What is child mental health? 甚麼是孩子的心智健康?

Mental health is something that all people have, from infants right through to adults, and it exists on a continuum ranging from good, to times when a person is feeling less well, to a variety of mental health difficulties.

 @ The child's ecology

Infants and children, more than any other age group, are shaped and influenced by a range of social, biological and environmental factors, all of which go into making the whole child. Their mental health and wellbeing cannot be separated from the broader context of their lives.

Children’s health and development occurs within multiple contexts, including their own individual characteristics, their family, school, local neighbourhood, and community environments. This is called the child’s ecology and is similar to how we think about an ecosystem in nature.

Each of the parts at different levels of the ecological system interact with each other, influence each other, and support each other. Therefore, changes in one area of a child’s life can influence other areas^1,2,3.

 @ Family relationships

The child’s family relationships (including extended family and carers), are considered the most influential factors in a child’s life. Other influences can include educators, neighbours, friends and health service providers.

The quality and stability of these relationships have a lasting impact on the child’s mental health and wellbeing, self-confidence, learning, and how the child relates to others.

Children’s relationships with the people who are most consistently in their life influence the way their brain grows and functions⁴.

 @ Child mental health difficulties

Most infants and children experience good mental health. They are able to meet challenges, express a range of emotions in response to experiences, regulate those emotions, explore their environment, and form secure relationships, within the context of their developmental stage and their age.

At the other end of the spectrum, mental health difficulties in infants and children might present as frequent or intense struggles with their emotions, their thoughts, behaviours, learning or relationships. Children experiencing mental health vulnerabilities might have trouble calming down after expressing a strong emotion, or have trouble controlling their moods and behaviour.

They might find it very challenging to be separated from their parent, or have problems with sleeping, eating, excessive crying, or engaging with school and their community. Often these things are not thought of or talked about in a way that considers child mental health.

Child mental health can also be referred to as the child’s social and emotional wellbeing.

@ Infant and Child Mental Health in Australia

1.      Over 13% of 4-11 year olds in Australia experienced a diagnosable mental health condition in the past 12 months⁵.

2.      30% of 7-18 year olds report lack of sleep, high levels of stress and depressive symptoms⁶.

3.      International studies indicate that 16-18% of children aged 0-5 years suffer from a mental health condition^7.

4.      An estimated 23% of Aboriginal 4-10 year olds experience psychological distress compared to 8% of an average group of all children the same age⁸.

Mental health is an integral part of overall health for children, just as it is for adults. These brief statistics highlight that children can and do experience mental health difficulties.

Prevention and early intervention are vital elements in improving infant and child emotional and social wellbeing and helping to prevent the development of mental illness as they journey into adolescence and adulthood.

¹ Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. American Psychologist, 32, 513-531
² Zubrick, Stephen R and Australia. Department of Families, Housing, Community Services and Indigenous Affairs, Growing Up in Australia, the Longitudinal Study of Australian Children 2008, Parenting and families in Australia, Dept. of Families, Housing, Community Services and Indigenous Affairs, Canberra.
³ Zubrick, Stephen R., Dudgeon, Pat, Gee, Graham, Glaskin, Belle, Kelly, Kerrie, Paradies, Yin, Scrine, Clair and Walker, Roz 2010, Social determinants of Aboriginal and Torres Strait islander social and emotional wellbeing. In Purdie, Nola, Dudgeon, Pat and Walker, Roz (ed), Working together: Aboriginal and Torres Strait islander mental health and wellbeing principles and practice, Commonwealth of Australia, Canberra, A. C. T., pp.75-90.
⁴ Center on the Developing Child, 2016. “Children develop within an environment of relationships” Center on the Developing Child, 2016 p 8.
⁵ Lawrence D, Johnson S, Hafekost J, Boterhoven De Haan K, Sawyer M, Ainley J, Zubrick SR (2015) The Mental Health of Children and Adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Department of Health, Canberra.
⁶ Fuller J. F., Swabey, A., Pullen K., Waldrop D., Wicking B. G., Wicking A (2015). Resiliency among Australian school students: A report on 43,799 primary and secondary school students, AARE Conference Proceedings, 29 Nov – 3 Dec 2015, University of Notre Dame, pp. 1-14. ISSN 1324-9320.
⁷ von Klitzing, K., Dohnert, M., Kroll, M., Grube, M. (2015). Mental disorders in early childhood. Deutsches Arzteblatt International, 112, 375-386.
⁸ Twizeyemariya, A., Guy, S., Furber, G. and Segal, L. (2017), Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability. The Milbank Quarterly, 95: 319–357. doi:10.1111/1468-0009.12263