Child Mental Health Issues Research Articles

Paediatric mental health training to school teachers in London, UK

IntroductionThe British National Foundation for Educational Research poll found that two thirds of school teachers feel they lack the appropriate training to help identify mental health issues in pupils.1 National Foundation for Education Research, http://www.gov.uk/government/uploads/DFE-June2015.I contacted 10 schools in London and teachers gave similar responses to the above poll, stating teachers did not feel confident identifying or managing common mental health issues in children and adolescents aged 5–18.AimTo deliver mental health training in a user friendly way to teachers and enable them to identify common mental health issues in young people.ObjectivesAddress underlying concerns teachers have regarding pupils mental health. Discuss strategies to manage common mental health issues.MethodI delivered a 2-hour training workshop to 25 teachers in two different schools in London, June 2016. The training included a lecture on emotional/behavioural and communication disorders in children. There was interactive discussion with teachers, discussing various scenarios, such as children becoming tearful, showing limited eye contact and displaying aggressive behaviour. We discussed how teachers were dealing with this and how better they could manage the situation.ResultsI got excellent feedback from teachers, 100% of teachers found the training very useful and would like to have more training of this kind in the future. A multidisciplinary approach is needed to improve the management of mental health in young people.ConclusionsThere is a gap in the knowledge teachers have on mental health within the young people and the stigma of mental health makes it more difficult for teachers to address these issues.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Development of a 22q11DS psycho-educational programme: exploration of the views, concerns and educational needs of parents caring for children or adolescents with 22q11DS in relation to mental health issues.

22q11.2 deletion syndrome (22q11DS) is a multisystem genetic condition with a broad phenotype. It is associated with a high prevalence of depression and anxiety during childhood and increased risk of schizophrenia in adulthood. Despite this, studies report that families may receive inadequate information of mental health (MH) risks at diagnosis. Therefore, this study investigated parents' experiences of caring for a child with 22q11DS, investigated their knowledge regarding the risk of MH problems and assessed the need for a psycho-educational programme. A qualitative design and purposeful sampling was utilized. Parents registered with the '22q11 Ireland' support group, and parents listed on the cleft palate database in a children's hospital in Ireland were invited to participate. Focus groups were held with 22 parents. Data were thematically analysed using Burnard's method of analysis. Most parents had some knowledge of the relationship between 22q11DS and an increased risk of MH issues. Parents reported that MH information relating to 22q11DS was mainly obtained from 22q11DS conferences, the '22q11 Ireland' support group and the Internet. Parents expressed a need for information to prevent or cope with their child's MH issues. Parents suggested that the following topics would be quite useful in a psycho-educational programme. These included information on the early warning signs of MH issues and guidance on when and how to tell the child about the condition and how to manage the child or young person's anxiety, obsessive behaviour or hearing voices. The findings indicated parental support for a psycho-educational programme that would provide relevant, accurate and timely information on how to effectively care for a child with 22q11DS MH needs.

The Syrian public health and humanitarian crisis: A ‘displacement’ in global governance?

ABSTRACTOngoing failure by the international community to resolve the Syrian conflict has led to destruction of critical infrastructure. This includes the collapse of the Syrian health system, leaving millions of internally displaced persons (IDPs) in urgent need of healthcare services. As the conflict intensifies, IDP populations are suffering from infectious and non-communicable disease risks, poor maternal and child health outcomes, trauma, and mental health issues, while healthcare workers continually exit the country. Healthcare workers who remain face significant challenges, including systematic attacks on healthcare facilities and conditions that severely inhibit healthcare delivery and assistance. Within this conflict-driven public health crisis, the most susceptible population is arguably the IDP. Though the fundamental ‘right to health’ is a recognised international legal principle, its application is inadequate due to limited recognition by the UN Security Council and stymied global governance by the broader international community. These factors have also negatively impacted other vulnerable groups other than IDPs, such as refugees and ethnic minorities, who may or may not be displaced. Hence, this article reviews the current Syrian conflict, assesses challenges with local and global governance for IDPs, and explores potential governance solutions needed to address this health and humanitarian crisis.

