Striking increase in mental health conditions in children and young people

University of Exeter |September 2018 | Striking increase in mental health conditions in children and young people

The first national-level study in over a decade to investigate trends in mental health problems in children and young people in the UK reports that there has been a notable increase in mental health conditions in children and young people. This research involved academics at University College London, Imperial College London, Exeter University and the Nuffield Trust. Researchers analysed data from 140,830 participants aged between 4 and 24 years, in 36 national surveys in England, Scotland and Wales over time.

girl-2096998_1920.jpg

They found since 1995 where just 0.8 % of children and young people (ages 4-24) had a mental health condition, by 2014 this figure had increased to 4.8 %. Data for this period demonstrates the increase in treatment in England (60%) , Scotland (75% )  and Wales (41%).

Key findings include:

  • Between 1995 and 2014 the proportion of children and young people aged 4-24 in England reporting a long-standing mental health condition increased six fold, meaning that by 2014 almost one in twenty children and young people in England reported having a mental health condition.
  • In 2008, when comparable data from the other two countries was available, 3% of 4-24 year olds in England and 3.7% in Scotland said they had a long-standing mental health condition, with 2.9% of 4-24 year olds in Wales saying they had received treatment. By 2014 these figures had grown to 4.8% in England, 6.5% in Scotland and 4.1% in Wales.
  • The age group with the biggest increases were young people aged 16-24, with young people in England almost 10 times  more likely to report a long-standing mental health condition in 2014 than in 1995 (0.6 vs. 5.9%).
  • Young boys aged 4-12 were consistently more likely to report a long-standing mental health condition than young girls. This was true across all countries. There was less of a consistent gender pattern in the 12-15 and 16-24 age groups.
  • Over the corresponding time period, the prevalence of total long standing conditions (both physical and mental) decreased slightly in England (20.3 to 19.5%,), increased slightly in Scotland (17.6% to 22.0%) and was broadly unchanged in Wales (13.1% vs. 13.5%).
  • Long-term trends in reported symptoms of mental health problems (as opposed to reports of a long-standing condition) showed no consistent evidence of an increase in emotional distress. However, the most recent evidence (from 2011-2014) showed concerning early signs of worsening emotional or psychological distress among young adults. For example, the odds of reporting above-threshold symptoms of emotional distress increased by 15% per year among young adults in Scotland.

Dr Dougal Hargreaves of Imperial College London and a Visiting Research Analyst at the Nuffield Trust said:

“We know that there is already a growing crisis in the availability of Child and Adolescent Mental Health Services, with many more children and young people needing treatment than there are services to provide it. Our study suggests that this need is likely to continue to grow in future. Without more radical action to improve access to and funding for CAMHS services, as well as a wider strategy to promote positive mental health and wellbeing, we may be letting down some of the most vulnerable in society.

“But it’s not all bad news. The increase in reports of long-standing mental health conditions may also mean that children and young people are more willing to open up about their mental health, suggesting that we have made some progress in reducing the stigma associated with mental ill health.” (Source: University of Exeter)

Pitchforth, J., Fahy, K., Ford, T., Wolpert, M., Viner, R., & Hargreaves, D| (n.d.|  Mental health and well-being trends among children and young people in the UK, 1995–2014: Analysis of repeated cross-sectional national health surveys| Psychological Medicine| 1-11. doi:10.1017/S0033291718001757

Abstract

BackgroundThere is a growing concern about the mental health of children and young people (CYP) in the UK, with increasing demand for counselling services, admissions for self-harm and referrals to mental health services. We investigated whether there have been similar recent trends in selected mental health outcomes among CYP in national health surveys from England, Scotland and Wales.

MethodsData were analysed from 140 830 participants (4–24 years, stratified into 4–12, 13–15, 16–24 years) in 36 national surveys in England, Scotland and Wales, 1995–2014. Regression models were used to examine time trends in seven parent/self-reported variables: general health, any long-standing health condition, long-standing mental health condition; Warwick–Edinburgh Mental Wellbeing Score (WEMWBS), above-threshold Strengths and Difficulties Questionnaire Total (SDQT) score, SDQ Emotion (SDQE) score, General Health Questionnaire (GHQ) score.

ResultsAcross all participants aged 4–24, long-standing mental health conditions increased in England, Scotland and Wales. Among young children (4–12 years), the proportion reporting high SDQT and SDQE scores decreased significantly among both boys and girls in England and girls in Scotland. The proportion with high SDQE scores but increased in Wales. The proportion with high GHQ scores decreased among English women.

