Journal articles: 'Child mental health – Ontario'

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Patten, Scott. "The 2014 Ontario Child Health Study." Canadian Journal of Psychiatry 64, no. 4 (April 2019): 225–26. http://dx.doi.org/10.1177/0706743719834483.

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Boyle, Michael H., Katholiki Georgiades, Laura Duncan, Jinette Comeau, and Li Wang. "The 2014 Ontario Child Health Study—Methodology." Canadian Journal of Psychiatry 64, no. 4 (April 2019): 237–45. http://dx.doi.org/10.1177/0706743719833675.

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Objective: To describe the methodology of the 2014 Ontario Child Health Study (OCHS): a province-wide, cross-sectional, epidemiologic study of child health and mental disorder among 4- to 17-year-olds living in household dwellings. Method: Implemented by Statistics Canada, the 2014 OCHS was led by academic researchers at the Offord Centre for Child Studies (McMaster University). Eligible households included families with children aged 4 to 17 years, who were listed on the 2014 Canadian Child Tax Benefit File. The survey design included area and household stratification by income and 3-stage cluster sampling of areas and households to yield a probability sample of families. Results: The 2014 OCHS included 6,537 responding households (50.8%) with 10,802 children aged 4 to 17 years. Lower income families living in low-income neighbourhoods were less likely to participate. In addition to measures of childhood mental disorder assessed by the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and OCHS Emotional Behavioural Scales (OCHS-EBS), the survey contains measures of neighbourhoods, schools, families and children, and includes administrative data held by the Ministries of Education and Health and Long-Term Care. Conclusions: The complex survey design and differential non-response of the 2014 OCHS required the use of sampling weights and adjustment for design effects. The study is available throughout Canada in the Statistics Canada Research Data Centres (RDCs). We urge external investigators to access the study through the RDCs or to contact us directly to collaborate on future secondary analysis studies based on the OCHS.

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Duncan, Laura, Katholiki Georgiades, Stephen Birch, Jinette Comeau, Li Wang, and Michael H. Boyle. "Children’s Mental Health Need and Expenditures in Ontario: Findings from the 2014 Ontario Child Health Study." Canadian Journal of Psychiatry 64, no. 4 (April 2019): 275–84. http://dx.doi.org/10.1177/0706743719830036.

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Objective: To estimate the alignment between the Ontario Ministry of Children and Youth Services (MCYS) expenditures for children’s mental health services and population need, and to quantify the value of adjusting for need in addition to population size in formula-based expenditure allocations. Two need definitions are used: “assessed need,” as the presence of a mental disorder, and “perceived need,” as the subjective perception of a mental health problem. Methods: Children’s mental health need and service contact estimates (from the 2014 Ontario Child Health Study), expenditure data (from government administrative data), and population counts (from the 2011 Canadian Census) were combined to generate formula-based expenditure allocations based on 1) population size and 2) need (population size adjusted for levels of need). Allocations were compared at the service area and region level and for the 2 need definitions (assessed and perceived). Results: Comparisons were made for 13 of 33 MCYS service areas and all 5 regions. The percentage of MCYS expenditure reallocation needed to achieve an allocation based on assessed need was 25.5% at the service area level and 25.6% at the region level. Based on perceived need, these amounts were 19.4% and 27.2%, respectively. The value of needs-adjustment ranged from 8.0% to 22.7% of total expenditures, depending on the definition of need. Conclusion: Making needs adjustments to population counts using population estimates of children’s mental health need (assessed or perceived) provides additional value for informing and evaluating allocation decisions. This study provides much-needed and current information about the match between expenditures and children’s mental health need.

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CADMAN, DAVID, MICHAEL BOYLE, and DAVID R. OFFORD. "The Ontario Child Health Study." Journal of Developmental & Behavioral Pediatrics 9, no. 3 (June 1988): 117???121. http://dx.doi.org/10.1097/00004703-198806000-00001.

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Steele, Margaret M., and Vicky Veitch Wolfe. "Child Psychiatry Practice Patterns in Ontario." Canadian Journal of Psychiatry 44, no. 8 (October 1999): 788–92. http://dx.doi.org/10.1177/070674379904400805.

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Boyle, Michael H., David R. Offord, Yvonne Racine, Mark Sanford, Peter Szatmari, and Jan E. Fleming. "Evaluation of the Original Ontario Child Health Study Scales." Canadian Journal of Psychiatry 38, no. 6 (August 1993): 397–405. http://dx.doi.org/10.1177/070674379303800605.

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This article presents evaluative information on the use of the original Ontario Child Health Study scales to serve as ordinal-level measures of conduct disorder, hyperactivity and emotional disorder among children in the general (non clinic) population. Problem checklist assessments were obtained from parents and teachers of children aged six to 16 and youth aged 12 to 16 drawn from a general population (n = 1,751); and a mental health clinic sample (n = 1,027) in the same industrialized, urban setting. The results showed that the original OCHS scales possess adequate psychometric properties to be used as ordinal-level measures of disorder. Correlations between individual items and their hypothesized scales were very strong, indicating convergent validity, while correlations between the same items and other (non hypothesized) scales were lower, indicating discriminant validity. Item analyses indicated that individual scale items possess both convergent and discriminant validity. Although the scales were skewed to the positive end of the continuum, they demonstrated good internal consistency (all estimates ≥ 0.74) and test-retest (all estimates ≥ 0.65) reliability. Finally, three different validity analyses confirmed hypotheses about how the original OCHS scales should perform if they provide useful measures of disorder.

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Georgiades, Katholiki, Laura Duncan, Li Wang, Jinette Comeau, and Michael H. Boyle. "Six-Month Prevalence of Mental Disorders and Service Contacts among Children and Youth in Ontario: Evidence from the 2014 Ontario Child Health Study." Canadian Journal of Psychiatry 64, no. 4 (April 2019): 246–55. http://dx.doi.org/10.1177/0706743719830024.

