Highlights in Child Mental Health Research: November 2020

Highlights:

• This systematic review investigated the relationships between social networking sites and depressive and anxiety symptoms in children and adolescents.

• Social networking sites (SNS) are defined in the review as “online platforms that enable individuals to engage, maintain and develop personal friendships or professional relationships” (p.201). Examples of SNS include Facebook, Twitter, Snapchat and Instagram.

• Data from 19 studies, published between January 2005 and March 2019, were analysed. Participants were children and young people aged 5 to 18 years.

• Included studies measured outcomes of depression and or anxiety symptoms in children and adolescents, assessed by psychometrically reliable and validated instruments.

• Key findings included:
  • Increased time spent or frequency of SNS use, and problematic or addictive behaviour on SNS, was significantly associated with higher levels of depressive
  • Increased time spent or frequency of SNS use, and higher levels of investment in SNS, were significantly associated with higher levels of anxiety
  • However, studies tended to be poor in quality and have small effect sizes. This suggests that results should be interpreted with caution.
  • Potential confounding factors were suggested to explain the relationship between SNS and depressive and anxiety symptoms, including:
    • Perceived social support
    • Social comparison
    • Fear of missing out.
• These findings will be of interest to practitioners and educators who support vulnerable children at risk of developing poor mental health.
• Due to a lack of high-quality evidence, is will be important that professionals consider the mechanisms that might explain the relationship between SNS and children’s wellbeing (i.e., perceived social support, frequent social comparison and fear of missing out).

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Highlights:

• This review synthesised evidence on emotion-focused parenting These interventions aim to facilitate healthy emotional communication between parents and children, strengthening their bond and the child’s emotional development.
• Four domains of emotion-focused parenting interventions were highlighted as contributing to change, including:
  • Emotional and attachment history of the parent
  • Emotional awareness and regulation of the parent
  • Parents’ response to their child’s emotions
  • Parents’ skills in guiding their child’s emotional competence.
• Data were synthesised from 50 studies evaluating parenting interventions that addressed these four domains. Studies were published between January 2019 and June 2020. .
• The study identified extensive evidence to support emotion-focused parenting interventions, supporting its use in child and adolescent mental health settings.
• Interventions identified as targeting emotion included:
  • Emotion coaching/communication parenting programs (e.g., Tuning in to Kids)
  • Emotion-focused family therapy (e.g., 2-day workshops)
  • Attachment-focused parenting programs (e.g., Circle of Security)
  • Mindfulness parenting programs (e.g., Mindfulness-Based Parenting)
  • Behaviours parenting programs with additional emotion-focused elements (e.g., Parent-Child Interaction Therapy).

• The study found that many reviewed interventions improved the emotional sensitivity and responsiveness of parents. This provides the foundation for facilitating healthy child emotional development.
• These findings will be of interest to practitioners and service providers who support children and adolescents with mental health difficulties. Professionals might be interested in drawing on this research to support a family-focused approach when working with children and adolescents.

Read the abstract here

Listen to the Emerging Minds podcast with Sophie Havinghurst on an emotion-focused approach to parenting

Highlights:

• This study is the first to provide objective data about the wait times and costs faced by families in Australia who try to access private mental health care for their child.
• Researchers used a ‘secret shopper’ method whereby they contacted private specialists posing as a parent enquiring about an initial mental health care appointment for their child.
• 327 specialist practitioners from Victoria and South Australia were contacted (198 psychologists, 81 paediatricians, and 48 psychiatrists).
• Key study findings included:
  • Families face lengthy waiting times and significant out-of-pocket costs when seeking an initial mental health care appointment with a private specialist.
  • Of the private practices contacted, around one third were not accepting new referrals. Reasons for not accepting new referrals included being at full patient capacity or not accepting referrals for children under age 12.
  • The average wait-time for an initial appointment was 44 days for paediatricians, 34 days for psychologists, and 41 days for psychiatrists.
  • The average out-of-pocket cost were $120 for paediatricians, $85 for psychologists, and $176 for psychiatrists.
• This landmark study highlights key barriers to mental health care for children in Australia, which include financial costs and the lack of a mental health workforce for supporting younger children. These difficulties are particularly pronounced in rural areas.
• The researchers offer multiple suggestions based on their findings, including:
  • Practitioners and service providers should ensure that accurate and accessible details about their practice are easily available to families (e.g., current contact details; scope of practice, including client age ranges; clear and transparent fee information). This should also apply to any listings on professional body websites.
  • Offering enhanced training in mental health for paediatricians may help strengthen the capacity of the workforce to support child mental health.
  •  ‘Shared care models’ should be considered by the sector to help reduce wait times and out-of-pocket costs. These models involve general practitioners working collaboratively ‘with child mental health specialists to co-manage children with mental health problems’ (p. 6).
  • Increased funding for public child and adolescent mental health services may help lessen the demands in the private sector and increase accessibility for families (particularly for those whom out-of-pocket costs are a barrier).

Read the abstract here

Read the news article on this study by the Murdoch Children’s Research Institute

Highlights:

• This article reviewed data from a cross-sectional study of Australian school students, examining the prevalence of racial discrimination and the impact this may have on socioemotional and sleep
• Study participants (n=4,664) were Australian school children in years 5-9 (10-15 years old).
• Participants reported their experiences of racial discrimination from peers, school and societal sources, and self-reported on the Strengths and Difficulties Questionnaire. Sleep problems were assessed on duration, latency, and disruption.
• Key findings included:
  • Experiences of direct and vicarious racial discrimination (witnessing the racial discrimination of others) was common for students from Indigenous or ethnic minority backgrounds.
  • Students from all backgrounds reported high levels of vicarious racial discrimination (70.15%).
  • Both direct and vicarious discrimination were associated with socioemotional and sleep problems. Strong evidence supports an association between direct experiences of discrimination and socioemotional outcomes (e.g., internalising and externalising difficulties, child strengths).
  • Strong evidence also supports an association between racial discrimination and sleep problems.
  • Racial discrimination had a similar effect on students’ wellbeing regardless of the source (e.g., peer, school or societal).
• This article may be of interest to professionals working with, or writing policies for, school children, particularly including children from Indigenous or ethnic minority backgrounds. Addressing racism where possible can help to support child and adolescent health.

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