The past few weeks our column has been devoted to the theme of creating Mentally Healthy Communities, first with a focus on the workplace, and then with an emphasis on spirituality. This week’s article, the last in this mini-series, will focus on children, highlighting the premise that addressing mental health and disorder in children may be the most effective way to improve the mental health of the population at large.
Our articles have come from a collection of papers devoted to creating and maintaining mentally healthy communities in Canada. The World Health Organization defines mental health as a state of social and emotional well-being, not merely the absence of disorder. Which means that it is essential for optimal human development and functioning across the lifespan; yet at any given time an estimated 14 per cent of children in Canada (more than 800,000) experience mental health disorders that cause significant symptoms and impairment at home, school, and In the community.
Why is mental health important in children? Well, disorders cause distress and prevent them from thriving and reaching their potential. They also prevent full participation in school, work, family, and the community life over the long term. And unfortunately, some mental health disorders persist into adulthood, meaning that children with mental health disorders often become adults with mental health disorders, particularly if undiagnosed and untreated. I think it’s fair to say, and the paper argues, that mental health disorders are the leading health problems that Canadian children face after infancy.
The article highlighted a strategy aimed at improving children’s mental health, including approaches for both prevention and intervention, namely: promoting healthy development for all children; presenting disorders in children at risk; providing treatment for children with disorders; and monitoring outcomes for all children. Promoting healthy development for all children would include understanding the role the social environment has on mental well-being in children, which could include: reducing socio-economic adversity, reducing child maltreatment, and reducing the impact of parental mental illness. Preventing disorders for children at risk would include fostering and maintaining resiliency (the ability to overcome adversity) against risk factors at the child, family, school, and community level. Protective factors such as: positive temperament, good learning abilities, warm, and consistent parenting, safety and stability, positive school experiences, positive consistent adult supports, and a sense of personal purpose to help overshadow the opposing risk factors. Providing treatment for children with disorders would need to include improving access to timely, effective treatments and dealing with the inefficiencies that currently exist in children’s services. Treatment is only effective if money is also being put into preventative services given the large number of children affected.
I’ve heard this quote before, and the paper uses it to deliver on its point, that ‘children’s mental health has become the orphan’s orphan within the health care system.’ Waitlists for chemotherapy or heart surgery in children would not be tolerated – there would be media coverage, telethons, and public outcry. Yet, a community Child and Youth Mental Health office in the province could potentially receive over 1,500 referrals a year, have 60 children on the waitlist at any given time, have a wait time of two months for an initial intake, and only have a handful of therapists, and go unnoticed. Why? Perhaps the stigma associated with mental disorders, the invisibility of mental health disorders meaning that children go undetected, or maybe the naiveté that significant mental health disorders could even exist in childhood. Isn’t it time that children and all facets of their health and well-being are made a priority - I think the article sums it up nicely: “Investments in children’s mental health are among the most important investments that any community could make.”
Eryn Wicker (M.A., R.C.C.) is a mental health clinician with the Child and Youth Mental Health team of the Ministry of Children and Family Development, Chilliwack. BC.