Functions of a group-based parenting program for parents of children with mental health issues-some observations from a tertiary care center

Child and adolescent mental health issues have a wide prevalence and cause serious burden and stress to the psychosocial health of parents and caregivers. Psychosocial interventions have proved to be useful adjuncts to pharmacological treatment in childhood psychiatric conditions because of their long standing nature and psychosocial implications. The present paper aims to identify and enlist the benefits of one such group-based parenting program practiced in a mental health services inpatient setting. The paper borrows from the experiences and observations of a psychiatric social worker who has considerable experience in conducting such group sessions. The material recorded here helps in understanding that parents and caregivers perceive benefits of significant magnitude from regular group session inputs, which help them to deal with the mental health issues of their children, and which also turn out to be a source of support.

32.1 CREATING BIG VALUE WITH BIG DATA: PRELIMINARY RESULTS

There is little doubt that big data research provides opportunities for a further understanding of child and adolescent mental health issues and more personalized and effective treatment approaches. The aim of this presentation is to show what is needed to start conducting big data research and how preliminary results can be translated to clinical care.

Mother's perceptions of child mental health problems and services: A cross sectional study from Lahore.

Objective:To assess the perceptions of mothers regarding child mental health problems, its causes, preferred treatment options, and to determine whom they would consult, if their child had a psychiatric illness.Methods:Following informed consent, a questionnaire covering perceptions regarding various aspects of child mental illness was used for data collection from mothers. They were asked to identify the symptoms and behaviours they considered psychopathological in children, which treatments they would prefer, where they would turn for help with a mentally ill child, and their understanding of the causes of child psychiatric disorders in addition to ways to increase awareness of child psychiatric issues in the society.Results:Ninety one mothers participated in the study. They equally perceived emotional, behavioural and cognitive symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, economic difficulties, social adversity and possession by evil spirits. A substantial proportion preferred medication, recitation of Holy Quran and psychotherapy as the preferred treatment options. Overall, mothers preferred consulting health professionals than religious scholars and faith healers. They were keen for steps to increase mental health awareness within their society.Conclusion:Despite different cultural perspective, mothers exhibit good understanding of symptoms of child mental health issues and appear open to various services and treatment options. Understanding parental perceptions and expectations from child psychiatric services are crucial in increasing families’ engagement in treatment.

Stigmatizing attitudes toward mental illness among primary school children in Kenya.

Literature describing stigmatizing attitudes towards people with mental illness by children in the developing world is lacking. Children's mental health issues in the Kenyan context are especially pertinent due to the increased likelihood of exposure to risk factors and the high prevalence of mental disorders. The objective of the current study was to examine socio-demographic factors associated with the endorsement of stigmatizing attitudes towards people with mental illness among Kenyan school children. We analyzed cross-sectional survey data from 4585 primary school-aged children in standards one through seven in the Eastern Province of Kenya. We examined relationships between the endorsement of stigmatizing attitudes and age, gender, district, religion, being in the standard appropriate for one's age, and parental employment status. Stigma scores decreased with increasing age (β = -0.83; 95 % CI = -0.99 to -0.67). Boys had higher stigma scores compared to girls (β = 1.55; 95 % CI = 0.86-2.24). Students from the rural district had higher average stigma scores as compared to those from the peri-urban district (β = 1.14; 95 % CI = 0.44-1.84). Students who were not in the standard appropriate for their age had lower stigma scores than those who were in the standard typical for their age (β = -1.60; 95 % CI = -2.43 to -0.77). Stigmatizing attitudes toward the mentally ill exist among primary school children in Kenya; thus, anti-stigma interventions are needed, and our findings highlight particular subgroups that could be targeted.

