By Iris Smith, Ph.D.

The term “mental health” encompasses several different cognitive, social, emotional, and behavioral domains that affect long term health and function. It affects how we respond to our environment, our interactions with others, how we manage stress, and make decisions. Good mental health in children includes indicators such as timely achievement of developmental milestones, healthy social and emotional development, regulatory, and coping skills. Poor mental health during childhood, especially when symptoms are serious enough to meet diagnostic criteria for a mental disorder, can have significant negative impacts on adult physical health, social function, employment, and mortality in adulthood.[1]

A CDC report summarizing data from 2013-2019 obtained from nine federal surveillance systems in the U.S. that collect data on children’s mental health found that 20.9% of 12–17-year-olds had experienced a major depressive episode at some point in their lives, 36.7% reported persistently feeling sad or hopeless in the past year and 18.8% had seriously contemplated suicide.[2]  Survey questions that inquired about receipt of mental health services indicated that many of the children in need of such services did not receive them.

The report found that the prevalence of specific mental health disorders varied based on ethnicity, rural or urban residence and income level, highlighting the importance of viewing mental health in the context of social determinants of health and health disparities.² More recently, the social disruptions resulting from the COVID epidemic may have also contributed to an increase in mental health disorders including substance use among adolescents. Data from the Adolescent Behaviors and Experiences Survey found that between January and June of 2021, 31.6% of high school students reported current use of tobacco products, alcohol, marijuana, or misuse of prescription opioids.[3] 

There are many factors that influence mental health. Children of mentally ill or substance abusing parents[4]^,[5] immigrant and refugee children, and children of incarcerated parents, children in war-torn areas, and those exposed to endemic community stress and violence may have an elevated risk of developing mental health problems. [6] There is a need for more evidence-based treatment and intervention strategies that address the specific needs of these vulnerable groups. Often families experience clusters of risk factors which can have negative impacts for parents as well as children.  A recent systematic review of published studies on family focused interventions found a “distinct lack of evidence” for family focused interventions for families with clustered risk factors. [7]  The collaborative mental health care model in pediatric primary care can be effective in connecting and coordinating care for troubled children and their families.[8]

Resources

Allen K, Melendez—Torres GJ, Ford T, Bonell C, Finning K, Fredlund M. (2022) Family Focused Interventions that Address Parental Domestic Violence and Abuse, Mental Ill-Health and Substance Abuse in Combination:  A Systematic Review.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9337671/

Bitsko RH, Claussen AH, Lichstein J et al. (2022). Mental Health Surveillance Among Children- United States, 2013-2019.  Morbidity and Mortality Weekly Report (MMWR) Suppl 2022; 71 (Suppl 2): pg. 1-42.  http://dx.doi.org/10.15585/mmwr.su7102a1

Centers for Disease Control and Prevention. Resources on Children’s Mental Health

Johnson EI and Arditti JA (2023)  Risk and Resilience Among Children with Incarcerated Parents:  A Review and Critical Reframing.  Annual Review of clinical Psychology 2023 19(1). https://www.annualreviews.org/doi/10.1146/annurev-clinpsy-080921-081447?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed