Highlights in child mental health research: April 2021

Highlights

• Kids Helpline is the only national helpline for children and youth (aged 5 – 25 years). It provides free information and counseling via telephone, email, and WebChat.
• This study explored patterns in the use of Kids Helpline in Australia by children and young people during the COVID-19 pandemic.
• The study mainly analysed combined data of children and young people aged 5 to 25 years but did report some findings specific to children aged 5 to 12 years.
• Key findings included:
  • The pandemic was associated with a swift and significant increase in overall demand for Kids Helpline. This increase was almost completely in the WebChat delivery method. For example, the monthly increase in demand for WebChat almost tripled in 2020 with the onset of the pandemic.
  • There was an increase in the number of contacts related to mental health, suicide/self-harm, and familial relationships.
  • The number of counselling contacts increased during the pandemic, including for children aged 5 to 12 years.
• The study also found that changes in overall demand appeared to be associated with fluctuations in the pandemic’s severity in Australia. Possible explanations offered for this pattern included:
  • The negative effects of the pandemic on emotional and psychological functioning.
  • COVID-19 restrictions limiting access to social support networks and in-person services.
• The authors suggest that further research is needed to explore the use and effectiveness of different modalities of providing helpline support to children and young people; this is especially needed for text-based modalities, e.g., WebChat, given increasing evidence to suggest that this method may be a preference for children and young people.

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Highlights

• This article reviews the potential impact of the COVID-19 pandemic on the mental health of infants and their mothers. The review focuses on the period from pregnancy until shortly after birth.
• The authors review the latest research on perinatal mental health during COVID-19. They also draw on literature from similar disaster situations to gain insights into possible impacts on infant and maternal mental health, as well as potential flow-on effects for child development.
• There is emerging research to suggest that the COVID-19 pandemic has been associated with increased levels of depressive symptoms and health-related anxiety in mothers during the perinatal period.
• Research from similar disasters to COVID-19 has highlighted how maternal mental health and maternal stress can impact on child development and wellbeing. Hence the effects of the pandemic on the mental health of the mothers might also have flow-on effects on infant mental health and development.
• The researchers offer some suggestions of how the mental health of infants and parents during the perinatal period might be supported, including:
  • Practitioners being aware of the risk factors for perinatal mental health issues, including disasters, family and domestic violence, financial stressors, being socially isolated, lacking support, and having pre-existing mental health concerns.
  • The importance of early mental health assessment, support, and treatment for mothers, including during pregnancy. While research into the effects of crisis scenarios on paternal mental health is lacking, the mental health of both parents should always be supported.
• Research in the area of perinatal mental health during COVID-19 is in its early stages and should be approached cautiously for various reasons (e.g. research being carried out under time pressures).

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Highlights

• This study explored the costs associated with health care for Australian children and adolescents with a diagnosed or ‘subthreshold’ mental disorder.
• Data from over 6,000 children and adolescents (aged 4 to 17 years old) were analysed.
• Mental health data were drawn from the Young Minds Matter Survey. Data on health care costs were obtained from Medicare (for healthcare attendances) and the Pharmaceutical Benefits Scheme (for prescription medications).
• Key findings included:
  • Health care costs were higher for children and adolescents with mental disorders (i.e. diagnosed or ‘subthreshold’ mental disorders) relative to those without mental disorders. For example, the average cost for mental health specific services for those with any mental disorder (diagnosed or ‘subthreshold’) was more than double that for those without mental disorders.
  • Mental disorders were estimated to contribute an additional $234 million per year to health care population costs. ‘Out of pocket’ payments made up approximately 16% of this amount.
  • Even disorders that were ‘subthreshold’ were large contributors to health care costs.
  • Health care costs were higher for those children and adolescents who had multiple mental disorders.
• This study was limited to Medicare and PBS data. Hence the entire economic cost has not been captured. Further research is needed to get a comprehensive understanding of the economic costs of mental health diagnoses in children and adolescents in Australia.
• Given that child and adolescent mental disorders are associated with substantial costs in health care, the authors propose that further research is needed to support access to timely and effective care.

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Highlights

• This article presents new guidelines on providing treatment to children, adolescents, and emerging adults with eating disorders using virtual care.
• While the development of the guidelines was triggered by the COVID-19 pandemic, they are designed to be used beyond the pandemic.
• The clinical practice guidelines were developed using various sources of evidence, including a review of research studies, grey literature (e.g., proceedings of conferences), and a Canadian Consensus Panel. The Panel consisted of a diverse range of practitioners, researchers, and lived experience advocates.
• The guidelines present current evidence and clinical practice recommendations regarding:
  • The impact of the COVID-19 pandemic on children and adolescents with eating disorders
  • The virtual treatment and support of this population
  • Other e-technology treatments for children and adolescents with eating disorders (e.g. text messaging, email)
  • Circumstances when an in-person evaluation might be required
• These guidelines will be of interest to practitioners and organisations who work in child and adolescent mental health, particularly those who specialise in supporting children and adolescents with eating disorders. Practitioners and organisations may be particularly interested in Table 15 (p. 26), which outlines good practice points to consider for virtual care.

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