Parent Reports of Mental Health Concerns and Functional Impairment on Routine Screening With the Strengths and Difficulties Questionnaire

ObjectiveThis study used the Strengths and Difficulties Questionnaire (SDQ) to describe the prevalence of parent-reported mental health (MH) concerns in youth presenting for primary care appointments and to examine relationships between children's MH issues and functional impairment. We hypothesized that increased MH symptomology would be associated with increased impairment and family burden. MethodsParents of 4- to 17-year-old children were approached at routine visits in 13 primary care sites. Chi-square tests, independent sample t tests, and a 1-way analysis of variance (ANOVA) were used to make comparisons between demographic groups. Age-, sex-, and race-adjusted ordered logistic regression models and ANOVAs examined relationships between impact and SDQ scales. ResultsBoys had higher total Hyperactivity and Peer Problems. Adolescents showed higher Emotional Symptoms, while younger children showed more Hyperactivity. Latinos reported more Conduct Problems, Hyperactivity, and Peer Problems. Latinos also indicated less distress on the child, impairment at home and school, and family burden. Regression analyses indicated increased odds of impairment with higher scale scores. MH symptoms identified with the SDQ in pediatric primary care settings were associated with parent-reported impairment affecting youth and their families. ConclusionsThe presence of significant impairment suggests that parents' concerns identified by screening are likely to be clinically important and worthy of practice strategies designed to promote assessment, treatment, and referral for these common problems. Identifying and exploring parents' concerns with strategic use of screening tools may allow primary care providers to directly engage families around the MH issues that affect them most.

Overview of the Evidence Base for Family Interventions in Child Psychiatry.

This article provides updated information about evidence-based family interventions for child and adolescent mental health issues. The article reviews randomized controlled trials for family-based interventions carried out over the last 15 years. The studies were selected from an evidence-based clearinghouse search for family therapy, and specific child and adolescent psychiatric disorders. It is hoped this review guides clinical treatment and encourages clinicians to consider family involvement in treatment. This is specifically necessary when there is a limited response to psychopharmacologic and individual or group psychotherapy treatment.

Psychiatry's Next Generation: Teaching College Students About Mental Health.

The authors describe an integrated area of study for undergraduate college students that targets an increase in knowledge of mental health issues in children, adolescents, and emerging adults; encourages mental health service utilization on college campuses; and exposes young minds to the possibilities of working with children and adolescents in the mental health field. An overview of the program is provided, including the resources required to oversee and manage the program, student requirements, a description of the role that clinicians and researchers play as the program faculty, and an explanation of the tuition model. The program currently includes 40 courses with an annual enrollment of over 3000 students, resulting in departmental revenues that currently exceed $11 million per year. Student evaluations of the courses are very positive, and in a program survey students reported that their participation in the program had a positive impact on their life (84.2%) and impacted their career choice (60.2%). The benefits of the program include a valuable outreach to college students regarding the importance of seeking help for mental health issues, a positive influence on early career decision-making, opportunities for clinical and research educators to develop their scholarly areas of interest, and a significant source of departmental discretionary revenues.

Commentary: Improving the lives of individuals with serious mental illness.