ConclusionsDespite a striking increase in the reported prevalence of long-standing mental health conditions among UK CYP, there was relatively little change in questionnaire scores reflecting psychological distress and emotional well-being.

 

The article is available in full from Psychological Medicine 

Related:

Read the accompanying blog on Nuffield Trust Striking increase in mental health conditions in children and young people

New study finds parents and teachers struggle to recognise symptoms of depression in children and young people

A new study from University of  Missouri-Columbia examined how patterns between student, teacher and parent reporting could be used to create a fuller picture of the child’s mental health. The researchers completed profile analyses of 643 school aged children (between the ages of 6 and 12). They found that while almost a third (30 per cent) of children in the study reported feeling mildly to severely depressed, parents and teachers often failed to recognize the child’s depression.  Although the team found that teachers and parents were more skilled at identifying other symptoms that might predict long-term risk for depression, such as social problems and  inattention. This could be crucial, as Herman found that the children showing severe signs of depression were six times more likely to have skill deficits than their peers.

child-830988_1920.jpg

Lead researcher Keith Herman, professor in the MU College of Education said: “The gold standard for identifying children who might be at risk for developing depression later in life is to ask the children themselves,” Herman said. “However, even if a child doesn’t say they feel depressed, certain outward behaviors might provide clues to the state of the child’s mental health. It’s important for teachers and parents to catch these behaviors early to prevent long-term problems that occur with depression.” (Source: Science Daily)

Full story at Science Daily Depressed children 6 times more likely to have skill deficits, MU study finds

Happiful magazine New Study Finds Parents and Teachers Struggle To Recognise Signs Of Depression In Children

Full reference: Herman, K. C. et al |2018| Using latent profile and transition analyses to understand patterns of informant ratings of child depressive symptoms|  Journal of School Psychology| P. 69, 84-99| https://doi.org/10.1016/j.jsp.2018.05.004

Abstract

The present study examined the latent profiles of child, parent, and teacher ratings of child depressive symptoms in a developmental sample of children from Hawaii at two time points (2nd and 3rd grade). The study attempted to identify patterns of agreement and discrepancy among raters and correlates of these patterns to test a new theory for understanding rating disagreements as Divergent Operations. Three profiles best described the ratings at both time points: Child-Only High Depression, Child-Only Mild Depression, and Normative (non-depressed). Second and third grade measures of child social skills, externalizing symptoms, attention problems, and language and academic competence confirmed the distinctiveness of these classes which provides support for a Divergent Operations perspective. Latent transition analyses suggested that depressive symptoms were relatively transient for each class. Implications regarding the measurement and identification of child depressive symptoms across development and the meaning and use of discrepant ratings are discussed.

Rotherham NHS staff can request this article here 

 

UCL research indicates that arteries of youths who smoke and drink are already starting to stiffen

UCL | August 218 |UCL research indicates that arteries youths who smoke and drink are already starting to harden 

New research from University College London (UCL) shows that smoking and drinking even infrequently and at lower levels (than in adult studies) as a youth , is linked to loss of arterial elasticity (arterial stiffening) (via UCL).

The study used analysed data from  more than 1,200 adolescents from Children of the 90s, the Avon Longitudinal Study of Parents and Children (ALSPAC), during a five-year period between 2004 and 2008.

adults-alcohol-alcoholic-beverage-1304473.jpg

“We found that in this large contemporary British cohort, drinking and smoking in adolescence, even at lower levels compared to those reported in adult studies, is associated with arterial stiffening and atherosclerosis progression,” said senior author, Professor John Deanfield (UCL Institute of Cardiovascular Science).

Interestingly the research team also discovered “that if teenagers stopped smoking and drinking during adolescence, their arteries returned to normal suggesting that there are opportunities to preserve arterial health from a young age.”

Dr Mariettta  Charakida who was part of the team involved in the research said: “The age at which participants started drinking alcohol was not associated with arterial health, suggesting that duration of exposure might not be that important at this young age,” added Dr Charakida. “In addition, no beneficial effect of low alcohol consumption was found with regards to arterial health.”

Read the full press release at UCL

The research article is published in the European Heart Journal 

Abstract

Aims

To determine the impact of smoking and alcohol exposure during adolescence on arterial stiffness at 17 years.