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Objectives: To present the 6-month prevalence and sociodemographic correlates of mental disorders and mental health–related service contacts in a sample of children (4 to 11 years) and youth (12 to 17 years) in Ontario. Methods: The 2014 Ontario Child Health Study is a provincially representative survey of 6537 families with children aged 4 to 17 years in Ontario. DSM-IV-TR mental disorders were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and included mood (major depressive episode), anxiety (generalized anxiety, separation anxiety, social phobia, specific phobia), and behaviour disorders (attention-deficit/hyperactivity disorder, oppositional-defiant disorder, conduct disorder).The MINI-KID was administered independently to the primary caregiver and youth aged 12 to 17 years in the family’s home. Results: Past 6-month prevalence of any mental disorder ranged from 18.2% to 21.8% depending on age and informant. Behaviour disorders were the most common among children, and anxiety disorders were the most common among youth. Among children and youth with a parent-identified mental disorder, 25.6% of children and 33.7% of youth had contact with a mental health provider. However, 60% had contact with one or more of the providers or service settings assessed, most often through schools. Conclusions: Between 18% and 22% of children and youth in Ontario met criteria for a mental disorder but less than one-third had contact with a mental health provider. These findings provide support for strengthening prevention and early intervention efforts and enhancing service capacity to meet the mental health needs of children and youth in Ontario.

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Yang, Julie, Paul Kurdyak, and Astrid Guttmann. "Developing Indicators for the Child and Youth Mental Health System in Ontario." Healthcare Quarterly 19, no. 3 (October 31, 2016): 6–9. http://dx.doi.org/10.12927/hcq.2016.24865.

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Manion, Ian, Don H. Buchanan, Michael Cheng, Joanne Johnston, and Kathy Short. "Embedding evidence-based practice in child and youth mental health in Ontario." Evidence & Policy: A Journal of Research, Debate and Practice 5, no. 2 (May 15, 2009): 141–53. http://dx.doi.org/10.1332/174426409x437892.

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Waddell, Charlotte, Katholiki Georgiades, Laura Duncan, Jinette Comeau, Graham J. Reid, Warren O’Briain, Robert Lampard, and Michael H. Boyle. "2014 Ontario Child Health Study Findings: Policy Implications for Canada." Canadian Journal of Psychiatry 64, no. 4 (April 2019): 227–31. http://dx.doi.org/10.1177/0706743719830033.

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Manassis, K., A. Ickowicz, E. Picard, B. Antle, T. McNeill, A. Chahauver, S. Mendlowitz, S. Monga, and G. Adler-Nevo. "An Innovative Child CBT Training Model for Community Mental Health Practitioners in Ontario." Academic Psychiatry 33, no. 5 (September 1, 2009): 394–99. http://dx.doi.org/10.1176/appi.ap.33.5.394.

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Boyle, Michael H., Katholiki Georgiades, Laura Duncan, Li Wang, and Jinette Comeau. "Poverty, Neighbourhood Antisocial Behaviour, and Children’s Mental Health Problems: Findings from the 2014 Ontario Child Health Study." Canadian Journal of Psychiatry 64, no. 4 (April 2019): 285–93. http://dx.doi.org/10.1177/0706743719830027.

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Objectives: To determine if levels of neighbourhood poverty and neighbourhood antisocial behaviour modify associations between household poverty and child and youth mental health problems. Methods: Data come from the 2014 Ontario Child Health Study—a provincially representative survey of 6537 families with 10,802 four- to 17-year-olds. Multivariate multilevel modelling was used to test if neighbourhood poverty and antisocial behaviour interact with household poverty to modify associations with children’s externalizing and internalizing problems based on parent assessments of children (4- to 17-year-olds) and self-assessments of youth (12- to 17-year-olds). Results: Based on parent assessments, neighbourhood poverty, and antisocial behaviour modified associations between household poverty and children’s mental health problems. Among children living in households below the poverty line, levels of mental health problems were 1) lower when living in neighbourhoods with higher concentrations of poverty and 2) higher when living in neighbourhoods with more antisocial behaviour. These associations were stronger for externalizing versus internalizing problems when conditional on antisocial behaviour and generalized only to youth-assessed externalizing problems. Conclusion: The lower levels of externalizing problems reported among children living in poor households in low-income neighbourhoods identify potential challenges with integrating poorer households into more affluent neighbourhoods. More important, children living in poor households located in neighbourhoods exhibiting more antisocial behaviour are at dramatically higher risk for mental health problems. Reducing levels of neighbourhood antisocial behaviour could have large mental health benefits, particularly among poor children.

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Boyle, Michael H., David R. Offord, Yvonne Racine, Jan E. Fleming, Peter Szatmari, and Mark Sanford. "Evaluation of the Revised Ontario Child Health Study Scales." Journal of Child Psychology and Psychiatry 34, no. 2 (February 1993): 189–213. http://dx.doi.org/10.1111/j.1469-7610.1993.tb00979.x.

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BOYLE, MICHAEL H., DAVID R. OFFORD, YVONNE A. RACINE, and GARY CATLIN. "Ontario Child Health Study Follow-up: Evaluation of Sample Loss." Journal of the American Academy of Child & Adolescent Psychiatry 30, no. 3 (May 1991): 449–56. http://dx.doi.org/10.1097/00004583-199105000-00016.

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Cadman, David, Michael Boyle, Peter Szatmari, and David R. Offord. "Chronic Illness, Disability, and Mental and Social Well-Being: Findings of the Ontario Child Health Study." Pediatrics 79, no. 5 (May 1, 1987): 805–13. http://dx.doi.org/10.1542/peds.79.5.805.

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Chronic childhood illness, disability, and psychosocial problems are receiving major attention in current pediatric care. Much of the evidence associating chronic physical problems and mental health and adjustment problems has come from clinic-based studies and is often inconsistent in its conclusions. This paper reports the findings of the Ontario Child Health Study, an epidemiologic survey of 3,294 children 4 to 16 years of age in the general community, concerning the relationship of psychiatric disorders and social adjustment problems among children with chronic illness, medical conditions, and long-term disability in contrast to children free of chronic physical health problems. Age- and sex-adjusted risks for psychiatric disorders and social problems, compared with those for healthy peers, were calculated: children with both chronic illness and associated disability were at greater than threefold risk for psychiatric disorders and considerable risk for social adjustment problems. Children with chronic medical conditions, but no disability, were at considerably less risk: about a twofold increase in psychiatric disorders but little increased risk for social adjustment problems was observed. A relative underuse of specialized mental health services by children who might benefit supports the opinion that all physicians in the community who care for children with chronic health problems should become skilled in the recognition of existing or incipient mental health and social problems and familiar with preventive and treatment approaches that may lessen the excessive burden of psychosocial problems among those with chronic ill-health.