A Dr. Satel’s Open Forum essay (1) illustrates, much has been said and written lately about the need to more adequately address the needs of people with serious mental illness and their families. Addressing these needs is a critical part of the overall mission of the SubstanceAbuse andMentalHealth Services Administration (SAMHSA). SAMHSA is also charged by Congress with helping to build resilience and emotional health, prevent substance abuse and mental illness and their disabling effects, implement current evidencebased practices, cultivate new practice models, and support individuals who are in recovery from mental and substance use disorders. SAMHSA has significant leadership responsibilities for substance abuse and mental health issues for children, adolescents, adults, and families. For example, SAMHSA is working with federal, state, and local partners to implement the Affordable Care Act and federal parity law, which together offer more than 60 million Americans expanded access to behavioral health treatment and services. This is the single largest expansion of mental health and substance abuse benefits in a generation. SAMHSAalsoworks to improveavailable treatments for people with schizophrenia, bipolar disorder, depression, and other serious conditions through policy making, distribution of grants, collection and dissemination of data, and clinician and public education. SAMHSA provides funds to address homelessness and criminal justice involvement, support mental health courts, create employment opportunities, provide outreach, and engage individuals with seriousmental illness whomight otherwise be in jail, on the streets, in emergency rooms, or not in treatment. Less than a third of SAMHSA’s budget is for mental health issues. The rest is appropriated to address substance use and addiction. Almost 80% of the mental health portion is targeted for persons with the most serious mental disorders. According to 2009 data, most of the funds spent in the United States for mental health services come from Medicaid (27%), private insurance (26%), state and local governments (15%), and Medicare (13%). The SAMHSA-administered mental health block grant is part of other federal spending on mental health care. Congress allocates these funds by formula to states for individuals with the most serious mental illnesses and allows states to determine the proportion to be used for adults and for children and the specific communitybased services to fund, as each state considers its Medicaid and other available funding. Congress recently implemented a 5% set-aside for individuals who are in the early stages of serious mental illnesses, including psychotic disorders. SAMHSA and the National Institute of Mental Health are providing states with guidance and assistance for this program. SAMHSA also funds grants to support family involvement in mental health care. To address treatment needs when traditional medications and psychiatric care are not effective or when they only partially help manage symptoms (2), a small portion of SAMHSA’s funding supports an annual conference about promising alternatives and adjunctive therapies. In addition, SAMHSA’s work in suicide prevention and disaster response saves thousands of lives each year, including the lives of many who do not have serious mental illness but who do have severe emotional responses that need attention to prevent devastating outcomes. Some critics have implied that SAMHSA should focus primarily on adults who meet criteria for certain diagnoses and who do not accept that they have a mental illness and do not agree to medical treatment. This group is one of themany SAMHSA is charged to address. As one commentator noted, all mental illness is serious, especially when symptoms cause concern or are not controlled (3). SAMHSA recognizes that behavioral health is essential to health and that mental and substance use disorders should be treated like any other health condition—when they are in a serious stage, when they are disabling, or when symptoms are under control. SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP) includes more than 330 model programs of all types and is just one part of SAMHSA’s commitment to disseminating evidence-based and promising practices. Any program developer—including those who create mandated treatment programs— can submit a program for review. If it is found to have sufficient research backing and is able to be replicated, it can be listed in NREPP. Through these and other initiatives, SAMHSA is changing the way mental illness is understood and treatment is provided. The recovery model advanced by SAMHSA and articulated by thePresident’sNewFreedomCommission on Mental Health in its 2003 report (4) includes helping those who are experiencing mental health conditions and their families receive Ms. Hyde is administrator of the Substance Abuse and Mental Health Services Administration, Rockville, Maryland (e-mail: pam. hyde@samhsa.hhs.gov).

Social Workers in Pediatric Primary Care: Communication, Gender, and Scope of Practice

While many child mental health issues manifest themselves in primary care, few pediatricians have received mental health training, and their communication with social workers may be limited due to unfamiliarity with mental health professions. The purpose of this study was to use ethnographic interviews to investigate factors affecting communication satisfaction between social workers and pediatricians. The study found that scope of practice issues were a communication barrier. This barrier is significant because health reform may lead social workers and pediatricians to collaborate more frequently in the future.

Increasing Awareness of Child Mental Health Issues among Elementary School Staff

Without sufficient education and training on mental illness, school teachers are less likely to have the capacity to recognize related symptoms in students and make appropriate referrals for care. The current pilot study tests the overall effectiveness of a new in-service training designed as the introductory component to a school-based mental health intervention. The training included information on the prevalence of mental health problems in the United States, common youth disorders, and treatment barriers that many families face. Participants’ knowledge before and after the training was measured using a 27-item instrument, and statistical significance was assessed for pre- to posttest changes for individual items. Results are overwhelmingly positive and provide evidence of an increase in accurate knowledge of child mental health issues. Implications for both practice and research are discussed.

