‘Adjusting to Life Events and Their Impact on Mental Health.’ The Second All Wales Mental Health Promotion Conference. Millennium Stadium Cardiff 22nd October 2008

Depression in Children and Adolescents Lynne Walsh Lecturer Swansea University

Children and Adolescents National Statistics (2004) found that one in ten children in the U.K aged between five and sixteen were diagnosed with a mental disorder. Mental disorder is diagnosed by the International Classification of Diseases (ICD-10) and recognizes mental disorder as a set of symptoms or behavior’s causing great distress affecting daily functioning.

Children and Adolescents The incidence of mental disorder in young people could be higher as these statistics only consider those children with an actual diagnosis of mental disorder. There are likely to be some children who suffer from mental disorder who have not been officially diagnosed.

Children and Adolescents The National Statistics (2004) survey undertaken between March and June 2004 commissioned by the Department of Health and the Scottish Executive found that four per cent of children had an emotional disorder which included anxiety and depression. Emotional disorders in five to ten year olds were similar affecting 2.2 % of boys and 2.5% of girls. However the 11-16 year age group showed differences between boys and girls.

Children and Adolescents The percentage increased for girls in the 11 to 16 year old age group to 6.1 per cent of girls compared with 4.0 per cent of boys of the same age group. The population which were studied included children and young people aged between five and sixteen years who lived in private households in the U.K.

Incidence of mental disorder in children. Higher incidence in lone parent families of 16% compared with lower incidence in two parent families of 8%. Higher incidence in families with neither parent working of 20% compared with lower incidence where both parents worked of 8%. Higher incidence in children with parents with no educational qualifications of 17% compared with lower incidence of parents with degree level qualifications of 4%. Based upon: Source National Statistics Survey (2004)

The National Institute of Clinical Excellence (NICE) (2005) Similar findings have been shown by The National Institute of Clinical Excellence (NICE) (2005) which stated that children who had depression were: Nearly twice as likely to be living with only one parent. More than twice as likely to have both parents out of work. More likely to have parents on low incomes and who were less educated. These findings support the view that sociological factors do have an impact and are linked with the causes of depression.

Young children and Depression Very young children may not be able to express their feelings verbally so it is important to observe their behavior. Jelineck and Snyder (1998) have found that these children may display a variety of symptoms which include delayed developmental milestones, failure to thrive, becoming apathetic and withdrawing from care providers.

Young children and Depression Thus play leaders, school teachers and health professionals, particularly health visitors, school nurses and nursery nurses will all need to be observant when dealing with young children.

Family influence Family influences and peer support can determine how early the young person accesses the appropriate treatment and help required. Many young people with severe depression also suffer from substance misuse and may also pursue risky behavior resulting in poor relationships and unwanted pregnancies. This then can lead to a downward spiral emotionally, physically and economically and has major social consequences upon their well being. This potentially becomes a major public health issue providing topical debate within policy initiatives.

Support in schools Support and screening within schools can provide a useful approach to depression in children and young people. Weist et al (2007) advocates the importance of screening students in schools for emotional and behavioral problems. This process would help to identify potential risks, needs, support and future health planning for young people and would also help to reduce barriers to learning. This would require informing teachers about mental health and encouraging them to promote child health and well being generally.

Associated Risk factors Children are more likely to suffer from depression if there is a family history of depression and if there is conflict within the family setting. It must be acknowledged that depression affects all ages, social classes and genders across the lifespan and many of the symptoms of severe depression are the same for both young people and adults. Brage et al (1995) highlighted that the three most important factors associated with depression are loneliness, self esteem and age.

Associated Risk Factors Other factors include previous depressive occurrences, poor academic performance and anxiety disorders. Some young people may also have substance abuse disorders and may have suffered physical, emotional or sexual abuse. For some children there may be multiple factors influencing their depressed state.

Impact of Depression Rutter and Quinton (1984) suggested that problems were less likely for the child if the other parent did not have mental health problems, the parents had no financial problems and there was no violence within the family. Children were more likely to be at risk where there was violence within the home, the ill parent suffered from delusions or hallucinations and the child was neglected.

Impact of Depression Walsh (2007) highlighted how adults with mental health problems suffering from acute psychotic episodes have a major impact on both their own lives and their families. These factors may also influence the incidence of these children having depression themselves in later life.

Conclusion It is evident that many life events can influence the mental health of both children and adolescents. The promotion of mental health is important in children as mental illness has a major impact on them during their lifespan.

References. Brage et al (1995) ICD 10 International Classification of Mental Disorder ( ..) Jelineck and Snyder (1998) National Statistics Survey (2004)

References NICE (2005) Depression in children and young people . Guideline 28. Rutter and Quinton ( 1984) Walsh, L (2007) Weist et al (2007)