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Georgiades, Katholiki, Khrista Boylan, Laura Duncan, Li Wang, Ian Colman, Anne E. Rhodes, Kathryn Bennett, Jinette Comeau, Ian Manion, and Michael H. Boyle. "Prevalence and Correlates of Youth Suicidal Ideation and Attempts: Evidence from the 2014 Ontario Child Health Study." Canadian Journal of Psychiatry 64, no. 4 (April 2019): 265–74. http://dx.doi.org/10.1177/0706743719830031.

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Objectives: To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario. Methods: Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y ( n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts. Results: The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89). Conclusions: Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury.

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Offord, David R., Michael H. Boyle, Jan E. Fleming, Heather Munroe Blum, and Naomi I. Rae Grant. "Summary of Selected Results." Canadian Journal of Psychiatry 34, no. 6 (August 1989): 483–91. http://dx.doi.org/10.1177/070674378903400602.

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Selected results from the Ontario Child Health Study (OCHS), a cross-sectional community survey of Ontario children four to 16 years of age, are presented in the areas of prevalence, risk indicators and service utilization. The six month prevalence of one or more of four psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization), in children four to 16 years of age, in Ontario was 18.1%. The highest rate was in 12 to 16 year old girls, and the lowest rate in four to 11 year old girls. Co-morbidity among these four disorders was high while the proportion of disorders identified by more than one respondent was low. Psychiatric disorders co-occurred significantly with other morbidities in children, including poor school performance, chronic health problems, substance use and suicidal behaviour. Chronic medical illness in the child as well as single parent status, living in a family on social assistance and residing in subsidized housing, were all strong indicators of increased rates of psychiatric disorders in children. Specialized mental health/social services, over a six month period, reached fewer than one of five children with psychiatric disorders, as measured in the study. In contrast, ambulatory medical care (primarily visits to family doctors and pediatricians) served almost 60% of Ontario children four to 16 years old, over the same six month period. The results are compared with those in the literature.

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Tanaka, M., T. O. Afifi, C. N. Wathen, M. H. Boyle, and H. L. MacMillan. "Evaluation of sex differences in health-related quality of life outcomes associated with child abuse: Results from the Ontario Child Health Study." Epidemiology and Psychiatric Sciences 24, no. 4 (May 1, 2014): 353–63. http://dx.doi.org/10.1017/s2045796014000274.

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Aims.Despite the advances in child maltreatment research, there is still the need for comprehensive information about how abuse affects a broad range of categories of young adult functioning, and the extent to which these vary by sex. We examined the associations between child physical abuse (PA) and sexual abuse (SA) and six areas of functioning (mental health, physical health, life satisfaction, illegal substance use, alcohol problems and daily smoking).Methods.Data were obtained from the 1983 Ontario Child Health Study and follow-up in 2000/2001 (n = 1893). Multilevel regression estimated the adjusted associations for PA (with severity) and SA with each of the outcomes. Estimates with an entire sample were presented with sex-by-abuse interactions to examine sex differences and then presented separately by sex.Results.In the adjusted model, severe PA and SA were associated with impairment in mental health, and both forms of PA (severe and non-severe) and SA were associated with low life satisfaction. In addition, severe PA was associated with illegal substance use. Child abuse variables were not associated with poor physical health, alcohol problems or smoking. Although sex-stratified analyses revealed different patterns, there was no significant sex difference in the integrated sample.Conclusions.This is among the first community-based studies to show a strong association between child PA and SA and low life satisfaction in young adults. The abuse effects were similar for both sexes.

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Jerome, Laurence. "Overrepresentation of Adopted Children Attending a Children's Mental Health Centre." Canadian Journal of Psychiatry 31, no. 6 (August 1986): 526–31. http://dx.doi.org/10.1177/070674378603100609.

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A retrospective analysis was made of case records of children attending a Children's Mental Health Centre during the years 1959 to 1973. Annual comparisons were made between the numbers of adopted, children seen in the province of Ontario and within the clinic setting. The results indicated that over a fifteen year period the adopted children in the clinic were seen with twice the expected annual incidence predicted from the community rates. “So far as it is known, the proportion of successful and unsuccessful adoptions does not seem unsatisfactory. This result is in accordance with clinical experience which does not suggest that an undue proportion of adopted children are referred to child guidance clinics.” Bowlby (1951)

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Place, M., E. Martin, A. J. Hildreth, J. Wilson, and J. Hulsmeier. "Validating the Ontario Child Health Scale in a UK population." European Child & Adolescent Psychiatry 8, no. 4 (December 17, 1999): 255–59. http://dx.doi.org/10.1007/s007870050099.

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Danseco, Evangeline, MaryAnn Notarianni, and Jana Kocourek. "Quality Standards on Youth Engagement and Family Engagement: Defining Excellence for Engagement." Canadian Journal of Community Mental Health 39, no. 2 (July 1, 2020): 59–64. http://dx.doi.org/10.7870/cjcmh-2020-011.

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To enhance consistency in practicing meaningful engagement to improve services, the Ontario Centre of Excellence for Child and Youth Mental Health co-developed quality standards on system-level youth and family engagement with agency representatives, researchers, youth, and families. These two quality standards encompass statements that describe high-quality engagement based on evidence.

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Lipman, Ellen L., David R. Offord, Yvonne A. Racine, and Michael H. Boyle. "Psychiatric Disorders in Adopted Children: A Profile from the Ontario Child Health Study." Canadian Journal of Psychiatry 37, no. 9 (November 1992): 627–33. http://dx.doi.org/10.1177/070674379203700906.

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Studies of clinical populations suggest that adopted children are overrepresented among children using mental health facilities, whereas studies using non clinical populations of adopted children have reached mixed conclusions about whether or not there is an increased psychological risk associated with adoption. Data from the Ontario Child Health Study, a community survey of children aged four to 16 years, which included a subpopulation of adopted children, were used to: 1. profile the characteristics of adoptive families; 2. examine the strength of adoptive status as a marker for psychiatric and educational morbidity; and 3. determine the extent to which adoptive status has an independent relationship with psychiatric and educational morbidities. The findings were: 1. adoptive mothers were significantly older than non adoptive mothers, but otherwise adoptive families did not differ significantly from non adoptive families, 2. adoption in boys, but not in girls, was a significant marker for psychiatric disorder and poor school performance; adoption in adolescent girls was a significant marker for substance use; and 3. multivariate analyses demonstrated no independent effect of adoption on psychiatric disorder or poor school performance; for adolescents, adoptive status did have an independent relationship with substance use for girls. The implications of these findings will be discussed.