Assessment of Mental Health Problems of School Children Aged 11-17 Years Using Self Report Strength and Difficulty Questionnaire (SDQ)

Introduction: It is now recognized that psychological disorders, among children and adolescents have high prevalence rate. Currently, there is limited data on the prevalence of mental health problems among adolescents especially in the developing country like Nepal. The objective of this study was to investigate the prevalence of mental health issues among school children aged 11-17 years. Materials and Methods: The self rated version of Strength and Difficulty Questionnaire (SDQ-YR1) were given to the students and answers were collected and the data was analyzed using SPSS version 16.1. The questions were in the Likert scale 0(not true), 1(somewhat true) and 2(certainly true). The data collected also included parent’s educational and occupational status. Results: A total of 159 students participated in the study after receiving well informed consent from the parents. There were 96(60%) boys and 63 (40%) girls’ participants in the study. Among all the participants in this study 18.6% had a total-Strength and Difficulty Questionnaire (SDQ) score that can be classified as abnormal by published cutoffs. The emotional problems (24.5%) and peer relationship problem (22%) were the two common problems screened as an abnormal SDQ score. Girls were significantly more likely to have emotional problems than boys (p value <0.05) where as boys were significantly more likely to have Hyperactivity/inattention score in SDQ than girls (p value<0.05).Gender difference was also significant statistically as girls had higher abnormal total SDQ score than boys (p value < 0.05). Conclusion: There is high prevalence of mental health issues in children but a study in large sample is recommended. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8752 J. Nepal Paediatr. Soc. 2013;33(3):172-176

More data needed on children's mental health and wellbeing

In this article, Dorothy Lepkowska looks at current mental health issues in children and young people and explains why more data is urgently needed.

Medicalisation and changes in advice to mothers about children's mental health issues 1970 to 1990 as compared to 1991 to 2010: evidence from Chatelaine magazine

In this article, I examine the ways in which the portrayal of children's mental health issues has changed in a high-circulating mass print magazine, Chatelaine, in Canada over the last four decades of the twentieth century through the advice given to mothers regarding their children's behaviour and emotions. I selected these four decades as they reflect the rapid growth in medicalisation, risk society, neoliberalism and intensive mothering and corresponding medical treatment for diagnosed children's mental health issues. I divided the 40 years into two 20-year periods so that I could compare and contrast the ways in which child mental health issues were represented. There were continuities between the two periods, particularly in regard to the focus on emotion work and management; there were also important differences. During this period, the changing content of the magazine indicated an increasing pathologisation of individual children through increased coverage of the risks of psychiatric diagnoses and the possibility of pharmaceutical and other biomedical interventions.

Advice to mothers about managing children's behaviours in Canada's premier woman's magazine: a comparison of 1945-1956 with 1990-2010

Recent research and theorizing has characterized contemporary mothering as medicalized, intensive and risky. The rate of diagnosis of children's mental health issues has grown rapidly, particularly since the 90s. This paper examines the construction of mothering in regard to children's behaviours and mental health through an exploratory and qualitative content analysis of the portrayal of advice to mothers in Chatelaine Magazine, the premier women's magazine published in Canada. The time periods chosen for comparison were 1945–1956 and 1990–2010. The first period was selected because it was a time of dramatic changes that occurred in family, occupational and domestic life for women immediately after World War II. The second represents the modern period. The findings of the paper suggest that mothering was intensive, medicalized and risky in both periods although the conceptualizations of problems differed.