Methods and results

Smoking and alcohol use were assessed by questionnaires at 13, 15, and 17 years in 1266 participants (425 males and 841 females) from the ALSPAC study. Smoking status (smokers and non-smoker) and intensity (‘high’ more than or equal to 100, ‘moderate’ 20–99, and ‘low or never’ less than 20 cigarettes in lifetime) were ascertained. Participants were classified by frequency (low or high) and intensity of drinking [light (LI less than 2), medium (MI 3–9), and heavy (HI more than 10 drinks on a typical drinking day)]. Carotid to femoral pulse wave velocity (PWV) was assessed at 17 years [mean ± standard deviation and/or mean difference (95% confidence intervals)]. Current smokers had higher PWV compared with non-smokers (P = 0.003). Higher smoking exposure was associated with higher PWV compared with non-smokers. Participants who stopped smoking had similar PWV to never smokers (P = 0.160). High-intensity drinkers had increased PWV. There was an additive effect of smoking intensity and alcohol intensity, so that ‘high’ smokers who were also HI drinkers had higher PWV compared with never-smokers and LI drinkers [mean adjusted increase 0.603.

Conclusion

Smoking exposure even at low levels and intensity of alcohol use were associated individually and together with increased arterial stiffness. Public health strategies need to prevent adoption of these habits in adolescence to preserve or restore arterial health.

Full reference: Charakida, M. et al.| 2018|Early vascular damage from smoking and alcohol in teenage years: the ALSPAC study|European Heart Journal|  ehy524 |https://doi.org/10.1093/eurheartj/ehy524

This article can be requested by Rotherham NHS staff here 

 

In the news:

BBC News Teenagers who smoke and drink suffer ill effects by age of 17

One in four 14-year-old girls self-harm, reports Children’s Society

The Children’s Society | August 2018 | The Good Childhood Report 2018

Every year The Children’s Society produces a wellbeing report, a comprehensive report into children’s wellbeing to hear what children have to say about their lives, what makes them happy and what needs to be improved for this generation. 

childhood
Image source: childrenssociety.org.uk

Key findings from the report:

  • Pressure to fit in with society’s expectations is making children unhappy
  • Alarming numbers of children are self-harming
  • Non-stop comments about appearance are harmful to girls’ well-being
  • Outdated gender stereotypes are damaging to boys’ and girls’ happiness
  • Family relationships are particularly important for girls

Children’s Society press release One in four 14-year-old girls self-harm

Read the full report at The Children’s Society

The Good Child Summary report  available here 

 

In the media:

BBC News Quarter of 14 year old girls self-harm 

The Telegraph Quarter of 14 year old girls self-harm, study finds, amid warning of ‘crisis in children’s mental health’ 

The Guardian Quarter of 14-year-old girls in UK have self-harmed, report finds

Children’s eye health at risk as parents believe sight tests take place at school  

Association of Optometrists| August 2018 | Children’s eye health at risk as parents believe sight tests take place at school

The Association of Optometrists (AOP) have launched the A B See Campaign to encourage parents to take their child/ren to have their eyesight tested. The campaign is in response to AOP’s survey findings, where a little over 1,2040 parents of children between the ages of 4 and 16  across the UK.  They found that children are missing out on vital eye health care because parents believe their children’s vision is tested at school. 

glasses-928465_1920.jpg

Key findings in the survey include almost three quarters (74%) of practising optometrists have seen children in the past year who had vision problems that could have been treated more successfully if they had been diagnosed at an earlier age.

Almost a quarter (24%) of 4-16-year-olds had never been taken for a sight test by their parents.  27% of parents admitted to waiting for their child to show certain behaviours before taking them for a sight test, such as sitting too close to the television or holding books close to their eyes.

While one in seven (14%) admitted to only booking a sight test when their child told them they were having trouble seeing.