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Danseco, Evangeline, Ann Barber, Kelcie Brown, and Charlie Carter. "Implementing Implementation: Practical Lessons Learned From Supporting Evidence- Informed Service Delivery in Community-Based Child and Youth Mental Health Agencies." Canadian Journal of Community Mental Health 36, no. 2 (October 1, 2017): 165–90. http://dx.doi.org/10.7870/cjcmh-2017-014.

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As child and youth mental health agencies apply the recommendations from the national mental health strategy, a strong focus has been placed on the implementation of evidence-informed practices to ensure the best outcomes for those they serve. Although a considerable amount of research exists on the implementation of best practices and the key factors to successful implementation, far less exists in terms of concrete strategies to support such initiatives. This article describes a unique initiative in Ontario that provided implementation supports and funding for agencies. Lessons learned and implications for bridging the gap between research and practice are explored.

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Comeau, Jinette, Katholiki Georgiades, Laura Duncan, Li Wang, and Michael H. Boyle. "Changes in the Prevalence of Child and Youth Mental Disorders and Perceived Need for Professional Help between 1983 and 2014: Evidence from the Ontario Child Health Study." Canadian Journal of Psychiatry 64, no. 4 (April 2019): 256–64. http://dx.doi.org/10.1177/0706743719830035.

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Objectives: To examine: 1) changes in the prevalence of mental disorders and perceived need for professional help among children (ages 4 to 11) and youth (ages 12 to 16) between 1983 and 2014 in Ontario and 2) whether these changes vary by age and sex, urban-rural residency, poverty, lone-parent status, and immigrant background. Methods: The 1983 ( n = 2836) and 2014 ( n = 5785) Ontario Child Health Studies are provincially representative cross-sectional surveys with identical self-report checklist measures of conduct disorder, hyperactivity, and emotional disorder, as well as perceived need for professional help, assessed by integrating parent and teacher responses (ages 4 to 11) and parent and youth responses (ages 12 to 16). Results: The overall prevalence of perceived need for professional help increased from 6.8% to 18.9% among 4- to 16-year-olds. An increase in any disorder among children (15.4% to 19.6%) was attributable to increases in hyperactivity among males (8.9% to 15.7%). Although the prevalence of any disorder did not change among youth, conduct disorder decreased (7.2% to 2.5%) while emotional disorder increased (9.2% to 13.2%). The prevalence of any disorder increased more in rural and small to medium urban areas versus large urban areas. The prevalence of any disorder decreased for children and youth in immigrant but not nonimmigrant families. Conclusions: Although there have been decreases in the prevalence of conduct disorder, increases in other mental disorders and perceived need for professional help underscore the continued need for effective prevention and intervention programs.

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Woodward, Christel A., Michael H. Boyle, David R. Offord, David T. Cadman, Paul S. Links, Heather Munroe-Blum, Carolyn Byrne, and Helen Thomas. "Ontario Child Health Study: Patterns of Ambulatory Medical Care Utilization and Their Correlates." Pediatrics 82, no. 3 (September 1, 1988): 425–34. http://dx.doi.org/10.1542/peds.82.3.425.

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Data from a large epidemiologic survey of Ontario children 4 to 16 years of age are presented concerning the frequency and correlates the use of ambulatory medical care services during a 6-month period in which a universal, first-dollar health insurance plan was used. Patterns of use of ambulatory medical care are described for three settings: doctor's offices, emergency rooms, and hospital outpatient departments. A group of children who are frequent users of ambulatory medical care (defined as using three or more services in 6 months) consumed nearly two thirds of all services. Two regression equations are presented—one predicting use/nonuse of ambulatory medical care and the other predicting the total number of visits for medical care. Although only a small proportion of the variance in use/nonuse and amount of use was explained, the major determinant of both ambulatory medical care use and frequency of use was the child's physical health status as perceived by the parent. Younger child, urban area of residence, the number of chronic medical problems of the child, and higher level of maternal education also contributed to the explanation of use v nonuse. Among ambulatory medical care users, high users were more likely to be described as having mental health problems and have parents who had been treated for "nerves." Family size and socioeconomic variables were not important factors in use, suggesting that universal health insurance reduces some barriers to ambulatory medical care for children.

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FLEMING, JAN E., MICHAEL H. BOYLE, and DAVID R. OFFORD. "The Outcome of Adolescent Depression in the Ontario Child Health Study Follow-up." Journal of the American Academy of Child & Adolescent Psychiatry 32, no. 1 (January 1993): 28–33. http://dx.doi.org/10.1097/00004583-199301000-00005.

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Danseco, Evangeline, Julia Kurzawa, Purnima Sundar, Jaime Brown, and Christal Huang. "Evaluating the sector-wide implementation of virtual child and youth mental health services in response to the COVID-19 pandemic: Perspectives from service providers, agency leaders and clients." Implementation Research and Practice 2 (January 2021): 263348952110456. http://dx.doi.org/10.1177/26334895211045690.

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Background The COVID-19 pandemic prompted an abrupt shift in the delivery of community-based child and youth mental health services as virtual care was rapidly adopted. The objective of this study was to evaluate the sector-wide transition to virtual care across Ontario, with a focus on implementation facilitators and barriers. Methods We used a multi-level mixed-methods design where agency leaders, service providers, and clients shared their experiences planning, implementing, and accessing virtual care. In total, 97 agency leaders, and 192 youth and family members responded to the surveys; 13 agency leaders, and 11 service providers participated in interviews or focus groups. Results Most agencies undertook a similar journey to implement virtual care. Stakeholders described common facilitators such as staff engagement, leadership support, and training activities. Barriers included internet connection issues, lack of resources, and privacy concerns. Service providers innovated as they implemented by partnering with agencies to meet clients’ needs, using multiple platforms to engage clients, and altering session duration to reduce fatigue. Clients found virtual care easy to use, felt confident using it, and intend to continue accessing virtual care. Conclusion Implementation of virtual care during the pandemic was complex and the evaluation involved obtaining perspectives at multiple levels. This research provides a blueprint for evaluations of the implementation of virtual mental health services, particularly in a child/youth context. Virtual care is a viable way to deliver mental health services, however, equity, accessibility, and appropriateness need to be addressed to ensure services are effective for children, youth, and their families. Plain language abstract Academic literature suggests that using technology to deliver child and youth mental health services is a promising way to enhance access to care and improve engagement for many children and youth. Despite this, the provision of virtual child and youth mental health services in Ontario prior to the COVID-19 pandemic was limited. Efforts that did exist were largely focused on providing care to those in rural and remote areas. The COVID-19 pandemic prompted a rapid shift to virtual care, as most in-person mental health services were suspended. This paper presents new insight into how virtual mental health services were quickly established and used across Ontario from the perspectives of senior leaders, service providers, and clients. Results from this evaluation showed that agencies followed similar steps to prepare to use virtual services. Staff engagement, support from leadership, and opportunities for staff training supported the implementation of virtual care while internet connections issues, lack of resources (like computers or phones), and privacy and safety concerns hindered the implementation. Most youth and family members found virtual services easy to use and intend to continue using them. Most agencies intend to continue to offer virtual services post-pandemic but noted that it was not appropriate or accessible for all clients. This study provides a foundation for additional research to examine situations and conditions that are most conducive to virtual care delivery to address child and youth mental health concerns. These results may encourage agencies to rely more confidently on virtual services as another means to meet clients’ needs and preferences.

