Highlights in child mental health research: November 2024

This month’s highlights include:

The impact of digital devices on children’s health

The authors conducted a systematic review of 40 studies (75,540 children aged 2–12) that link the use of digital devices to physical and mental health impacts on children. They found that digital device use led to decreased physical activity, sleep disturbances, behavioural issues, lower academic performance, socioemotional challenges, and eye strain. Home confinement during COVID-19 further increased these negative effects. The review highlighted the need for balanced digital device use and parental awareness of the risks involved.

Evaluation of the Pregnancy to Parenthood program

The Pregnancy to Parenthood (P2P) is a community-based program in Western Australia that supports vulnerable families by focusing on maternal mental health and the mother-infant relationship. Using Australia clinical data with 105 mother-infant pairs, this study aimed to see how well P2P works for improving maternal mental health (depression and anxiety) and caregiving relationships. The study found reduced perinatal depression symptoms for 71% of mothers and reduced anxiety for 68% of mothers who completed the P2P program, with significant improvements in caregiving behaviours.

Early language capacity and mental health challenges in adulthood

This meta-analysis explored the association between low language capacity in childhood and mental health outcomes (anxiety and depression) in adulthood. The study found that people who had language problems as children tended to have poorer mental health as adults. They found a strong link between anxiety and childhood language problems but not a clear link to depression symptoms. The findings underline the lasting impact of early language impairments beyond communication, affecting long-term mental health.

Individual placement support services and youth mental health

Young people’s mental health often affects their education and employment outcomes, while conversely not engaging in employment or education can negatively affect their mental health. Integrated Individual Placement and Support (IPS) services aim to help young people with educational and vocational challenges at the same time as improving their mental health. A study of 2,128 headspace clients (15-25 years) compared 544 who received IPS services and 1,584 who received standard youth mental health services. IPS clients showed greater improvements in mental health, quality of life, psychosocial functioning, and psychological distress. This suggests that integrating IPS into clinical settings may achieve positive vocational outcomes and that it supports equal or better mental health improvements than standard care.

Why is this important?

• Children are spending more time on digital devices than in the past. This has been linked to various negative emotional and behavioural outcomes, such as anxiety, depression, sleep problems, and poor academic performance.
• During the COVID-19 lockdowns, young people’s use of digital devices increased.

What did they do?

• The authors conducted a systematic review of 40 studies (75,540 children aged 2–12) that linked the use of digital devices to the physical and mental health impacts on children. The outcomes they considered included physical activity and body composition, motor skills and posture, sleep habits and behaviours.
• The authors also looked at how the COVID-19 pandemic affected children who had experienced e-learning.
• The study explored time spent on different types of digital screens (e.g. tablets, smartphones, TVs, laptops and game consoles) and digital media (e.g. videos, websites, social media and online advertising). The comparison group was made up of children who didn’t use either type of device.

What did they find?

• Most studies were from Australia (n=6), China (n=6), Canada (n=5) or Germany (n=4). They typically offered cross-sectional snapshots (n=28) of digital device and media use, while four studies used experimental methods.
• The authors concluded that prolonged use of digital devices has a significant negative impact on a range of children’s physical and mental health outcomes.
• Digital device use led to decreased physical activity, sleep disturbances, behavioural issues, lower academic performance, socioemotional challenges, and eye strain. Home confinement during COVID-19 further increased digital device exposure with additional negative effects.
• Children with digital devices in their bedrooms had more screen time and a higher risk of sleep challenges compared to those who read books before bed.

What does this mean for practice?

• The review highlighted the need for balanced digital device use and parental awareness of the risks of excessive screen time on children’s health.
• Those in clinical practice should inquire about children’s digital device usage at an early age and offer guidance to parents about reducing screen time for their children.
• To encourage healthy digital habits, children should have times without screens and activities that don’t involve digital devices. Schools can help by teaching digital skills or encouraging activities that don’t use screens.

Why is this important?

• The risk of developing mental health symptoms grows during the perinatal period. If not treated, these can negatively affect maternal health, family relationships, caregiving quality, birth outcomes, and child development.
• Although young mothers commonly experience mental health challenges (0ne in six mothers have postnatal depression, 1 in 10 have anxiety during the first year of their child’s life), they do not often engage with mental health services.

What did they do?