Read the full news story from the Association of Optometrists 

In the news:

BBC News Children ‘getting sight problems because of eye test delays’

Huff Post This Is When You Should Take Your Child For An Eye Test

Guidance for health services for children and young people with Special Educational Needs and Disability (SEND

NHS England | July 2018 | Guidance for health services for children and young people with Special Educational Needs and Disability (SEND)

A new quick guide published by NHS England  is intended to help local areas develop their transition processes for young people with special educational needs and disability (SEND) from childhood to adulthood. 

guidance
Image source: england.nhs.uk

Related: Quick Guide: Commissioning for transition to adult services
for young people with Special Educational Needs and Disability (SEND)

 

 

 

 

Digital media use linked to behavioural problems in children

“We can say with confidence that teens who were exposed to higher levels of digital media were significantly more likely to develop ADHD symptoms in the future” says Professor Adam Leventhal  of the Keck School of Medicine of USC discussing the findings of a study that has now been in the JAMA (Journal of the American Medical Association).  The research assessed young people’s digital media usage any association between occurrence of ADHD symptoms during adolescence and tracked almost 2600 teenagers over a  24-month period.

online-942410_1920

The research team’s findings indicate that teens who are heavy users of digital devices are twice as likely as infrequent users to show symptoms of attention-deficit/hyperactivity disorder (ADHD), the study finds. Unlike earlier studies on this topic which were conducted before social media, mobile apps and tablets existed, this study included digital media which Leventhal explains “has increased digital media exposure far beyond what’s been studied before.”

 

While the researchers acknowledge the study does not show causation there was a significant association between higher frequency of modern digital media use and subsequent symptoms of ADHD over a two-year follow-up. 9.5 percent of the 114 children who used half the digital media platforms frequently and 10.5 percent of the 51 kids who used all 14 platforms frequently showed new ADHD symptoms. By contrast, 4.6 percent of the 495 students who were not frequent users of any digital activity showed ADHD symptoms, approximate to background rates of the disorder in the general population (via Science Daily).

Read the full news article from Science Daily 

Abstract

Importance  Modern digital platforms are easily accessible and intensely stimulating; it is unknown whether frequent use of digital media may be associated with symptoms of attention-deficit/hyperactivity disorder (ADHD).

Objective  To determine whether the frequency of using digital media among 15- and 16-year-olds without significant ADHD symptoms is associated with subsequent occurrence of ADHD symptoms during a 24-month follow-up.

Design, Setting, and Participants  Longitudinal cohort of students in 10 Los Angeles County, California, high schools recruited through convenience sampling. Baseline and 6-, 12-, 18-, and 24-month follow-up surveys were administered from September 2014 (10th grade) to December 2016 (12th grade). Of 4100 eligible students, 3051 10th-graders (74%) were surveyed at the baseline assessment.

Exposures  Self-reported use of 14 different modern digital media activities at a high-frequency rate over the preceding week was defined as many times a day (yes/no) and was summed in a cumulative index (range, 0-14).

Main Outcomes and Measures  Self-rated frequency of 18 ADHD symptoms (never/rare, sometimes, often, very often) in the 6 months preceding the survey. The total numbers of 9 inattentive symptoms (range, 0-9) and 9 hyperactive-impulsive symptoms (range, 0-9) that students rated as experiencing often or very often were calculated. Students who had reported experiencing often or very often 6 or more symptoms in either category were classified as being ADHD symptom-positive.

Results  Among the 2587 adolescents (63% eligible students; 54.4% girls; mean [SD] age 15.5 years [0.5 years]) who did not have significant symptoms of ADHD at baseline, the median follow-up was 22.6 months (interquartile range [IQR], 21.8-23.0, months). The mean (SD) number of baseline digital media activities used at a high-frequency rate was 3.62 (3.30); 1398 students (54.1%) indicated high frequency of checking social media, which was the most common media activity. High-frequency engagement in each additional digital media activity at baseline was associated with a significantly higher odds of having symptoms of ADHD across follow-ups. This association persisted after covariate adjustment. The 495 students who reported no high-frequency media use at baseline had a 4.6% mean rate of having ADHD symptoms across follow-ups vs 9.5% among the 114 who reported 7 high-frequency activities and vs 10.5% among the 51 students who reported 14 high-frequency activities.

Conclusions and Relevance  Among adolescents followed up over 2 years, there was a statistically significant but modest association between higher frequency of digital media use and subsequent symptoms of ADHD. Further research is needed to determine whether this association is causal.

Full reference:

Ra CK, Cho J, Stone MD, et al |Association of Digital Media Use With Subsequent Symptoms of Attention-Deficit/Hyperactivity Disorder Among Adolescents| JAMA| 2018| 320| (3)|P.255–263|  doi:10.1001/jama.2018.8931

 

The article can be requested by Rotherham NHS staff here