The world’s largest school-based mental health programmes

School-based mental health programmes are now delivered to millions of children, particularly in high-income countries.

J Michael Murphy and colleagues have published a review of those programmes that reach the largest populations. In an article for the Harvard Review of Psychiatry, they profile eight programmes that have shown their effectiveness using randomised controlled trials or quasi-experimental studies. Most of the programmes focus on primary prevention or target specific vulnerable populations, rather than being aimed at supporting children with diagnosed disorders.

For each of the programmes, there is a description of its approach and a review of the supporting evidence. The eight programmes are:

  • Positive Behavioral Interventions & Supports
  • FRIENDS
  • Positive Action
  • Promoting Alternative Thinking Strategies (PATHS)
  • Skills for Life
  • MindMatters
  • Good Behavior Game
  • Cognitive-Behavioral Intervention for Trauma in Schools

Between them, the programmes have reached more than 25 million children, although the authors point out that these have mainly been in high-income countries. There is limited evidence that these programmes could be implemented at scale in low- and middle-income countries.

The authors suggest that, with the growing availability and diversity of programmes, greater attention can now be paid to assessing the processes and practices of implementation that are associated with successful, widely disseminated and sustainable programmes.

Source: Scope, scale, and dose of the world’s largest school-based mental health programs (August 2017), Harvard Review of Psychiatry

Social media and children’s mental health

In a new report from the Education Policy Institute, Emily Firth has examined the evidence of the impact of using social media on young people’s mental health and emotional well-being.

One of the key findings from the report is evidence of a beneficial impact. This is because young people can connect with others to improve their social skills online, develop their character and resilience and collaborate on school projects. In the recent PISA well-being survey of 15-year-olds, 90.5% of boys and 92.3% of girls in the UK agreed or strongly agreed with the statement “It is very useful to have social networks on the internet”. Also, importantly, those with mental health problems are able to use the internet to seek support, either through social media networks or through the online provision of advice and counseling support. For example, 78% of young people contacting the organisation Childline now do so online.

However, the report also highlights several negative effects on the well-being of young people linked with social media, including cyber-bullying, concerns about excessive use and sharing of private information and harmful content. It also finds that attempts to restrict children’s internet access are likely to be counterproductive as they hinder the development of vital skills needed to counter such risks. Rather than seeking to protect young people from all online risks­, the report calls on policy makers to promote proactive measures that build resilience in children, in order to help them lead safe digital lives.

Source: Social media and children’s mental health: a review of the evidence (June 2017) Education Policy Institute

How much sleep do teenagers need?

In a new study published in Child Development, Andrew J Fuligni and colleagues examined whether there is an “optimal” amount of sleep for peak levels of academic achievement and mental health in teenagers.

A total of 421 pupils (mean age = 15.03 years) with Mexican-American backgrounds from the 9th and 10th grades (Years 10 and 11) of two high schools in the Los Angeles area reported the amount of sleep they had every night for two weeks. Official school records were obtained at the end of the academic year to measure academic achievement. The Youth Self-Report form of the Child Behavior Checklist was used as a measure of mental health. A year later, 80% repeated the same process and a second wave of data was collected.

Pupils who averaged 8.75 – 9 hours of sleep per school night demonstrated peak levels of mental health, whereas those who averaged 7 – 7.5 hours of sleep per night had the highest levels of academic achievement (see also an earlier study reported in Best Evidence in Brief).

While the results showed that the “optimal” amount of sleep needed is different for the two developmental outcomes, the researchers note that reducing sleep for the sake of academic performance may result in a greater decline in mental health than in the decline in academic performance from increasing sleep for the sake of mental health.

Source: Adolescent sleep duration, variability, and peak levels of achievement and mental health (January 2017), Child Development DOI: 10.1111/cdev.12729

Does playing video games harm young children?

A new study has looked at the association between playing video games and young children’s mental health and cognitive and social skills.

Published in Social Psychiatry and Psychiatric Epidemiology, the study used data from the School Children Mental Health Europe project, conducted in six European countries (Germany, The Netherlands, Romania, Lithuania, Bulgaria, and Turkey). More than 3,000 children aged 6-11 took part in the study in 2010. Parents were asked how long their child played video games each week, provided demographic information, and completed a Strengths and Difficulties Questionnaire (SDQ, a measure of mental health status) for the child. Teachers also completed the SDQ for each child, and evaluated the child’s academic performance and motivation at school. Children completed Dominic Interactive, a computerised assessment tool for mental health status.

Results showed that factors associated with video game usage included being older, a boy, and belonging to a medium-sized family. Having a less-educated, single, inactive, or psychologically distressed mother decreased time spent playing video games. The results were adjusted for child age and gender, number of children, mother’s age, marital status, psychological distress, and other demographic characteristics. This showed that high video game usage (more than five hours each week) was significantly associated with higher intellectual functioning, increased academic achievement, a lower prevalence of peer relationship problems, and a lower prevalence of mental health difficulties.

Source: Is Time Spent Playing Video Games Associated with Mental Health, Cognitive and Social Skills in Young Children? (2016), Social Psychiatry and Psychiatric Epidemiology.

Study shows delayed school entry yields mental health benefits

A study carried out by Stanford University and the Danish National Centre for Social Research provides evidence that children who delay school entry by one year demonstrate better self-regulation skills when compared to children who start school on time. These benefits persisted as the students progressed through primary school. The authors found that the one-year delay resulted in a 73% reduction in inattention and hyperactivity by the time the average student was 11 years old. Danish children start school in the calendar year they turn 6, so there can be up to a year’s difference in the age of the class.
The data were obtained from a national Danish mental-health screening tool completed by more than 54,000 parents of 7-year-olds and a follow-up of almost 36,000 parents when these same children were 11 years old.

Given that increased ability to control behaviour and pay attention in class leads to improved academic performance, researchers examined school assessment scores and found that students who delayed school entry demonstrated higher scores than those who did not.

Source: The Gift of Time? School Starting Age and Mental Health (2015), The National Bureau of Economic Research.

Mental wellness in early childhood

Child Trends has released a new research brief on mental wellness in early childhood. Using research from various sources such as university publications, journal articles, and government websites, they identify five “things to know” to help parents and caregivers lay a solid foundation for healthy childhood development.

  1. Infants experience and perceive a range of emotions. Caregivers may underestimate the degree to which infants’ social-emotional development is affected by early experiences. Although infants as young as six months can “begin to sense and be affected by their parents’ moods,” fewer than 35% of caregivers believe that infants are capable of experiencing emotions in this way.
  2.  Early positive interactions promote emotional wellness throughout the lifespan. Interactions between caregivers and infants are critically important, as “neural connections are formed through the interaction of genes and a baby’s environment and experiences,” especially through communication with caregivers.
  3. Having appropriate expectations of young children’s development is important. Emotional development is a critical component of brain development that is not always emphasised as much as cognitive, physical, or verbal development. Each person’s development is unique, but caregivers should understand general social-emotional milestones – such as copying caregivers’ actions – in order to keep expectations appropriate and monitor potential red flags.
  4.  Parents and caregivers should be mindful of their own emotional well-being, seeking support if they need it. Caregivers who effectively treat their mental illness may lower the effects of the illness on their children.
  5. Young children are resilient and, if properly supported, can overcome potentially traumatic events. Young children may be able to overcome the effects of adverse events through consistent, predictable, supportive interactions.
 
Source: Five Things to Know about Mental Wellness in Early Childhood (2015), Child Trends.