• The Pregnancy to Parenthood (P2P) model is a community-based program in Western Australia aimed at supporting vulnerable families by focusing on maternal mental health and the mother-infant relationship. P2P includes weekly meetings with the mother and baby to support their emotional needs and help with caregiving.
• The study aimed to see how well the P2P model of care works for improving maternal mental health and caregiving (e.g. mothers reporting how they think and feel about their babies and their relationship) for mothers with mental health and mother-infant relationship issues.
• The authors evaluated the P2P intervention by using clinical surveys with 105 mother-infant pairs, collecting data from pregnant mothers or those with children under two years old.

What did they find?

• The study included 105 mothers with an average age of 31 years, 70% were married or cohabitating, 71% had existing psychiatric conditions, and 37% were in the lowest socio-economic groups (according to the Australian Bureau of Statistics).
• On average, mothers attended total of 20 sessions of P2P (between five to 52 sessions).
• The study found reduced perinatal depression symptoms for 71% and reduced anxiety for 68% of mothers who completed the P2P program, with significant improvements in caregiving behaviours.

What does this mean for practice?

• These findings suggest that integrated perinatal and infant models of care (such as P2P) can help improve maternal mental health and caregiving, but more research is needed to see how well it works for family well-being and to guide policy and mental health services.
• Early intervention is crucial to reduce the effects of intergenerational mental health issues.

Why is this important?

• One in ten children experience developmental language problems. They often have issues understanding or producing language (e.g. delayed speech, a limited vocabulary, and difficulties with understanding or forming sentences).
• 40% to 60% of childhood language problems remain undiagnosed or untreated.
• This study addresses a research gap in understanding how childhood language difficulties affect long-term mental health. It specifically links language capacity in early years to anxiety and depression in adulthood.

What did they do?

• The authors used random-effects meta-analyses to explore the association between low language capacity in childhood and mental health outcomes (anxiety and depression) in adulthood.
• They analysed nine studies that compared mental health outcomes in adults with and without childhood language difficulties.
• They calculated odds ratios to measure the links between childhood language problems and anxiety or depression in adulthood.

What did they find?

• The study found that people who had language problems as children tended to have increased likelihood of worse mental health as adults compared to people who did not have childhood language problems.
• The authors found a strong link between a history of language problems and anxiety in adulthood. However, there was no clear link to depression (meaning the association was not strong enough to be considered statistically significant).

What does this mean for practice?

• The findings underline the lasting impact of early language impairments beyond communication, affecting long-term mental health.
• Practitioners need to be aware of the symptoms and impacts of childhood language problems on mental health, so they can identify potential issues and recommend programs to prevent mental health challenges later in life.

Why is this important?

• Young people’s mental health issues and vocational disengagement are often linked to each other in a self-reinforcing cycle. Experiencing mental ill-health has been linked with negative employment outcomes, while not being able to obtain employment or education can negatively impact young people’s mental health.
• Individual Placement and Support services (IPS) are evidence-based employment services for people experiencing mental-ill health. The services are client-driven and provide ongoing support, including after gaining employment.
• This study evaluated the effectiveness of IPS services for improving mental health outcomes for young people and for addressing a critical gap in support for young individuals transitioning into the workforce.

What did they do?

• The authors conducted a cohort study using data collected from 50 headspace service users engaged with IPS programs. ‘headspace’ is the National Youth Mental Health Foundation providing early intervention mental health services to 12–25 year olds in Australia.
• They compared data for 2,128 headspace clients (15-25 years): 544 received IPS services and 1,584 received standard youth mental health services.
• Information was gathered on participants’ mental health, employment status, and service engagement over time. Quantitative measures were analysed to identify trends and outcomes associated with IPS participation.

What did they find?

• IPS clients showed greater improvements in mental health, quality of life, psychosocial functioning, and psychological distress.
• The study found a notable increase in employment rates among participants, highlighting the effectiveness of IPS in supporting young people in gaining and retaining jobs.
• Young people accessing IPS services experienced better self-confidence and felt more integrated into their communities.
• Tailored support addressing both employment and mental health needs was considered a key factor in the success of the IPS model.

What does this mean for practice?

• The research provides evidence to guide practitioners and policymakers in integrating mental health and employment support systems.
• IPS services for young people experiencing mental ill-health show promise in addressing both educational/vocational challenges and mental wellbeing.