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Czincz, Jennifer, and Elisa Romano. "Examining How the Mental Health Needs of Children Who Have Experienced Maltreatment are Addressed within Ontario Children’s Aid Societies." Canadian Journal of Family and Youth / Le Journal Canadien de Famille et de la Jeunesse 2, no. 1 (February 1, 2010): 25–51. http://dx.doi.org/10.29173/cjfy7466.

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American data suggest that there is often a lack of mental health service provision to children in the child welfare system that have experienced maltreatment and are exhibiting psychological difficulties. These data are concerning given that the existing literature unanimously concludes that children who have experienced maltreatment present with significantly higher rates of mental health difficulties than general samples of children in the community. Given that little Canadian research has been conducted in this area, this study examined the need identification and referral process made to mental health services by Ontario Children’s Aid Societies (CAS) for children who have experienced maltreatment. Findings indicate a high prevalence of mental health difficulties in this population and a limited standardized approach to the identification and assessment of these issues. It was found that the majority of children who do receive referrals to mental health services are referred to community-based psychologists. Findings regarding the tracking of community referrals and interagency collaboration were encouraging as compared to American data.

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Stewart, Shannon L., Jeff W. Poss, Elizabeth Thornley, and John P. Hirdes. "Resource Intensity for Children and Youth: The Development of an Algorithm to Identify High Service Users in Children’s Mental Health." Health Services Insights 12 (January 2019): 117863291982793. http://dx.doi.org/10.1177/1178632919827930.

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Children’s mental health care plays a vital role in many social, health care, and education systems, but there is evidence that appropriate targeting strategies are needed to allocate limited mental health care resources effectively. The aim of this study was to develop and validate a methodology for identifying children who require access to more intense facility-based or community resources. Ontario data based on the interRAI Child and Youth Mental Health instruments were analysed to identify predictors of service complexity in children’s mental health. The Resource Intensity for Children and Youth (RIChY) algorithm was a good predictor of service complexity in the derivation sample. The algorithm was validated with additional data from 61 agencies. The RIChY algorithm provides a psychometrically sound decision-support tool that may be used to inform the choices related to allocation of children’s mental health resources and prioritisation of clients needing community- and facility-based resources.

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Grant, Naomi Rae, David R. Offord, and Heather Munroe Blum. "Implications for Clinical Services, Research and Training." Canadian Journal of Psychiatry 34, no. 6 (August 1989): 492–99. http://dx.doi.org/10.1177/070674378903400603.

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The Ontario Child Health Study (OCHS) described in the companion paper (1) confirms the fact that psychiatric disorders among children and adolescents are prevalent, that comorbidity and associated impairements are common and that only a minority of children are seen by any definite mental health or social service. The current assessment and treatment methods and the present service system leave the majority of children unserved. Children and their families suffer a good deal before they are adequately diagnosed and treated, and treatment service delivered on a one-by-one basis are expensive. The OCHS data, has, it follows, important implications for clinical work, for mental health service planning, for further research and for training in child and adolescent psychiatry. This paper does not address all the implications of the OCHS in these areas but does attempt to address those which follow from the summary of the OCHS data described in (1).

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Tilleczek, Kate, Moira Ferguson, Valerie Campbell, and Katherine Elizabeth Lezeu. "Mental Health and Poverty in Young Lives: Intersections and Directions." Canadian Journal of Community Mental Health 33, no. 1 (July 1, 2014): 63–76. http://dx.doi.org/10.7870/cjcmh-2014-006.

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This paper provides a conceptual synthesis of literature that addresses intersections of mental health, poverty, and school. It is based on a research synthesis for the youth policy framework for Ontario, Stepping Stones. The paper addresses research on challenges involving income inequality, poverty, and mental health that impinge upon school, and examines the enduring ill effects of these issues and academic struggles on young lives. It suggests practices that show promise to support youth. Findings suggest that transitions through school involve multiple developmental negotiations and are a critical site of slippages and successes. The paper ends with a set of reflective questions around age out (of the child and youth services system), the need to address stigma by animating the abundant character of young lives (addressing the subtleties and nuances of the life stories, biographies, and narratives of young people and their communities), the need for authentic collaborations across health and education, and working with and for young people as they collectively and individually determine and negotiate their lives.

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Barmaki, Reza. "The Bourgeois Order and the ‘Normal’ Child: The Case of Ontario, 1867–1900." International Journal of Mental Health and Addiction 5, no. 3 (May 8, 2007): 263–76. http://dx.doi.org/10.1007/s11469-007-9080-x.

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Aderibigbe, Oluwakemi Olanike, Shannon L. Stewart, John P. Hirdes, and Christopher Perlman. "Substance Use among Youth in Community and Residential Mental Health Care Facilities in Ontario, Canada." International Journal of Environmental Research and Public Health 19, no. 3 (February 2, 2022): 1731. http://dx.doi.org/10.3390/ijerph19031731.

