Mental health is one of those topics that seems to be left out of many conversations. Maybe it's because there is a stigma to it, or it makes us uncomfortable. If we don't talk about it for adults, we ignore it even more for our children. Whatever the reason, mental health is an important part of being human.
Mental health, according to the World Health Organization, is not just the absence of disorder. Rather, it is "a state of social and emotional wellbeing." As such, it is a resource for living and functioning during our whole lives. Nevertheless, most disorders originate in childhood, making this the best time to intervene; early prevention to avoid needing treatment later.
At any given time, some 14 per cent of our children, or about 800,000 in Canada, experience mental disorders causing symptoms and impairment. These figures come from a study of children aged four to 17 in Canada, the U.S. and Great Britain. To be included in the count, children had to meet a high threshold, displaying significant symptoms and impairment.
The survey found that 6.4 per cent of children experienced some form of anxiety disorder (for B.C., that is about 42,000 children). Attention-deficit/hyperactivity was found in 4.8 per cent; conduct disorder was present in 4.2 per cent; and any depressive disorder showed up in 3.5 per cent of children in the study.
The starting point for understanding mental health from an early childhood development perspective is to look at causation. Research on causal factors suggests a combination of genes and environment. Socioeconomic disparities in childhood are known to also affect school entry preparedness.
These disparities have also been shown to predict mental health problems in adulthood. Thus, improving socioeconomic status for the most disadvantaged families is associated with reducing the incidence of behavioural disorders for children from these families.
Canadian health policy has typically emphasized the downstream side of mental health disorders. That is, treating the problem with specialized services once it has developed.
Despite this, an estimated three-quarter of children with mental disorders do not receive any specialized treatment. The response must be to aim at the prevention end of the treatment spectrum, that is, upstream in early childhood before disorders develop. Once they have, ensuring children can access treatment is crucial.
But what can we do to prevent mental disorders? Certainly, not all of these are preventable, but considerable research on risk factors shows prevention programs can work.
Risk factors include difficult temperament, learning difficulties, negative parenting (parental conflict, harshness or inconsistency), child maltreatment and more. Improving any of these factors reduces the chance for mental health problems downstream.
Resilience, the ability to overcome adversity and to thrive in difficult contexts, is a very powerful antidote to later problems. Children who are resilient exhibit characteristics like good learning abilities, warm and consistent parenting, safety and stability and ongoing, positive adult support.
Canadians make little investments in programs aimed at prevention mental disorders in young children, but that is exactly where funding would do the most good. Ethically, we must do this because all children have the right to thrive and meet their potential.
Dr. Paul Martiquet is the Medical Health Officer for the Sea to Sky.
