Charlotte Waddell

Children, anxiety and learning

June 28, 2007

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Over 800,000 Canadian children suffer from social and emotional problems that interfere with their learning and development. Mental disorders often develop as a result, persisting into adulthood and costing Canadians more than $14 billion annually.

Yet almost none of Canada’s considerable health spending goes toward prevention programs that might stop mental disorders from developing in childhood.

That’s why the Faculty of Health Sciences’ new Children’s Health Policy Centre recently conducted a systematic review of all the existing research on prevention programs to see which might work in Canada.

"We wanted to give some assistance to policy-makers who had asked us which programs had a meaningful impact for children and deserved further investment," says Charlotte Waddell, (above) SFU’s Canada Research Chair in children’s health policy. She led the review and heads the centre.

"We identified several programs that seem to have very good effectiveness for preventing serious anti-social behaviour or for preventing anxiety and depression."

The review, ‘Preventing Mental Disorders in Children’ was published in the May/June 2007 issue of The Canadian Journal of Public Health.

Two of the identified programs, Nurse Home Visitation and Perry Preschool, involve teaching at-risk families in disadvantaged circumstances how to better manage their parenting and the social and emotional needs of their children. Nurse Home Visitation begins with prenatal care and carries on to include parent education until the child is two-years-old. Perry Preschool, also for high-risk families, provides early child education as well as parent training while children are in their pre-school years.

Long-term follow-up for both programs revealed that as the children grew up, they were far less likely to engage in serious anti-social behaviour and were far more likely to finish school, find meaningful work and participate in their community.

The team identified two other effective programs for slightly older children. One of them, Friends, is a 16-week program that teaches children coping strategies for dealing with issues that worry or scare them such as shyness, bullying and problems at home. Friends has been shown to prevent both anxiety and depression. The other program, Coping with Stress, teaches children similar skills with good results in preventing depression. Both programs can be delivered in schools.

What the team also found is that very few provinces in Canada are delivering programs like those identified in the research, even though these programs are not inordinately expensive. One exception is in B.C., where the Ministry of Children and Family Development is piloting the Friends program in schools across the province, with good results so far. "We encourage more policy-makers to consider investing in prevention," says Waddell. "Surely investments in mental health are among the most important investments that we as Canadians can make."

Why is Charlotte Waddell so passionate about children’s mental health problems?

It all stems from a high school job in Hamilton, Ontario where she worked with inner-city kids. The experience taught her what it means to be severely disadvantaged in Canadian society. Then there was her master’s research in Brazil, where she studied the effects of malnutrition on children of migrant agricultural workers. Finally, an eight-year stint as a health policy-maker with B.C.’s First Nations taught her the importance of addressing underlying social disparities that contribute to mental health problems, starting in childhood. These experiences propelled her back to university to become a physician and then a child psychiatrist and researcher.

Today, Waddell is a Canada Research Chair in children’s health policy and head of SFU’s new Children’s Health Policy Centre. There is no question, she says, that children growing up in adverse circumstances are more likely to develop mental health problems such as anti-social behaviour, anxiety and depression. Yet with the right mix of early childhood interventions, many of these problems can be prevented. Her goal: to give Canadian public policy-makers the information they require to address this urgent need.

Waddell continues to practice as a child psychiatrist working with children who are in trouble with the law. "Most have had serious neglect and abuse issues and mental health problems stemming from their circumstances." Yet she sees a great deal of hope. "We find they’ve been disenfranchised from basic community and adult supports," she says. "But with the right supports, these children can go back to school, develop their talents and go on to deal with their mental health problems and life circumstances." The experience of working with these children informs her research, making her even more committed to working with policy-makers and public groups to find effective ways to better address the causes of mental health problems much earlier in life.

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