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There is a need to improve the integration of substance use and mental health care for children and youth. This study examines risk and protective factors for substance use among youth with mental health conditions who received community-based or residential care services between 2012–2020 in Ontario, Canada. In this study, a cross-sectional design was used to examine patterns and factors associated with substance use among youth (12–18 years) assessed in the community (n = 47,418) and residential (n = 700) mental health care facilities in Ontario, Canada. Youth were assessed with the interRAI Child and Youth Mental Health Assessment (ChYMH). Substance use is identified by any substance use (including alcohol) 14 to 30 days prior to assessment. Logistic regression with generalized estimating equations was used to examine clinical, psychosocial, and environmental factors associated with substance use. This study shows that 22.3% of youth reported the use of substances in the community settings and 37% in residential settings. Older age group (Youth older than 16 years), being a victim of abuse, having experienced self-injurious ideation/attempt, being at risk of disrupted education, and having a parent/caregiver with addiction or substance use disorder were significantly associated with substance use. Several factors reduced the risk of substance use, including being a female, having anxiety symptoms, and having cognition problems. In conclusion, the study found that individual and parental factors increase youth’s risk of substance use, highlighting the importance of a holistic approach that includes consideration of social and biological risk factors to prevention/risk reduction, risk assessment, management, and recovery.

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Mason, Robin, Janice Du Mont, Maeve Paterson, and Ilene Hyman. "Experiences of child protection workers in collaborating with adult mental health providers: An exploratory study from Ontario, Canada." Children and Youth Services Review 86 (February 2018): 271–76. http://dx.doi.org/10.1016/j.childyouth.2018.02.005.

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Duncan, Laura, Katholiki Georgiades, Graham J. Reid, Jinette Comeau, Stephen Birch, Li Wang, and Michael H. Boyle. "Area-Level Variation in Children’s Unmet Need for Community-Based Mental Health Services: Findings from the 2014 Ontario Child Health Study." Administration and Policy in Mental Health and Mental Health Services Research 47, no. 5 (January 23, 2020): 665–79. http://dx.doi.org/10.1007/s10488-020-01016-3.

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SANFORD, MARK N., DAVID R. OFFORD, MICHAEL H. BOYLE, ALEX PEACE, and YVONNE A. RACINE. "Ontario Child Health Study: Social and School Impairments in Children Aged 6 to 16 Years." Journal of the American Academy of Child & Adolescent Psychiatry 31, no. 1 (January 1992): 60–67. http://dx.doi.org/10.1097/00004583-199201000-00010.

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Tonmyr, Lil, Ellen Jamieson, Leslie S. Mery, and Harriet L. MacMillan. "Child Abuse and Disability in an Ontario Community Sample: Does Social Capital Matter?" International Journal of Mental Health Promotion 8, no. 2 (May 2006): 23–30. http://dx.doi.org/10.1080/14623730.2006.9721736.

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Offord, David R., Michael H. Boyle, and Beverly R. Jones. "Psychiatric Disorder and Poor School Performance among Welfare Children in Ontario." Canadian Journal of Psychiatry 32, no. 7 (October 1987): 518–25. http://dx.doi.org/10.1177/070674378703200704.

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Parental welfare status was found to be a marker for identifying a group of children with an increased prevalence of psychiatric disorder and poor school performance. The marker was particularly strong for psychiatric disorder in young boys and for poor school performance in young girls. For instance, the prevalence rates of psychiatric disorder, in the 6 to 11 age group, for welfare and non-welfare boys, were 40.0% and 13.9%, respectively; and for poor school performance in welfare and non-welfare girls, 27.8% and 6.1%, respectively. The relationship between different measures of psychosocial disadvantage and these child deficits was examined. Multivariate analyses revealed, for example, that parental welfare status made an independent contribution to the prediction of psychiatric disorder and was a more powerful predictor of poor school performance in girls compared to boys. The implications of these and other results are discussed.

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John, Lindsay H., David R. Offord, Michael H. Boyle, and Yvonne A. Racine. "Factors predicting use of mental health and social services by children 6-16 years old: Findings from the Ontario Child Health Study." American Journal of Orthopsychiatry 65, no. 1 (1995): 76–86. http://dx.doi.org/10.1037/h0079597.

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Stewart, Shannon L., Ashley Toohey, Angela Celebre, and Jeff W. Poss. "Abuse, Mental State, and Health Factors Pre and during the COVID-19 Pandemic: A Comparison among Clinically Referred Adolescents in Ontario, Canada." International Journal of Environmental Research and Public Health 18, no. 19 (September 28, 2021): 10184. http://dx.doi.org/10.3390/ijerph181910184.

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Throughout the COVID-19 pandemic, population surveys revealed increased levels of anxiety and depression, while findings from large-scale population data analyses have revealed mixed findings with respect to the mental health consequences for children and youth. The purpose of this study was to examine the impact of the COVID-19 pandemic on the well-being and health-compromising behaviors of adolescents (12–18 years) previously referred for mental health services. Data were collected (pre-pandemic n = 3712; pandemic n = 3197) from mental health agencies across Ontario, Canada using the interRAI Child and Youth Mental Health assessment. Our findings revealed no increased incidence of witnessing domestic violence nor experiencing physical, sexual, or emotional abuse. Further, there were no increases in the risk of self-harm and suicide, anxiety, or depression among our sample of clinically referred youth. Finally, results demonstrated no increase in problematic videogaming/internet use, disordered eating, or alcohol intoxication, and a decrease in cannabis use. Our findings add to the growing body of knowledge as to the impact of the COVID-19 pandemic on children and youth. Further, findings underscore the importance of understanding the nuanced impact of the pandemic on various subgroups of children, youth, and families and highlight the need for continued monitoring of outcomes for these children and youth.

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Kim, Soyeon, Alexa Martin-Storey, Alexander Drossos, Samantha Barbosa, and Katholiki Georgiades. "Prevalence and Correlates of Sexting Behaviors in a Provincially Representative Sample of Adolescents." Canadian Journal of Psychiatry 65, no. 6 (December 13, 2019): 401–8. http://dx.doi.org/10.1177/0706743719895205.

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Objectives: To examine the prevalence and correlates of sending and receiving sexts (i.e., sexually explicit images) in a provincially representative sample of adolescents in Canada. Methods: Data from the 2014 Ontario Child Health Study, a provincial survey of households with children in Ontario, which includes a sample of 2,537 adolescents aged 14 to 17 years (mean age = 15.42, male = 51.6%) were used to address the research objectives. Results: The past 12 months prevalence of sending and receiving sexts was 14.4% and 27.0%, respectively. In unadjusted logistic regression analyses, non-White adolescents and those living in low-income households were less likely to send or receive sexts compared to White and non-low-income adolescents. Adolescents who disclosed their sexual and/or gender minority identities were 3 to 4 times more likely to send and receive sexts than youth who had not disclosed these identities. Higher levels of mental health problems generally observed among adolescents who sent or received sexts. In fully adjusted models, low income and ethnic minority status were associated with reduced odds of sending and receiving sexts, while sexual and/or gender minority disclosure status was associated with increased odds. Social anxiety was associated with reduced odds of sending and receiving sexts, while conduct disorder was associated with elevated odds. Conclusion: The prevalence of sexting behavior was higher among adolescents who disclosed their sexual or gender minority identities. Sexting behaviors were associated with higher levels of mental health problems. Identifying vulnerable populations and the potential mental health ramifications associated with sexting behavior is vital to mitigating negative sequelae.

