Study reveals fourfold range in rates of mental health problems among US children based on relational and social risks

Date:
January 25, 2022
Source:
Johns Hopkins University Bloomberg School of Public Health
Summary:
The analysis, based on 2016-2019 data survey responses covering
nearly 132,000 children ages 3 to 17, examined the complex interplay
between common mental health problems among children, social and
relational health risks, and protective factors.



FULL STORY ==========================================================================
A large multi-year study based on 2016-2019 data found that children
facing relational and social risks are more likely to have mental,
emotional, or behavioral health problems, but the negative impact of these problems on child resilience, self-regulation and school engagement can
be offset by protective factors such as strong caretaker-child connection
and family resilience.


==========================================================================
The study, led by researchers at Johns Hopkins Bloomberg School of Public Health, also found that children who were facing relational risks only,
such as substance abuse among family members, were more likely to have
mental, emotional, or behavioral concerns than those who were only facing social risks, such as economic hardship.

The findings are published as the U.S. and other countries face a
crisis in children's mental health exacerbated by the pandemic. The
study appears online in the January 2022 issue of Child and Adolescent Psychiatric Clinics of North America.

The study found that, overall, 21.8 percent of U.S. children ages 3 to
17 have one or more of the common mental, emotional, and behavioral
health conditions assessed. The prevalence of mental health problems
across U.S. children ranged from about 15 to 60 percent, increasing with
the type (social, relational, or both) and number of these risks that
children had been exposed to.

The analysis, based on survey responses covering nearly 132,000 children
ages 3 to 17, examined the complex interplay between common mental
health problems among children, social and relational health risks,
and protective factors.

"If we treat children with mental, emotional, and behavioral problems
without individually and collectively addressing social and relational
health risks, or even assessing them, which is often the case, we are
missing some of the biggest factors driving the mental and emotional
suffering of our children," says study leader Christina Bethell, PhD, MPH,
MBA, professor in the Department of Population, Family and Reproductive
Health and director of the Child and Adolescent Health Measurement
Initiative at the Bloomberg School.



========================================================================== Research suggests that both social and relational health risks contribute
to mental, emotional, and behavioral health problems in children. Much
prior research has focused on individual social and relational health
risks. The new study investigated both the individual and combined
effects of these factors on U.S. children.

For their analysis, Bethell and her colleagues gathered data from
the National Survey of Children's Health, an annual survey led by the
U.S. Health Resources and Services Administration's Maternal and Child
Health Bureau in collaboration with the U.S. Bureau of the Census. The
survey, administered to thousands of parents and caregivers each year,
provides data on multiple, intersecting aspects of children's lives -- including physical and mental health, access to quality health care,
and the child's family, neighborhood, school, and social context.

The study found that over two-thirds of children with mental health
conditions experienced at least one of the eight evidence-based social
or relational health risk factors examined in the analysis compared to
about half of children without mental health conditions.

Factors examined included economic hardship, food insecurity, unsafe neighborhood, racial discrimination, multiple Adverse Childhood
Experiences (ACEs) like substance abuse or domestic violence, poor
caregiver mental health, and low levels of caregiver coping or high
aggravation with their child.

Relational -- versus social health risks -- were both more prevalent
among children with mental health problems and had a stronger association
with these conditions. Nearly one-third of children with mental health
problems experienced both types of risks.



==========================================================================
A key focus of the study was on identifying opportunities to promote
positive outcomes among children with mental, emotional, and behavioral conditions who also experience social and relational health risks, with
a focus on their engagement in school and building their own resilience, assessed as the ability to regulate emotions and behavior when facing challenges.

Researchers found that the chances a child was engaged in school were 77 percent less if they lacked self-regulation. Offering hope, the chances
a child with mental health problems demonstrated good self-regulation --
a key component of resilience -- were 5.73 times greater when children
also experienced stronger parent-child connection. These odds were over
2.25 times greater when their family reported staying hopeful and could identify strengths to draw on during difficult times. Findings were
consistent across all levels of social and relational health risks.

Bethell notes that both parent-child connection and family resilience are learned behaviors that can be strengthened through supports to families
and skills building. Bethell notes that the American Academy of Pediatrics recommend promoting these factors during routine well-child check-ups,
through schools, in mental health treatment, and in the community
at large.

"There is a mental, emotional, and behavioral health crisis for children
in our country, but most children with these conditions have risk factors
that we can identify and do something about," says study co-author
Tamar Mendelson, PhD, MA, a Bloomberg Professor of American Health in
the Bloomberg School's Department of Mental Health. "Ultimately, we
need to address the structural and systemic issues that threaten young
people's well-being; at the same time, there is a lot we can be doing
to decrease risk factors for families." This study was funded by the
Robert Wood Johnson Foundation.

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Content may be edited for style and length.


========================================================================== Journal Reference:
1. Christina D. Bethell, Andrew S. Garner, Narangerel Gombojav,
Courtney
Blackwell, Laurence Heller, Tamar Mendelson. Social and
Relational Health Risks and Common Mental Health Problems Among
US Children. Child and Adolescent Psychiatric Clinics of North
America, 2022; 31 (1): 45 DOI: 10.1016/j.chc.2021.08.001 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220125112533.htm

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