Mental health in Iraq: issues and challenges

Little research has been done into the mental health of Iraqis. Only one national survey is available—the Iraq Mental Health Survey (IMHS) of 2007, with 4332 respondents—which showed that anxiety disorders were the most common group (13·8%) and major depressive disorder the most common disorder (7·2%). 1 Alhasnawi S Sadik S Rasheed M et al. for the Iraq Mental Health Survey Study GroupThe prevalence and correlates of DSM-IV disorders in the Iraq Mental Health Survey (IMHS). World Psychiatry. 2009; 8: 97-109 PubMed Google Scholar Child and adolescent mental health issues are particularly important: the IMHS reported substantially increasing lifetime prevalence of most disorders across generations, and individuals younger than 18 years constitute almost half the population. 2 WHOMental Health Atlas 2011—Iraq. http://www.who.int/mental_health/evidence/atlas/profiles/irq_mh_profile.pdf Google Scholar Since 2008, myself and colleagues at the Johns Hopkins Bloomberg School of Public Health have done assessments of needs, and research into the feasibility and effect of mental health treatments in Iraq. These assessments have confirmed the importance of mental health problems among the many adult survivors of trauma in both Iraqi Kurdistan 3 Bolton P, Michalopoulos L, Ahmed A, Murray LK, Bass J. The mental health and psychosocial problems of survivors of torture and genocide in Kurdistan, northern Iraq: a brief qualitative study. Torture (in press). Google Scholar and southern Iraq (unpublished). In both regions most participants described substantial symptoms of depression, anxiety, and post-traumatic stress. Civilian mortality after the 2003 invasion of IraqA historical view of the war in Iraq is essential to the understanding of the internecine controversies that arose about the validity of mortality studies, and the political pressures that influenced their interpretation to the world. The US Department of State (DoS) and US Agency for International Development (USAID), which were responsible for humanitarian assistance and recovery, were aware that, in prolonged warfare, preventable mortality and morbidity can exceed direct deaths from violence as public health infrastructure and social protections rapidly deteriorate. Full-Text PDF Physical rehabilitation services in IraqIn Iraq, little information is available to describe the scope of disability. However, WHO estimates that about 0·5% of the world population is in need of a prosthetic or orthotic device.1 This figure would mean that, of roughly 31 million Iraqi citizens,2 155 000 are in need of devices. As per standards of the International Society for Prosthetics and Orthotics and WHO, one qualified prosthetist or orthotist with three assistants can manufacture 250 devices per year; the lifespan of an appropriate device (ie, one that is well made, well aligned, fitted, and finished cleanly) is 3 years. Full-Text PDF When the violence of war comes homeThere has been considerable focus on documenting the psychopathological sequelae of deployment-related trauma, but, despite much speculation, few data are available to ascertain the risk of violence arising from deployments. In The Lancet, Deirdre MacManus and colleagues1 extend the findings from self-report studies and use the data from criminal records to show for the first time the link between combat and interpersonal violence. The consequences of interpersonal violence are enormous in terms of human suffering, even greater than those caused by non-interpersonal trauma. Full-Text PDF

The importance of the couple relationship for children's mental health

This paper reviews the links between distressed couple relationships and adult and child mental health issues. It shows that the quality of couple relationships has an effect on a range of public health concerns that health visitors are involved with. It is implicated in adult and child mental health, in physical health, and in the attachment status of children. This paper reviews research evidence which suggests that focusing on the couple relationship can give greater benefits than focusing on parenting alone. The more couples that can manage their conflicts in a cooperative way, the better the outcomes for their children. It offers pointers for practice on the basis that health visitors are ideally placed to work with families through ‘thinking couple’ as well as ‘thinking parent’.

Disaster Research Team Building: A Case Study of a Web-based Disaster Research Training Program.

This case study describes the process and outcomes of the Northwest Center for Public Health Practice Child and Family Disaster Research Training (UWDRT) Program housed at the University of Washington, which used web-based distance learning technology. The purposes of this program were to provide training and to establish a regional cadre of researchers and clinicians; to increase disaster mental health research capacity and collaboration; and to improve the scientific rigor of research investigations of disaster mental health in children and families. Despite a number of obstacles encountered in development and implementation, outcomes of this program included increased team member awareness and knowledge of child and family disaster mental health issues; improved disaster and public health instruction and training independent of the UWDRT program; informed local and state disaster response preparedness and response; and contributions to the child and family disaster mental health research literature.