An estimated one in eight children from high-income countries, including Canada, has a mental health disorder at any given time, according to research from Simon Fraser University (SFU).
Health Sciences Professor Charlotte Waddell specializes in child and youth mental health, health policy, determinants of health and children’s rights. She is also the director of the Children’s Health Policy Centre at SFU’s Faculty of Health Sciences, an interdisciplinary research group focused on improving social and emotional wellbeing for all children, and on the public policies needed to achieve this.
To determine the mental state of children in high-income countries, Waddell, lead author Jen Barican—now an SFU alumnus—and the research group considered close to two decades of research from 11 countries covering more than 60,000 children aged four to 18. The countries included Australia, Canada, Chile, Denmark, Great Britain, Israel, Lithuania, Norway, South Korea, the United States and Taiwan. The research indicated that even in affluent countries, many children experience symptoms and impairment relating to mental health problems. Yet only 44.2 per cent of children with mental disorders are receiving any services and support for these conditions. This is despite effective prevention interventions being known for most disorders and effective treatments being known for all.
The paper, Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking, discusses the implications, particularly the need to substantially increase public investments in effective mental health interventions. It also discusses the urgency of providing these interventions, given that the challenges have increased since the start of the COVID-19 pandemic.
We met with Professor Waddell to discuss her findings.
Can you describe some of the mental health disorders children are experiencing according to the study?
The overall prevalence of any childhood mental disorder was 12.7 per cent, with the most common conditions being anxiety disorders (5.2 per cent); attention deficit hyperactivity disorder (ADHD) (3.7 percent); oppositional defiant disorder (3.3 per cent); substance use disorder (2.3 per cent); conduct disorder (1.3 per cent); and major depressive disorder (1.3 percent). Among those with disorders, over one quarter of young people had two or more disorders concurrently. Concerningly, again, less than half of children with mental disorders received any services for these conditions.
Why do you think so many young people are experiencing mental health disorders?
These rates are comparable to past reviews we have done, which speaks to the issue of service shortfalls being chronic—but we can bring these numbers down if we significantly augment children’s mental health services, particularly by adding prevention programs. For the most common disorders, prevention programs have proven effectiveness. Other countries, such as Australia have been able to increase children’s access. We can, too!
What are some of the barriers to prevention and treatment?
The biggest barrier is insufficient availability of both prevention and treatment options that can be accessed in a timely way when the needs first arise. We would not likely accept only 44 per cent of children with cancer accessing needed services—but we are doing so for mental health. Another barrier may be public awareness. Unless you have experienced the problem, it is perhaps difficult for many people to imagine the consequences—the avoidable distress, symptoms and inability to fully participate for children with these health problems, particularly when they cannot get the services they need. Yet another barrier may be the difficulty many people have investing in prevention, that is, when we are averting an event—a disorder—which has not happened yet. But the public health evidence is very strong. There are many excellent studies showing we can indeed prevent many of the most common childhood mental disorders.
The Children’s Health Policy Centre recently began participating in a new study investigating how COVID-19 public health measures—such as school closures, distancing and masking—have affected children’s day-to-day lives. Based on your previous work and experience, what do you think needs to happen right now to help improve the mental well-being of children?
Addressing children’s mental health first requires a coherent central policy commitment and leadership to make this issue a priority and ensure sustained engagement across all relevant public sectors. This includes children’s services, public health and healthcare, public health and education.
Addressing children’s mental health also requires the development of comprehensive plans for reducing the avoidable adversities that contribute to the development of selected childhood mental disorders such as socioeconomic disparities, while also preventing disorders in children at risk, providing treatment for all children with disorders and tracking population outcomes through surveillance programs.
As well, given how few children with mental disorders are receiving any services for these conditions, British Columbia will need to substantially increase children’s mental health budgets.
The need for public action is essential if all children are to flourish. This collective flourishing will in turn benefit all of us—with fewer children needlessly experiencing mental disorders and associated disability, and ensuring that children go on to thrive, contribute and meet their full potential.
To learn more visit: The Children’s Health Policy Centre at SFU.
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