry in the context of a local public health crisis and a nationally declared pediatric mental health crisis. Methods. This survey-based study included 1203 children aged 3 to 17 years whose caregivers enrolled them in the Flint Registry between December 2018 and March 2020 and who completed a follow-up survey between October 2020 and March 2022. The baseline and follow-up surveys included caregiver reports of childhood anxiety and depression and overall mental health wellness. Results. At enrollment, Flint Registry caregivers reported significantly higher rates of anxiety and depression among their children than caregivers reported nationally (12.9% vs 9.4% and 8.2% vs 4.4%; P < .001). Flint Registry caregivers also reported declines in their children's overall mental health wellness at follow-up, t(1472) = -4.17; P < .001. Conclusions. Our findings reveal a disparate burden of pediatric mental health disorders and exemplify the health inequities vulnerable populations face. Public Health Implications. More proactive and preventive steps should be taken to lessen this burden, especially in chronically disadvantaged communities that experience public health crises. (Am J Public Health. 2023;113(12):1318-1321. https://doi.org/10.2105/AJPH.2023.307406).

Caregiver experiences of racism and child mental health outcomes: cross-sectional analysis from Aotearoa New Zealand.

This study aimed to estimate the prevalence of vicarious racism experienced by children (0-14 years) in Aotearoa New Zealand and investigate the association between vicarious racism and diagnosed child mental health conditions. Adult and child 2016/2017 New Zealand Health Survey data were merged to create child-caregiver dyads. Multivariable logistic regression models were used to investigate the association between the caregiver experiences of racism (exposure) and diagnosed child mental health conditions (outcome), adjusting for confounders and exploring potential pathway variables. Looking at 2,989 dyads, the prevalence of "any" vicarious racism was higher for Māori (28.1%; 95% CI 24.2-31.9), Pacific (23.2%; 95% CI 17.9-28.5) and Asian (29%; 95% CI 23.6-34.5) children compared to European/Other children (12.5%; 95% CI 10.2-14.8). A statistically significant association was identified between >2 reports of vicarious racism and the outcome (OR= 2.53, 95% 1.18-5.43). Adding caregiver psychological distress reduced this association (OR= 1.92, 95% 0.91-4.08). Children in Māori, Pacific and Asian ethnicity groupings experience higher exposure to vicarious racism than those in the European/Other grouping. Multiple experiences of vicarious racism are associated with increased odds of diagnosed child mental health conditions in a dose-response distribution.