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King, Bryn, Barbara Fallon, Ami Goulden, Carolyn O’Connor, and Joanne Filippelli. "What Constitutes Risk of Future Maltreatment Among Young Mothers? An Examination of Child Protection Investigations in Ontario, Canada." Families in Society: The Journal of Contemporary Social Services 100, no. 4 (June 6, 2019): 409–21. http://dx.doi.org/10.1177/1044389419847319.

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Despite younger maternal age being a risk factor for child welfare involvement, the literature on decision making once young mothers are investigated for child protection concerns is limited. This article examines characteristics and decision making related to investigating workers’ determinations that young children of adolescent and young adult mothers are at risk of future maltreatment. Using a provincially representative data set, this study found that children of young mothers were more likely to be deemed at risk of future maltreatment than those of adult mothers, and this assessment was also related to more intensive child welfare involvement. Among young mothers, a risk determination was strongly associated with maternal mental health concerns and socioeconomic circumstances. Practice and policy shifts should address the need for timely and effective material and emotional supports.

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van Warmerdam, Jacqui, Rinku Sutradhar, Paul Kurdyak, Cindy Lau, Jason D. Pole, Paul C. Nathan, and Sumit Gupta. "Long-Term Mental Health Outcomes in Mothers and Siblings of Children With Cancer: A Population-Based, Matched Cohort Study." Journal of Clinical Oncology 38, no. 1 (January 1, 2020): 51–62. http://dx.doi.org/10.1200/jco.19.01382.

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PURPOSE Although a diagnosis of childhood cancer can have a profound effect on the entire family unit, its impact on the long-term mental health of family members is not well characterized. METHODS A provincial childhood cancer registry in Ontario, Canada, was linked to birth records to identify separate population-based cohorts of mothers and siblings of children diagnosed with cancer between 1998 and 2014. The mother and sibling cohorts were matched to corresponding population controls and linked to health services data. The rate of mental health–related outpatient visits (family physician, psychiatrist) and the incidence of severe psychiatric events (psychiatric emergency department visit, psychiatric hospitalization, suicide) were compared between mothers and siblings and their controls. Possible predictors of mental health outcomes were examined, including demographics, characteristics of the cancer-affected child, and cancer treatment. RESULTS We identified 4,773 mothers and 7,897 siblings of children diagnosed with cancer during the study period. Compared with controls, both groups experienced elevated rates of outpatient visits (mothers: rate ratio [RR], 1.4; P < .0001; siblings: RR, 1.1; P < .0001). The risk of severe psychiatric events was not increased in either cohort. Mother and sibling demographic factors associated with increased risk of adverse mental health included younger maternal age at cancer diagnosis, low socioeconomic status, and rural residence among mothers and older sibling age among siblings. Treatment-related variables pertaining to the cancer-affected child were not associated with mental health outcomes. Mental health outcomes clustered within families. CONCLUSION Both mothers and siblings experience elevated and prolonged need for mental health–related health care as compared with the general population. Demographic risk factors predict subpopulations at highest risk. Increased psychosocial support for family members during and after cancer therapy is warranted.

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McCann, Maggie, Kriti Kumar, Natasha Lepore, Emma Metivier, Kelcie Lahey, Hailey Barootes, Karissa Holyer, Michael Miller, and Rod Lim. "8 The Effect of Decreased Physical Activity on Physical and Mental Health of School-Aged Children During the COVID-19 Pandemic." Paediatrics & Child Health 27, Supplement_3 (October 1, 2022): e3-e4. http://dx.doi.org/10.1093/pch/pxac100.007.

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Abstract Background School-aged children are recommended to complete at least one hour of moderate to vigorous intensity physical activity per day. North American data has shown that due to COVID-19 restrictions placed on in person schooling and extracurricular activities, children were not meeting recommended levels of physical activity. Additional barriers to activity during the first wave of the COVID-19 pandemic included lack of access to public facilities including community centers, parks, and outdoor recreation. Decreased physical activity in children has been shown to have a negative impact on both physical and mental health, and childhood development. However, there is a paucity of literature on parents’ perceptions of the association between physical activity and physical and mental health. Objectives The objective of this study was to gain a better understanding of the implications of the COVID-19 pandemic on levels of physical activity and parents’ perceptions surrounding physical activity and physical and mental health. Design/Methods An online survey was distributed to parents of school-aged children aged 4-13 in Ontario. The survey included questions regarding demographics, children’s physical activity prior to and during the first wave of the COVID-19 pandemic, and parental perceptions regarding the pandemic’s impact on mental and physical health. This study received ethics approval, was hosted on the REDCapTM platform, and distributed from February-June 2021 through a local school board, the Pediatrics section of the Ontario Medical Association, and through social media. Results Of 361 participants, 90.4% strongly agreed that physical activity was important for mental health, and 92.2% strongly agreed that physical activity was important for physical health. There was a statistically significant decrease in the overall mean number of hours of physical activity per week between pre-COVID and the first wave of COVID (mean difference = 9.34 hours, SD = 10.06, p<0.001). Additionally, parents of children with decreased physical activity reported a statistically significant negative impact on physical and mental health as compared to parents whose children had no change in amount of physical activity. Decreased energy, poor sleep, increased anxiety, mood disturbances, and disruptive behaviour were noted by over 50% of respondents. Conclusion This survey highlights that parents themselves perceived a significant negative impact on children’s mental and physical well-being with decreased physical activity during the COVID-19 pandemic. This emphasizes the importance of retaining access to recreational facilities and extracurricular activities. Future research includes identifying ways to re-engage parents and children with physical activity during times of decreased access.

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Livingston, Eliza, Nicolette Joh-Carnella, Daniel M. Lindberg, Ashley Vandermorris, Jennifer Smith, Miya Kagan-Cassidy, Danielle Giokas, and Barbara Fallon. "Characteristics of child welfare investigations reported by healthcare professionals in Ontario: secondary analysis of a regional database." BMJ Paediatrics Open 5, no. 1 (August 2021): e001167. http://dx.doi.org/10.1136/bmjpo-2021-001167.

