Major study finds one in five children have mental health problems
Results from the Ontario Child Health Study (OCHS)
April 17, 2019
Science Daily/McMaster University
One in five Ontario children and youth suffer from a mental disorder, but less than one-third have had contact with a mental health care provider, says the Ontario Child Health Study (OCHS).
Although those overall results echo a similar study from 1983, the new study found a much larger proportion of children and youth with a disorder had contact with other health providers and in other settings, most often through schools.
The new study, called the 2014 OCHS for when data collection started, found that the patterns of prevalence among different sexes and age groups have changed.
Hyperactivity disorder in boys four to 11 years old jumped dramatically from nine to 16 percent, but there has been a substantial drop in disruptive behaviour among males 12 to 16 years old from 10 to 3 per cent. There has been a steep increase in anxiety and depression among both male and female youth from 9 to 13 per cent.
At the same time, there was a significant rise in perceptions of need for professional help with mental health disorders, rising from seven per cent in the original OCHS in 1983 to 19 per cent in the 2014 OCHS. However, the study authors say it is difficult to estimate whether it is tied to the growing prominence of anti-stigma and mental health awareness campaigns over the past three decades.
In 30 years, the prevalence of any disorder increased in communities with a population of 1,000 to 100,000, rather than large urban areas, and there is strong evidence that poor children are more likely to have a disorder if their neighbourhood is one where violence is more common.
The study also found that in the past year more than eight per cent of youth thought about suicide, and 4 per cent reported a suicide attempt.
The 2014 OCHS study included 10,802 children and youth aged four to 17 in 6,537 families. It replicated and expanded on the landmark 1983 Ontario Child Health Study of 3,290 children in 1,869 families.
The Canadian Journal of Psychiatry has simultaneously published eight papers on different aspects of the 2014 OCHS results.
"This is a very robust study we feel represents the situation in Canada," said Michael Boyle, co-principal investigator of the study. "That means there are more than a million Canadian children and youth with a mental health problem. This needs to be addressed."
Co-principal investigator Kathy Georgiades added: "This study underscores the continued need for effective prevention and intervention programs."
https://www.sciencedaily.com/releases/2019/04/190417153803.htm
Exclusion from school can trigger long-term psychiatric illness
August 29, 2017
Science Daily/University of Exeter
Excluding children from school may lead to long-term psychiatric problems and psychological distress, a study of thousands of children has shown.
Research by the University of Exeter, published in the journal Psychological Medicine found that a new onset mental disorder may be a consequence of exclusion from school.
The study, also found that -- separately -- poor mental health can lead to exclusion from school.
Professor Tamsin Ford, a child and adolescent psychiatrist at the University of Exeter's Medical School, warned that excluded children can develop a range of mental disorders, such as depression and anxiety as well as behavioural disturbance. The impact of excluding a child from school on their education and progress is often long term, and this work suggests that their mental health may also deteriorate.
The study is the most rigorous study of the impact of exclusion from school among the general population so far and included a standardised assessment of children's difficulties.
Consistently poor behaviour in the classroom is the main reason for school exclusion, with many students, mainly of secondary school age, facing repeated dismissal from school. Relatively few pupils are expelled from school, but Professor Ford warned that even temporary exclusions can amplify psychological distress.
Professor Ford, who practises as a child and adolescent psychiatrist as well as carrying out research, said identifying children who struggle in class could, if coupled with tailored support, prevent exclusion and improve their success at school, while exclusion might precipitate future mental disorder. These severe psychological difficulties are often persistent so could then require long-term clinical support by the NHS.
Professor Ford said: "For children who really struggle at school, exclusion can be a relief as it removes then from an unbearable situation with the result that on their return to school they will behave even more badly to escape again. As such, it becomes an entirely counterproductive disciplinary tool as for these children it encourages the very behaviour that it intends to punish. By avoiding exclusion and finding other solutions to poor behaviour, schools can help children's mental health in the future as well as their education."
Exclusion from school is commoner among boys, secondary school pupils, and those living in socio-economically deprived circumstances. Poor general health and learning disabilities, as well as having parents with mental illness, is also associated with exclusion.
The analysis by a team led by Professor Ford of responses from over 5000 school-aged children, their parents and their teachers in the British Child and Adolescent Mental Health Surveys collected by the Office of National Statistics on behalf of the Department of Health found that children with learning difficulties and mental health problems such as depression, anxiety, ADHD and autism spectrum conditions were more likely to be excluded from the classroom.
The research team found more children with mental disorder among those who had been excluded from school, when they followed up on their progress, than those who had not. The research team omitted children who had a previous mental disorder from this analysis.
The researchers concluded there is a 'bi-directional association' between psychological distress and exclusion: children with psychological distress and mental-health problems are more likely to be excluded in the first place but exclusion predicted increased levels of psychological distress three years later.
Claire Parker, a researcher at the University of Exeter Medical School, who carried out doctoral research on the project said:
"Although an exclusion from school may only last for a day or two, the impact and repercussions for the child and parents are much wider. Exclusion often marks a turning point during an ongoing difficult time for the child, parent and those trying to support the child in school."
Most research into the impact of exclusion has so far involved the study of individuals' experience and narratives from much smaller groups of people chosen because of their experience, which may not be so representative.
This study included an analysis of detailed questionnaires filled in by children parents and teachers as well as an assessment of disorder by child psychiatrists, drawing on data from over 5000 children in two linked surveys to allow the researchers to compare their responses with students who had been excluded. This sample from the general population included over 200 children who had experienced at least one exclusion.
The report concluded: "Support for children whose behaviour challenges school systems is important. Timely intervention may prevent exclusion from school as well as future psychopathology. A number of vulnerable children may face exclusion from school that might be avoided with suitable interventions."
Professor Ford added: "Given the established link between children's behaviour, classroom climate and teachers' mental health, burn out and self-efficacy, greater availability of timely support for children whose behaviour is challenging might also improve teachers' productivity and school effectiveness" .
https://www.sciencedaily.com/releases/2017/08/170829124507.htm