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ObjectivesThis study examines the characteristics and outcomes of child welfare investigations reported by hospital-based and community-based healthcare professionals.MethodsA sample of 7590 child maltreatment-related investigations from the Ontario Incidence Study of Reported Child Abuse and Neglect-2018, a cross-sectional study, was analysed. Bivariate analyses compared characteristics of hospital and community healthcare-reported investigations. Chi-square automatic interaction detector analyses were used to predict the most influential factors in the decision to provide a family with services following a child welfare investigation from each referral source.ResultsCommunity healthcare-reported investigations were more likely to have a primary concern of physical abuse while hospital-reported investigations were more likely to be focused on assessing risk of future maltreatment. Hospital-reported investigations were more likely to involve noted primary caregiver (eg, mental health issues, alcohol/drug abuse, victim of intimate partner violence (IPV)) and household risk factors. The most significant predictor of service provision following an investigation was having a caregiver who was identified as a victim of IPV in hospital-reported investigations (χ2=30.237, df=1, adj. p<0.001) and having a caregiver for whom few social supports was noted in community healthcare-reported investigations (χ2=18.892, df=1, adj. p<0.001).ConclusionHealthcare professionals likely interact with children who are at high risk for maltreatment. This study’s findings highlight the important role that healthcare professionals play in child maltreatment identification, which may differ across hospital-based and community-based settings and has implications for future collaborations between the healthcare and child welfare systems.

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Walsh, Christine, Harriet L. MacMillan, and Ellen Jamieson. "The relationship between parental substance abuse and child maltreatment: findings from the Ontario Health Supplement." Child Abuse & Neglect 27, no. 12 (December 2003): 1409–25. http://dx.doi.org/10.1016/j.chiabu.2003.07.002.

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Fallon, Barbara, Joanne Filippelli, Nicolette Joh-Carnella, Elizabeth Milne, and Jessica Carradine. "Promoting Protective Factors in Environments of Risk for Young Children: An Organizing Framework for Practice, Policy, and Research." Gender and the Genome 2, no. 4 (October 2018): 96–110. http://dx.doi.org/10.1177/2470289718820843.

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Early childhood is an important developmental period, which lays the foundation for future learning, behaviour, physical and mental health and gene expression. The most vulnerable children in society are often referred to and receive services from the child welfare system because of a concern of abuse and neglect and/or a poor developmental trajectory. This paper presents an organizing framework for how the child welfare system, in concert with allied partners, can support interventions for young children and families by acknowledging its crucial role in improving their development and well-being. The framework is informed by research amassed from numerous disciplines, including child welfare, development, neuroscience, neurobiology and epigenetics. Although the notions of protection and well-being are central considerations in child welfare legislation in Ontario, Canada, the operationalization of wellbeing has proven challenging in child welfare practice, policy and research. The framework proposes ten key indicators and priorities for identifying and promoting optimal child development. Findings from the 2013 cycle of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013), the only provincial source of aggregated child welfare investigation data, are presented to articulate the divide between the environmental context of a population of at-risk children and the conditions that both protect children and increase the likelihood that they will thrive in adulthood. This paper argues there are different points of entry and intervention across sectors and provides a foundation for further discussion on how to promote well-being for society's most vulnerable children.

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Chiorean, Andreea, Calan Savoy, Karen Beattie, Salhab el Helou, Maysoon Silmi, and Ryan J. Van Lieshout. "Childhood and adolescent mental health of NICU graduates: an observational study." Archives of Disease in Childhood 105, no. 7 (January 23, 2020): 684–89. http://dx.doi.org/10.1136/archdischild-2019-318284.

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ObjectiveTo investigate the mental health of children and adolescents admitted to neonatal intensive/special care units (NICUs) in infancy.MethodsThis cross-sectional study used a provincially representative cohort from the 2014 Ontario Child Health Study. Parents provided data on psychiatric disorders using the MINI International Neuropsychiatric Interview for Children and Adolescents in 3141 children aged 4–11 years (NICU n=389; control n=2752) and in 2379 children aged 12–17 years (NICU n=298; control n=2081). Additionally, 2235 adolescents aged 12–17 years completed the interview themselves (NICU n=285; control n=1950). Odds of psychiatric disorder were compared in those admitted and controls.ResultsBased on parent reports, NICU graduates aged 4–11 years had increased adjusted ORs (95% CI) of 1.78 (1.39 to 2.28) for any psychiatric disorder, with a marginal prevalence of 32.4% in NICU participants and 27.6% in controls. At this age, NICU graduates also had increased ORs of 1.74 (1.25 to 2.40) for psychiatric comorbidity, 1.48 (1.04 to 2.11) for oppositional defiant disorder, 1.61 (1.19 to 2.19) for attention-deficit hyperactivity disorder, 4.11 (2.33 to 7.25) for separation anxiety disorder and 2.13 (1.37 to 3.31) for specific phobia. At 12–17 years, 40.5% and 30.5% of NICU graduates and 30.6% and 17.9% of controls had any psychiatric disorder as reported by parents and self-report, respectively. Parents and adolescents, respectively, reported increased adjusted ORs (95% CI) of 1.63 (1.18 to 2.26) and 1.55 (1.13 to 2.11) for any disorder, 1.64 (1.06 to 2.54) and 1.74 (1.11 to 2.73) for psychiatric comorbidity, and 1.89 (1.22 to 2.93) and 3.17 (2.03 to 4.95) for oppositional defiant disorder.ConclusionsNICU graduates are at increased risk for psychiatric disorders during childhood and adolescence.

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Joh-Carnella, Nicolette, Barbara Fallon, Rachael Lefebvre, Daniel Lindberg, and Laura Davidson. "Caregiver drug use in Ontario child welfare investigations: The need for coordinated intervention." Child Abuse & Neglect 121 (November 2021): 105261. http://dx.doi.org/10.1016/j.chiabu.2021.105261.

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Turner, Sarah, Caitlin Menzies, Janique Fortier, Isabel Garces, Shannon Struck, Tamara Taillieu, Katholiki Georgiades, and Tracie O. Afifi. "Child maltreatment and sleep problems among adolescents in Ontario: A cross sectional study." Child Abuse & Neglect 99 (January 2020): 104309. http://dx.doi.org/10.1016/j.chiabu.2019.104309.

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Journal articles on the topic 'Child mental health – Ontario'

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